Effectiveness, Safety, and Barriers to Early Mobilization in the Intensive Care Unit

Abstract

Purpose. Patients admitted to the intensive care unit (ICU) are generally confined to bed leading to limited mobility that may have detrimental effects on different body systems. Early mobilization prevents or reduces these effects and improves outcomes in patients following critical illness. The purpose of this review is to summarize different aspects of early mobilization in intensive care. Methods. Electronic databases of PubMed, Google Scholar, ScienceDirect, and Scopus were searched using a combination of keywords. Full-text articles meeting the inclusion criteria were selected. Results. Fifty-six studies on various aspects such as the effectiveness of early mobilization in various intensive care units, newer techniques in early mobilization, outcome measures for physical function in the intensive care unit, safety, and practice and barriers to early mobilization were included. Conclusion: Early mobilization is found to have positive effects on various outcomes in patients with or without mechanical ventilation. The newer techniques can be used to facilitate early mobilization. Scoring systems—specific to the ICU—are available and should be used to quantify patients’ status at different intervals of time. Early mobilization is not commonly practiced in many countries. Various barriers to early mobilization have been identified, and different strategies can be used to overcome them.

Avaliação da independência funcional e da qualidade de vida após a alta da unidade de terapia intensiva: um estudo do coorte prospectivo

“…Tem como objetivo promover a recuperação e preservação da funcionalidade, resultando na redução do tempo de desmame, ventilação mecânica e hospitalização. 17,18 Assim, a fisioterapia ajuda a melhorar a funcionalidade e a qualidade de vida pós-alta.…”

Extracorporeal membrane oxygenation and rehabilitation in patients with COVID‐19: A scoping review

“…Physiotherapy plays a crucial role in enhancing the recovery of patients in critical care settings, and it is well known that patients attending rehabilitative activities in intensive care units can gain significant improvements. 63 , 64 , 65 , 66 , 67 , 68 Nevertheless, at the beginning of the COVID‐19 pandemic, very little information was available on the physiotherapeutic regimen to be safely adopted in such a population. 69 All those professionals involved in the rehabilitation field were supported in their practice by general recommendations issued in order to face such an unprecedented situation.…”

“…Physiotherapy plays a crucial role in enhancing the recovery of patients in critical care settings, and it is well known that patients attending rehabilitative activities in intensive care units can gain significant improvements 63–68 . Nevertheless, at the beginning of the COVID‐19 pandemic, very little information was available on the physiotherapeutic regimen to be safely adopted in such a population 69 .…”

Heart Failure-Related Cardiogenic Shock: Pathophysiology, Evaluation and Management Considerations

“…Because of the presence of monitoring devices, tMCS devices, or hemodynamic or electrical instability, patients with CS are often restricted to bedrest, resulting in limited mobility that can exacerbate underlying deconditioning and may have detrimental effects on various body systems. 64 Early mobilization can prevent or reduce these effects and is associated with improved outcomes in patients after critical illness. Early mobilization has recently been studied in a variety of critical illnesses and has been shown to limit or prevent physical and cognitive dysfunction and to provide various benefits in mechanically ventilated patients.…”