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This observational study suggests that PT is feasible in patients with EVDs and can be safely tolerated. Further research is warranted in a larger patient population conducted prospectively to assess the potential benefit of early mobility in this patient population.

This study sought to evaluate the effects of a brief curricular intervention on medical students' attitudes toward physical disability in healthcare settings. Students participated in a focused curriculum about people with disabilities (PWDs), which included 2.5 hours of lectures, panel discussions, and video presentations. After the curricular sessions, students were surveyed (n = 237), and their attitudes toward PWDs in healthcare settings were compared with those of students who did not undergo the intervention (n = 251) using the Disability Attitudes in Health Care (DAHC) scale. Thematic analysis of the students' comments regarding the session was performed to supplement the DAHC scale. The intervention group responded with significantly more positive attitudes on 6 of the 17 items on the DAHC scale, and multiple linear regression analysis confirmed the independent effect of the curriculum on higher DAHC scale scores. Female students had more positive attitudes on the survey than did male students, although the effect of the curriculum was independent of gender. Previous experiences with PWDs did not correlate to higher attitude scores. These results suggest that a brief curricular intervention on disability can engender more positive attitudes in medical students toward PWDs.

Objective: Growing evidence supports the benefits and safety of early mobilization of patients in intensive care units. Frequently cited barriers to early mobilization are insufficient staffing and training. This study examines the number of professionals and years of physical therapy or occupational therapy experience needed to mobilize patients in neuro-intensive care units with external ventricular drains (EVDs). Design: The study was a retrospective review of a prospective quality improvement database, which includes 185 encounters with 90 patients with EVDs from June 2014 through July 2015. Results: Ninety-five percent of encounters required at most 2 professionals for mobilization. No evidence of association between number of people required to mobilize and highest activity achieved was found. Neither the number of people to mobilize patients nor the primary therapist's years of experience were associated with the type of activity achieved or the occurrence of an adverse event. Conclusion: This analysis suggests that patients with EVDs in the neuro-intensive care unit can be safely and efficiently mobilized by physical therapists and occupational therapists of varying levels of clinical experience. Early mobilization of patients with EVDs may demand fewer staff resources than perceived by clinicians.

Prolonged immobility in ICU patients can lead to muscle wasting and weakness, longer hospital stays, increased number of days in restraints and hospital acquired infections. Increasing evidence demonstrates the safety and feasibility of early mobilization in the ICU. However, there is a lack of evidence in the safety and feasibility of mobilizing patients with external ventricular drains (EVD). The purpose of this study was to determine the safety and feasibility of early mobility in this patient population. Methods We conducted a prospective, observational study. All patients in the study were managed with standard protocols and procedures practiced in our ICU including early mobility. Patients with an EVD that received early mobilization were awake and following commands, had a Lindegaard ratio <3.0 or middle cerebral artery (MCA) mean flow velocity<120 cm/sec, a MAP>80 mm Hg, and an ICP consistently <20 mm Hg. Data was collected by physical therapists at the time of encounter. Results 90 patients with a total of 185 patient encounters were recorded over a 12-month period. The average time between EVD placement and PT session was 8.3±5.5 days. In 149 encounters (81%), patients were at least standing or better. Patients were walking with assistance or better in 99 encounters (54%). There were four adverse events recorded (2.2%) during the entire study. Conclusion This observational study suggests that PT is feasible in patients with EVDs and can be safely tolerated. Further research in a larger patient population conducted prospectively is warranted to assess the potential benefit of early mobility in this patient population.