Defining new barriers to mobilisation in a highly active intensive care unit – have we found the ceiling? An observational study

Negotiated mobilisation: An ethnographic exploration of nurse–patient interactions in an intensive care unit

“…Most patients were mobilized passively with a mechanical bed lift during times of observation (Table 2). This corresponds to the study by Brock et al (2018) where nurses provided more passive mobilization than physiotherapists. Other studies have questioned the role of nurses in relation to mobilization and rehabilitation, compared to that of physiotherapists, in ensuring physical activity in the ICU (Garzon-Serrano et al, 2011;Pellatt, 2003).…”

Exercise interventions are delayed in critically ill patients: a cohort study in an Australian tertiary intensive care unit

“…Intervention studies have reported the median time to sitting out of bed (SOOB) to range between 1.7 and 8.5 days [13][14][15][16].There is also inconsistency in the literature regarding the proportion of patients who participate in active out of bed exercise in ICU settings, which has ranged from 40% to 73% [17,18]. The duration of bed rest in the ICU has been the only risk factor reported to have consistently been associated with persistent muscle weakness [4].…”

“…This is consistent with the growing body of literature where reports of between 24% and 73% of patients completed exercise interventions within the ICU[9-12, 17, 18, 23-25] and have noted that less than 5% of mechanically ventilated patients completed upright activities[9][10][11][12]26]. A recent prospective study reported that 73% of patients were mobilised during their ICU admission, this proportion may represent something of an upper limit of what is feasible with critically ill patients[17]. Early interventional studies in the United States report a range of times to commence sitting typically between 3 and 9 days[15,16].…”

PROtocol‐based MObilizaTION on intensive care units: stepped‐wedge, cluster‐randomized pilot study (Pro‐Motion)

“…Secondary outcome parameters were presence/duration of MV, delirium, ICU or hospital stay and unwanted safety events. Because of new publications in the field (Brock et al, 7 ; Sibilla et al, 35 ), we added a post‐hoc analysis of out‐of‐bed mobilization, and time, duration, frequency, barriers, tolerance including stopping mobilization (Table S5), first day out of bed and best mobilization during ICU stay were assessed. The feasibility of the study design (percentage of recruited patients) and adherence to the intervention (reported items of the traffic light system) were also assessed.…”

“…Secondary outcome parameters were presence/duration of MV, delirium, ICU or hospital stay and unwanted safety events. Because of new publications in the field, 17,29 we added a post-hoc analysis of out-of-bed mobilization, and time, duration, frequency, barriers, tolerance including stopping mobilization (Table S5)…”