Early Mobility Assessment for Critically Ill Patients

Introduction[edit | edit source]

As technology and science evolve in intensive care medicine, more patients are surviving critical illness episodes.[1] However, prolonged stays in intensive care units (ICU) are linked with functional declines, increased morbidity and mortality and increased length of stay in hospital.[2] Patients who survive a stay in ICU often go on to experience various long term challenges on discharge, some psychological (i.e. cognitive impairment, post traumatic stress disorder, persistent anxiety),[3] as well as social, financial and physical impairments, including  ICU acquired weakness,[1] decreased physical function and a decrease in quality of life.[3] These long lasting sequelae are  referred to as post-intensive care syndrome.[1]

It has been found that early mobility (EM) programmes can have a positive impact on these factors.[2] Mobilisation is described as physical activity which results in certain physiological effects.[4][5] It is energy consuming and includes various activities that produce movement (such as actively moving limbs, actively rolling in bed, sitting on the edge of the bed etc).[6]

  1. 1.0 1.1 1.2 Clarissa C, Salisbury L, Rodgers S, Kean S. Early mobilisation in mechanically ventilated patients: a systematic integrative review of definitions and activities. J Intensive Care. 2019;7:3.
  2. 2.0 2.1 Perme C, Chandrashekar R. Early mobility and walking program for patients in intensive care units: creating a standard of care. Am J Crit Care. 2009;18(3):212-221.
  3. 3.0 3.1 Linke CA, Chapman LB, Berger LJ, Kelly TL, Korpela CA, Petty MG. Early Mobilization in the ICU: A Collaborative, Integrated Approach. Crit Care Explor. 2020;2(4):e0090. 
  4. Iwashyna TJ, Hodgson CL. Early mobilization in ICU is far more than just exercise. The Lancet. 2016; 388(10052): 1351‐1352.
  5. Lai CC, Chou W, Chan KS, Cheng KC, Yuan KS, Chao CM et al. Early Mobilization Reduces Duration of Mechanical Ventilation and Intensive Care Unit Stay in Patients With Acute Respiratory Failure. Arch Phys Med Rehabil. 2017;98(5):931-939.
  6. Arias-Fernández P, Romero-Martin M, Gómez-Salgado J, Fernández-García D. Rehabilitation and early mobilization in the critical patient: systematic review. J Phys Ther Sci. 2018;30(9):1193-1201.