NO JUDUL PENULIS TAHU BACKGROUND METHODS RESULTS CONCLUSIONS

. N
1 Impact of Early Bhakti K. Patel , 2014 ICU-acquired Th is is a secondary On logistic regression Th e duel eff ect of early
Mobilization on MD ; Anne S. weakness (ICU-AW) analysis of all analyses, early mobilization mobilization in reducing
Glycemic Control Pohlman , MSN ; has immediate and patients with and increasing insulin dose clinically relevant ICU-
and ICU-Acquired Jesse B. Hall , long-term conse- mechanical pre- AW
Weakness in Critically MD , FCCP ; and quences for critically ventilation (N 5 104) vented the incidence of and promoting
Ill Patients John P. Kress , ill patients. previously enrolled ICU-AW (OR, 0.18, P 5 .001; euglycemia suggests its
Who Are Mechanically MD , FCCP Strategies for the in a randomized OR, 0.001, P 5 .011; potential usefulness as
Ventilated prevention of controlled trial of respectively) inde- an alternative to IIT.
DOI: Downloaded weakness include early occupational pendent of known risk
10.1378/chest.13- From: modifi ca- and physical therapy factors for weakness. Early
2046 http://journal.pu tion of known risk vs conventional mobilization also
blications.chestne factors, such as therapy, which significantly reduced
(Patel et al., 2014) t.org/ by a hyperglycemia and evaluated the end insulin requirements to
Bibliotheque De L immobility. Intensive point of functional achieve similar glycemic
Universite Laval insulin therapy independence. Every goals as compared with
User on (IIT) has been patient had IIT and control patients
05/11/2015 proposed to prevent blinded muscle (0.07 units/kg/d vs 0.2
critical illness strength testing on units/kg/d, P , .001).
polyneuropathy. hospital discharge to
However, the eff ect determine the
of insulin incidence of clinically
and early apparent weakness.
mobilization on Th e eff ects of
clinically apparent insulin dose and
weakness is not well early mobilization on
known. the incidence of ICU-
AW were assessed.

2 Improving mobility in Laptin Ho 2022 Early intensive care Prospective cohorts Those receiving early Here, we report that
the intensive care unit 1,*, Joe Hin unit (ICU) of patients admitted mobilization in the improvement in mobility
with a Cheung Tsang protocolized consecutively intensive care unit had score earlier in the
protocolized, early 2,*, Emmanuel rehabilitative before-and-after higher ICU mobility score course of intensive
mobilization program: Cheung programs have been (control, n=92; (2.63; 95% confidence care hospitalization with
observations of a 1, Wing Yan Chan de- intervention, n=90) interval, 0.65–4.61; the introduction of a
single center before- 2, Ka Wai Lee scribed previously, the introduction of P<0.001) upon discharge protocolized early
and-after the 2, Sweetie R Lui yet with differing an early mobilization from the intensive care, rehabilitative program.
 implementation of a 2, starting time points program in a single with
multidisciplinary Chung Yau Lee and mostly on center, general earlier out of bed
program 2, Alfred Lok mechanically hospital ICU. mobilization on day 5
Hang Lee ventilated Improvement in compared to the control
https://doi.org/ 3, Philip Koon patients. We mobility as assessed group of day 21 (P<0.001).
10.4266/ Ngai Lam extended the by ICU mobility No
acc.2021.01564 concept to all score, on ICU differences were found in
Acute and Critical admitted ICU admission and terms of mortality,
(Ho et al., 2022) Care 2022 August patients and upon ICU discharge, intensive care
37(3):286-294 investigate the was measured as a hospitalization and
efficacy of primary outcome. subsequent hospi-
early mobilization in talization duration after
improving mobility discharge from ICU.
of the critically ill,
address issues
surrounding the
timing
and intensity of an
early rehabilitative
program.
