Early Mobilization After Myocardial Infarction: Historical Perspective and Critical Appraisal

Wenger, Nanette K.

doi:10.1007/978-1-4684-3854-3_3

Cited by 3 publications

(3 citation statements)

References 25 publications

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“…In the 1960s, the standard of care for an acute myocardial infarction involved six weeks of strict bedrest. 13 Those who survived the acute care hospitalization often had severe J o u r n a l P r e -p r o o f functional limitations from muscle and strength loss, which often persisted well-beyond hospitalization. In the 1970s and 1980s, randomized trials comparing earlier mobilization to prolonged bedrest found functional benefits and reduced length of hospital stay in myocardial infarction survivors who were mobilized earlier.…”

Section: Discussionmentioning

confidence: 99%

Patient and Family Perspectives on Early Mobilization in Acute Cardiac Care

2022

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Section: Discussionmentioning

confidence: 99%

Patient and Family Perspectives on Early Mobilization in Acute Cardiac Care

2022

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“…To our knowledge, this is the first study to assess the perspectives of CV healthcare providers about mobilization. Understanding CV providers' perspectives on mobilization is important because of the historical reluctance to mobilize patients with acute CV disease due to concern for ischaemia, arrhythmias and haemodynamic instability and the evidence for prolonged bed rest in contemporary cardiac units (Cortes et al., 2015; Howie‐Esquivel & Zaharias, 2013; Wenger, 1980). Cardiac ICUs have become increasingly like medical ICUs with increased patient medical complexity and growing critical care needs (Goldfarb et al., 2019).…”

Section: Discussionmentioning

confidence: 99%

“…

Bed rest and immobilization has been part of the culture of care in acute cardiology for over a century (Wenger, 1980). Mobilizing patients with an acute myocardial infarction or heart failure episode was considered dangerous due to the risk of coronary ischaemia and arrhythmia.

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confidence: 99%

Beliefs, attitudes and knowledge of cardiovascular healthcare providers on mobilization

et al. 2021

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Aim To assess the beliefs, attitudes and knowledge of nurses, physicians and physiotherapists in a cardiovascular intensive care unit (CICU) on patient mobilization. Design Survey of CV healthcare providers in the CICU at two academic tertiary care hospitals. Methods The validated Patient Mobilization Attitudes and Beliefs Survey was distributed to CV providers. The survey is a 26‐item self‐administered questionnaire that assesses providers' perceived barriers in three domains: attitude, behaviour and knowledge. Results Participants (N = 142) completed the survey (nurses, N = 67, physicians, N = 59 and physiotherapists, N = 16; 155 eligible participants, 91.6% overall completion rate). Nurses had lower overall knowledge, attitude and behaviour barriers to mobilization than physicians, but higher than physiotherapists (all p < .001). The highest barriers to mobilization for nurses were adequate staffing, patient‐level and time restraint. These findings should inform efforts to overcome existing barriers and to transform acute cardiovascular mobility culture.

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Early mobilization post-myocardial infarction: A scoping review

2020

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Bedrest and immobilization following a myocardial infarction (MI) can lead to functional impairment that can persist following hospitalization. Early mobilization (EM) is associated with good functional and clinical outcomes in critical care, medical and surgical settings. However, the impact and current role of EM in post-MI care has not been well-defined. Our objective was to assess the evidence for post-MI mobilization, define current post-MI mobilization practice, and understand perspectives of cardiovascular professionals toward mobilization. A scoping review related to “early mobilization” and “myocardial infarction” was performed using the Joanna Briggs Institute Methodology. Pubmed, Embase, Google Scholar, Cochrane Library and CINAHL databases were included. Results were categorized into six topic areas. There were 59 references included in the analysis. There was evidence for the effectiveness and safety of earlier mobilization in experimental studies of the pre-revascularization era, but there was a lack of strong evidence for EM in contemporary post-MI care. Mobilization appears to be safe following arterial catheterization and is associated with minimal hemodynamic and respiratory compromise. Most people are delayed in mobilizing post-MI and spend the majority of the initial hospitalization period lying in bed. Only 1 of 7 current major cardiovascular professional societies guidelines recommend EM post-MI. There were no studies exploring the perspectives of cardiovascular professionals toward mobilization. EM may be beneficial in the post-MI care. However, there is an evidence gap for the impact of EM post-MI in the contemporary literature. More robust evidence from randomized clinical trials is required to inform clinicians and influence practice.

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Early Mobilization After Myocardial Infarction: Historical Perspective and Critical Appraisal

Cited by 3 publications

References 25 publications

Patient and Family Perspectives on Early Mobilization in Acute Cardiac Care

Patient and Family Perspectives on Early Mobilization in Acute Cardiac Care

Beliefs, attitudes and knowledge of cardiovascular healthcare providers on mobilization

Early mobilization post-myocardial infarction: A scoping review

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