Early mobilization in clinical practice: the reliability and feasibility of the ‘Start To Move’ Protocol

Hoffman, Mariana; Clerckx, Béatrix; Janssen, Kristel J.M.; Segers, Johan; Demeyere, Inge; Frickx, Bregje; Merckx, Else; Hermans, Greet; Meulen, Isa Van der; Lancker, Tessa Van; Ceulemans, Natalie; Hollebeke, Marine Van; Langer, Daniël; Gosselink, Rik

doi:10.1080/09593985.2020.1805833

Cited by 5 publications

(4 citation statements)

References 27 publications

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“…However, when physiotherapy sessions were performed, the prescribed level of physiotherapy could be obtained. This was in accordance with a previous study ( 21 ). Indeed, the prescribed levels depend on patient examination.…”

Section: Discussionsupporting

confidence: 94%

“…However, due to severity of patients or sedation, patients may start physiotherapy course after few days in intensive care ( 20 ). However, most studies demonstrated safety and feasibility of early mobilization ( 21 ). In the current study, mobilization started within the ( median, IQR) 3 (2–5) first days of mechanical ventilation, with a longer delay for cancer patients.…”

Section: Discussionmentioning

confidence: 99%

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Feasibility and Safety of Active Physiotherapy in the Intensive Care Unit for Intubated Patients with Malignancy

Gautheret

Bommier²,

Mabrouki

et al. 2023

JRM

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Objectives: Physiotherapy leads to improvements in critically ill patients who receive mechanical ventilation. However, cancer patients have not been included in previous studies on this subject. This study explored the feasibility and safety of physiotherapy in the intensive care unit for patients with malignancy.Design: Observational prospective single-centre study, comparing cancer and control patients. Patients: All consecutive patients admitted to the intensive care unit who needed invasive mechanical ventilation for more than 2 days with no contraindication to physiotherapy were included in the study.Methods: The main outcome was the proportion of physiotherapy sessions at the prescribed level in each group.Results: A total of 60 patients were included within 1 year. A total of 576 days were screened for physiotherapy sessions and 367 physiotherapy-days were analysed (137 days for control patients and 230 days for cancer patients). The ratio of physiotherapy sessions performed/prescribed did not differ between groups: 0.78 (0.47–1) in the control group vs 0.69 (0.6–1) in the cancer group (odds ratio 1.18 (IC95% 0.74–1.89); p = 0.23). A sensitivity analysis including patient effect as random variable confirmed those results (odds ratio 1.16 (0.56–2.38), p = 0.69). Adverse events occurred with the same frequency in cancer patients and non-cancer patients.Conclusion: Physiotherapy in cancer patients who require intubation is feasible and safe. However, only two-thirds of prescribed physiotherapy sessions were performed. Studies are warranted to explore the barriers to physiotherapy in the intensive care unit setting.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Feasibility and Safety of Active Physiotherapy in the Intensive Care Unit for Intubated Patients with Malignancy

Gautheret

Bommier²,

Mabrouki

et al. 2023

JRM

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“…When evaluating the professionals' criteria to determine favorable conditions to start EM, a large number of the professionals considered hemodynamic stability the most relevant, which is considered the main barrier for starting EM and consistent with that reported by other authors (24), followed by the neurological stability related to the level of collaboration (32). This difficulty in starting with EM has also been reported in the literature (3,24,25), for example, excessive sedation, lack of personnel, concern for safety, insufficient guidelines and protocols, limited equipment, and inadequate staff training (33).…”

Section: Discussionsupporting

confidence: 83%

Early mobilization in intensive care unit in Latin America: A survey based on clinical practice

et al. 2022

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BackgroundThe application of early mobilization (EM) in intensive care units (ICUs) has shown to improve the physical and ventilatory status of critically ill patients, even after ICU stay. This study aimed to describe the practices regarding EM in ICUs in Latin America.MethodsWe conducted an observational, cross-sectional study of professionals from all countries in Latin America. Over 3 months, professionals working in ICU units in Latin America were invited to answer the survey, which was designed by an expert committee and incorporated preliminary questions based on studies about EM recommendations.ResultsAs many as 174 health professionals from 17 countries completed the survey. The interventions carried out within each ICU were active mobilization (90.5%), passive mobilization (85.0%), manual and instrumental techniques for drainage of mucus secretion (81.8%), and positioning techniques (81%). The professionals who most participated in the rehabilitation process in ICUs were physiotherapists (98.7%), intensive care physicians (61.6%), nurses (56.1%), and respiratory therapists (43.8%). In only 36.1% of the ICUs, protocols were established to determine when a patient should begin EM. In 38.1% of the cases, the onset of EM was established by individual evaluation, and in 25.0% of the cases, it was the medical indication to start rehabilitation and EM.ConclusionThis report shows us that EM of critically ill patients is an established practice in our ICUs like in other developed countries.

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“…Nutritional management involved early enteral feeding, only supplemented by parenteral nutrition if the caloric goal was not reached from day 8 onwards (15). All patients received progressive passive and active mobilization according to the UZLeuven “start-to-move” protocol (16) to the best of the physiotherapists’ ability. This protocol involves weekly assessment of strength with the Medical Research Council-sum (MRC-sum) score in conscious patients with an expected ICU stay greater than or equal to 5 days (16, 17).…”

Section: Methodsmentioning

confidence: 99%

Occurrence Rate and Outcomes of Weaning Groups According to a Refined Weaning Classification: A Retrospective Observational Study*

Hollebeke

Campos

Müller

et al. 2023

Critical Care Medicine

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OBJECTIVES:The weaning according to a new definition (WIND) classification groups mechanically ventilated (MV) patients into "short weaning, " "difficult weaning, " "prolonged weaning, " and "no weaning. " The aims of the study were: 1) to describe the weaning group distribution, 2) to evaluate if "short weaning" patients can be divided into groups with distinct characteristics and outcomes depending on the MV duration, and 3) to study 1-year outcomes related to weaning groups.

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Early mobilization in clinical practice: the reliability and feasibility of the ‘Start To Move’ Protocol

Cited by 5 publications

References 27 publications

Feasibility and Safety of Active Physiotherapy in the Intensive Care Unit for Intubated Patients with Malignancy

Feasibility and Safety of Active Physiotherapy in the Intensive Care Unit for Intubated Patients with Malignancy

Early mobilization in intensive care unit in Latin America: A survey based on clinical practice

Occurrence Rate and Outcomes of Weaning Groups According to a Refined Weaning Classification: A Retrospective Observational Study*

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