3 Mobilization of Alberto Sibilla, PT, 2020 Growing evidence In a 1-day, Swiss Among 161 mechanically Mobilization
Mechanically MSc1, Peter suggests that early point ventilated patients, a total during mechanical
Ventilated Nydahl, RN, mobilization benefits prevalence study of 33% (n ¼ 53) had active ventilation occurred
Patients in Switzerland MScN2, Nicola intensive care unit conducted in 35 ICUs mobilization, with infrequently with
Greco, PT, MSc1, (ICU) patients. (representing 45% of walking achieved by only greater organ failure
https://doi.org/ Giuseppe Mungo, However, national all ICUs), the highest 2% (n ¼ 4). More severe associated with lower
10.1177/08850666177 PT, BSc1, Natalie practices and the level of mobilization organ failure was mobilization. Addressing
28486 Ott, PT, BSc1, Ines culture of individual for mechanically associated with lower the
Unger, PT, BSc1, ICUs influence ventilated mobilization (respiratory identified modifiable
(Sibilla et al., 2020) Spencer Rezek, mobilization patients was Sequential barriers via structured
PT, BSc1, Sarah activities. characterized using Organ Failure Assessment efforts to achieve
Gemperle, RN, the validated ICU score: P ¼ .037, cardiac: P multidisciplinary culture
BScN3, Mobility Scale, along ¼ .008, neurology: P change is essential to
Dale M. with data collection < .001). Barriers to decrease the
Needham, MD, for potential safety mobilization were reported common use of bed rest
PhD4, and Sapna events and in 71% in Swiss ICUs.
R. Kudchadkar, mobilization barriers. (n ¼ 115), with deep
MD5 sedation significantly
higher among patients
 Journal of receiving passive versus
Intensive Care active mobilization (14% vs
Medicine 0%, P ¼
2020, Vol. 35(1) .005). Potential safety
55-62 events occurred in 20% (n
ª The Author(s) ¼ 33) of patients without
2017 significant differences
Article reuse between passive and active
guidelines: mobilization. Availability of
sagepub.com/ physiotherapists and
journals- appropriate equipment
permissions were not reported barriers.
DOI:
10.1177/0885066
617728486
journals.sagepub.
com/home/jic
4 PROtocol-based Peter Nydahl 2019 BACKGROUND: Early After a control Out-of-bed mobilizations Implementing a protocol
MObilizaTION on , Ulf Günther , mobilization of period, five ICUs increased non-significantly for early mobilization of
intensive Anja Diers , patients in intensive were allocated to the from 36⋅2% (n = 55) of 152 ICU patients showed a
care units: stepped- Stephanie Hesse , care units (ICUs) implementation of patients during the control trend towards more
wedge, Christian improves patient an inter-professional period to 45⋅8% (n = 55) of patients being
cluster-randomized Kerschensteiner , recovery, but protocol for early 120 patients during the mobilized. Without
pilot study (Pro- Silke Klarmann, implementation mobilization in a intervention period additional staff in
Motion) Christoph remains challenging. randomized, (difference 9⋅6%; 95% participating
Borzikowsky and Protocols may monthly order. confidence interval −2⋅1 to ICUs, a significant
doi: Sascha Köpke enhance the rate Mobilization 21⋅3%). Of 55 mobilized increase in ICU
10.1111/nicc.12438 of out-of-bed of ICU patients was patients per group, more mobilizations was not to
mobilizations. evaluated by patients were mobilized be anticipated. More
(Nydahl et al., 2020) AIM: To evaluate the monthly 1-day point once per day during the research should address
effect of prevalence surveys intervention whether more staff
implementing a using the ICU period (intervention: n = 41 would increase the
protocol for early Mobility Scale. The versus control: n = 23 number of frequent
mobilization on the primary outcome patients). Multiple daily mobilizations
rate of out-of-bed was the percentage mobilizations decreased and if this is relevant to
mobilizations and of patients mobilized (control: n = 32 control outcomes.
other outcomes of out of bed, versus intervention: n = 14 RELEVANCE TO CLINICAL
ICU patients. defined as level 3 on patients). Secondary PRACTICE:
STUDY DESIGN: the ICU Mobility outcomes, Implementing inter-
 Multicentre, Scale (sitting on edge such as days with professional protocols
stepped-wedge, of bed) or higher. mechanical ventilation, for mobilization is
cluster-randomized Secondary outcomes delirium and in ICU and feasible and safe and
pilot study. were mechanical hospital, did not may contribute to an
ventilation, delirium significantly differ. increase of ICU patients
and ICU- and Adherence to the protocol mobilized out of bed.
hospital-days, as well was >90%; unwanted
as unwanted safety events were rare.
safety events.
