The Effect of Early Mobilization with Elastic Band Exercise on the Duration of Mechanical Ventilator Weaning of Critically Ill Patients.

Abstract

Objective The purpose of this study was to investigate the effect of early mobilization with elastic band exercise on the duration of mechanical ventilator weaning in the patient in intensive care unit (ICU).Methods: Seventy-five ICU and Sub ICU patients were recruited and randomly assigned to a control group(C) and an intervention group including early mobilization (EM) for control group and early mobilization with elastic band exercise (EMEB) for intervention group. The primary outcome was the duration of mechanical ventilator weaning in ICU. The secondary outcomes were the strength of the arm muscle measuring by the handgrip strength, and functional class level. ResultsThe all groups were not significant in a severity-of-disease classification system of ICU-scores. EM and EMEB were significantly reduced the ventilation duration and functional class level in ICU. Nevertheless, EMEB was significantly increased the strength of the arm muscle with a hand grip dynamometer compares with EM group (p<0.05). EMBM was significantly decreased the ventilation duration in ICU and increased handgrip strength, and level of physical activity (p<0.05). Thus, EMBM may be applied using treatment in ICU.

Effects of different types and frequencies of early rehabilitation on ventilator weaning among patients in intensive care units: A systematic review and meta-analysis

“…All 4 studies using the PM approach had significantly shorter ventilator duration in the intervention group; however, differences in the ventilator-free days were not significant [ 31 – 33 , 35 ]. One of the studies using early mobilization with/without an elastic band was beneficial with respect to ventilator duration when compared to multiple components including passive and active range of motion and breathing exercises [ 34 ]. A study using rotation therapy (changing position continuously for 18 h/day) and percussion showed significantly shorter ventilator duration and longer ventilator-free days than that of routine position changing every 2–4 h [ 36 ].…”

“…In the subgroup analysis of treatment types, only early rehabilitation with PM had a significant and optimal treatment effect on ventilator duration (SMD = 0.91; 95% CI = 0.23–1.58; P < 0.01) ( Fig 4A ). However, in contrast to the control protocol with lower-dose early rehabilitation, the experimental protocol with higher-dose early rehabilitation did not significantly reduce ventilator duration (SMD = 0.19; 95% CI = -0.27–0.66; P = 0.41; heterogeneity test, χ 2 = 17.45, P = 0.002; I 2 = 77%) ( Fig 4B ) [ 34 , 40 – 42 , 44 ].…”

“…Various studies have used multi-component programs with relatively low intensity as a comparison to identify the effect of the specific component. According to our meta-analysis, the overall effect of intervention programs was not superior to controls [ 34 , 40 – 42 , 44 ]. However, the non-significant result does not mean that these protocols did not have positive effects on ventilator duration.…”

“…When the EPT was the only extra component in the intervention group, the intervention protocol was not significantly better than the control program [ 40 , 44 ]. As the gap of intervention intensity enlarged, the additional components consisting of EPT and PM had a significant benefit on ventilator duration [ 34 ]. On the other hand, most EPTs in our included studies were limb-strengthening exercises and had limited benefit on ventilator weaning.…”