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Table 1 Randomized studies of the effects of early mobilization

From: Early mobilization of mechanically ventilated patients in the intensive care unit

Reference # n Study group Days between intubation and onset of Outcomes
Intervention Control Intervention Control
[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)