5 Early mobilisation Ginga Suzuki , 2022 Introduction It is Methods and In the control group, outcome
using a mobile patient Hiromi important to prevent analysis We will patients will be treated The primary endpoint
lift in the intensive Kanayama, Ryo the deterioration conduct a single- according will be the number of
care unit: protocol for Ichibayashi, of activities of daily centre, to the above- mentioned days from
a Yoshiaki Arai, Yuji living to improve the open- label, protocol. In the meeting the
randomised controlled Iwanami, long- term randomised intervention rehabilitation initiation
trial Yuka Masuyama, prognoses of controlled trial. The group, a mobile patient lift, criteria to achieving
Saki Yamamoto, patients in the inclusion Golvo 9000 lowBase an ICU mobility scale
doi:10.1136/ Hibiki Serizawa, intensive care unit criteria are as (Hillrom (IMS) ≥4 (standing
bmjopen-2021- Yoshimi (ICU). The follows: age ≥18 BV, Amsterdam, The position).24 As
057942 Nakamichi, patients’ conditions, years, independent Netherlands) will be used indicated in the
Masayuki along with the lack walking to assist rehabilitation protocols
(Suzuki et al., 2022) Watanabe, of human and before admission during the standing section, IMS is
Mitsuru Honda, technical resources, and expected position. In addition, it will an assessment method
Satoru Ebihara often become mechanical also be that has not been
barriers to achieving ventilation for used for posture change incorporated
early mobilisation at least 48 hours. and sitting position. into our protocol. We
after the The participants will Although adopted IMS as a
introduction of be randomly divided our ICU has 15 beds and measure of mobil-
mechanical into groups with only one lift, rehabilitation isation to evaluate the
ventilation. We plan (intervention group) is effect of adding a lift to
to verify the or without (control fully feasible. The an existing
usefulness of a group) a mobile lift physiotherapist was protocol, and since the
mobile protocol. A mobile originally familiar standing section of IMS
patient lift for early lift will be used in with handling the lift, but clearly
mobilisation. the intervention the nurses received states that it includes
group. The primary training the use of a lift, we
endpoint will be the from the physiotherapist to adopted IMS as
number of days use the lift in a month’s the measure of
required to achieve period. Often, the nurse mobilisation in this
 an ICU mobility scale alone would perform the
of ≥4 (standing standing position, although
position). The results the physiotherapist was
of the two groups more
will likely to perform the higher
be analysed using stages of mobilisation.
the Student’s t- test. Both
physiotherapists and
nurses will routinely follow
the
protocol shown in figures 1
and 2, and the
endotracheal
tube and ventilator will not
interfere with the standing
position. Even in such a
situation, if the patient’s
condi-
tion permits, mobilisation
to the standing position
and
sometimes beyond will be
performed. If the patient’s
mobility is high and a lift is
not necessary, the patient
can
be placed in a standing
position without using a
lift. After
ICU discharge, nurses will
not actively participate in
the
rehabilitation of patients;
therefore, the lift will not
be
used in the general ward.
6 Early mobilization Paula Caitano 2018 OBJECTIVES: To METHODS: A RESULTS: A total of 140
practices of Fontela,I Thiago assess early prospective, patients were included
mechanically Costa Lisboa,I,II,III mobilization observational, with a mean age of 57±17
study. The secondary
endpoints will be time
of preparation and
postprocessing
of mobilisation,
mobilisation time, the
Sequential Organ
Failure Assessment
score at first achieving
IMS≥4, Func-
tional Status Score (FSS)-
ICU and Medical
Research
Council (MRC) score at
the start of mobilisation,
IMS/
FSS- ICU/MRC at ICU
discharge, Barthel
index/MRC at
hospital discharge,
presence and duration
of delirium
(confusion assessment
method (CAM)- ICU),
length
of ICU stay, 28
ventilator- free days,
ICU mortality and
hospital mortality. Other
unexpected adverse
events will
be recorded in the data
set as appropriate.
CONCLUSIONS:
In southern Brazilian
ICUs, the prevalence of
 ventilated Luiz Alberto practices of multicenter, 1-day years. The median and patient mobilization was
patients: a 1-day Forgiarini-Ju´ mechanically point-prevalence interquartile low, with only 10% of all
point-prevalence nior,IV Gilberto ventilated patients in study was conducted range was 7 (3-17) days for mechanically
study in southern Friedman southern Brazilian across 11 the length of ICU stay to ventilated patients and
Brazil intensive care units ICUs and included all the day of the survey and 7 only 2% of patients with
Copyright & 2018 (ICUs) and to identify mechanically (3-16) days for the duration an endotracheal tube
DOI: CLINICS – barriers associated ventilated adult of mobilized out of bed as
10.6061/clinics/2018/ with early patients. Hospital mechanical ventilation part of routine
e241 mobilization and and ICU (MV). The 8-level care.
possible characteristics and mobilization scale was
(Fontela et al., 2018) complications. patients’ classified into two
demographic data, categories: 126 patients
the highest level of (90%) remained in bed
mobilization (level 1–3) and 14 (10%)
achieved in the 24 were mobilized out of bed
hours prior to the (level 4–8). Among patients
survey and related with an
barriers, and endotracheal tube,
complications that tracheostomy, and
occurred during noninvasive ventilation,
mobilization were 2%, 23%, and 50% were
collected in the mobilized out of bed,
hospital and the ICU. respectively (po0.001 for
differences among the
three groups). Weakness
(20%), cardiovascular
instability
(19%), and sedation (18%)
were the most commonly
observed barriers to
achieving a higher level of
mobi-
lization. No complications
were reported.
