Table 1 Randomized studies of the effects of early mobilization

[2]

104

Exercise and mobilization

Standard care

1.5

7.4

Primary: number of patients returning to independent functional status (ability to perform 6 daily activities and walking independently) at time of discharge from hospital.

Secondary: (1) number of hospital days with delirium

(2) number of ventilator-free days during first 28 days of hospitalization

(3) length of stay in ICU and in hospital

[3]

90

Usual care + bicycle ergometer, 20 min/day, at an intensity level adjusted individually ×5 days/week

Respiratory therapy adjusted to the individual needs + standardized sessions of upper and lower extremities mobilization 5 days/week

14

10

Primary: distance covered in 6 min at time of discharge from the hospital

Secondary: isometric quadriceps strength and functional status

[4]

150

Mechanically ventilated patient: physical therapy 15 min/day

Non-mechanically ventilated patients: physical therapy 2 × 15 min

Exercises: walking in place, moving from sitting to standing, arm and leg active and active resistance motion

Physical therapists provided respiratory and mobility management, based upon individual patient assessment according to unit protocols

Usual care was available 7 days/week, 12 h/day

5

5

Primary: distance covered in 6 min at 12 months

Secondary: Timed Up and Go Test, physical function in ICU test, assessment of QOL

Instrument utility and short form 36 health survey

[5]

120

Delivered for 30 min/day, 7 days/week, while in ICU.

Intensive physical therapy program included:

1. Proper breathing techniques during exercise

2. Progressive range of motion;

3. Muscle strengthening exercises

4. Exercises to increase core mobility and strength

5. Retraining of functional mobility

Standard of care physical therapy programs based on national survey

Range of motion exercises, positioning, and functional mobility retraining 3 days/week for 20 min in ICU

8

8

Primary: short form of the continuous scale physical functional performance test at 4 weeks

Secondary: number of ICU- and hospital-free days on day 28; discharged home, all-cause mortality on day 28, and institution-free days on days 90 and 180

[6]

50

Early goal-directed mobilization comprised functional rehabilitation treatment at the highest level of activity possible for that patient assessed by the ICU mobility scale while receiving mechanical ventilation.

Not based on protocol

All usual unit practices were continued, without restrictions to physical therapy or sedation practice

3

3

Primary: higher maximum level of activity measured using the ICU mobility scale, increased duration of activity measured in min/day during the ICU stay compared with standard care

Secondary: time from admission to first mobilization; duration of mechanical ventilation, ICU and hospital length of stay, and overall duration of hospitalization; serious adverse events, number of ventilator- and ICU-free days on day 28; measurement of physical function with the physical function in ICU, the functional status score in ICU, and the Medical Research Council Manual Muscle Tests; ICU-acquired weakness

[7]

300

Standardized rehabilitation therapy

7 days a week from enrollment through hospital discharge

protocol contained 3 exercise types: passive range of motion, physical therapy, and progressive resistance exercises

Usual care; received routine care as dictated by the patient’s attending physician from Monday through Friday

1

7

Primary: hospital length of stay

Secondary: Short Performance Physical Battery score, muscular strength, short form Functional Performance Inventory score, 36-Item Short Form Health Survey physical health survey and mental health survey, mini-mental state examination score (measure of physical function were obtained at ICU discharge, hospital discharge and 2, 4, and 6 months after enrollment, health-related quality-of-life measures were obtained at hospital discharge and 2,4, and 6 months after enrollment)