7 Early mobilization and The TEAM Study 2015 Introduction: The Method: This was a Results: We studied 192 Conclusions: Early
recovery in Investigators aim of this study was prospective, multi- patients (mean age 58.1 ± mobilization of patients
mechanically to investigate centre, cohort study 15.8 years; mean Acute receiving mechanical
ventilated patients in The TEAM Study current mobilization conducted in twelve Physiology and Chronic ventilation was
the ICU: a bi-national, Investigators practice, strength at ICUs in Australia and Health uncommon. More than
multi-centre, Critical Care ICU discharge and New Zealand. Evaluation (APACHE) (IQR) 50% of
prospective cohort (2015) 19:81 functional recovery Patients were II score, 18.0 (14 to 24)). patients discharged
study 2015 The TEAM at 6 months among previously Mortality at day 90 was from the ICU had
Study mechanically functionally 26.6% (51/192). Over 1,351 developed ICU-acquired
DOI 10.1186/s13054- Investigators; ventilated ICU independent and study days, weakness, which was
015-0765-4 licensee BioMed patients. expected to be we collected information associated with death
Central. ventilated for >48 during 1,288 planned early between
(Hodgson et al., 2015) hours. We measured mobilization episodes in ICU discharge and day-
mobilization during patients on mechanical 90.
invasive ventilation, ventilation for Clinical trial registration:
sedation depth using the first 14 days or until ClinicalTrials.gov
the Richmond extubation (whichever NCT01674608.
Agitation and occurred first). We Registered 14 August
Sedation Scale recorded the highest level 2012.
(RASS), of early mobilization.
co-interventions, Despite the presence of
duration of dedicated physical therapy
mechanical staff, no mobilization
ventilation, ICU- occurred in 1,079 (84%) of
acquired weakness these episodes.
(ICUAW) at ICU Where mobilization
discharge, mortality occurred, the maximum
at levels of mobilization were
day 90, and 6-month exercises in bed (N = 94,
functional recovery 7%), standing at
including return to the bed side (N = 11, 0.9%)
work. or walking (N = 26, 2%). On
day three, all patients who
were mobilized were
mechanically ventilated via
an endotracheal tube (N =
10), whereas by day five
50% of the patients
mobilized were
mechanically ventilated via
a tracheostomy tube (N =
18).
In 94 of the 156 ICU
survivors, strength was
assessed at ICU discharge
 and 48 (52%) had ICU-
acquired weakness
(Medical Research Council
Manual Muscle Test Sum
Score (MRC-SS) score
<48/60). The MRC-SS score
was higher in
those patients who
mobilized while
mechanically ventilated
(50.0 ± 11.2 versus 42.0 ±
10.8, P = 0.003). Patients
who
survived to ICU discharge
but who had died by day
90 had a mean MRC score
of 28.9 ± 13.2 compared
with
44.9 ± 11.4 for day-90
survivors (P <0.0001).
8 Comparison of Clément 2018 Background: In the Methods: A Results: The results were Conclusion: Most bed
exercise intensity Medrinal1,2*, ICU, out-of-bed randomised, single- analysed in 19 patients. FES exercises were low-
during Yann Combret3,4, rehabilitation is blind, placebo- cycling was the only intensity and induced
four early Guillaume often delayed and in- controlled crossover exercise that increased low levels of muscle
rehabilitation Prieur2, Aurora bed exercises are trial was carried out cardiac output, work. FES cycling was
techniques in Robledo generally low- to evaluate the with a mean increase of 1 the
sedated and Quesada2, Tristan intensity. effects of L/min (15%). There was a only exercise that
ventilated patients in Bonnevie5,6,7, Since the majority of four bed exercises concomitant increase in increased cardiac output
ICU: a Francis Edouard rehabilitation is (passive range of muscle oxygen uptake, and produced sufficient
randomised cross-over Gravier7, Elise carried out in bed, it movements (PROM), suggesting intensity of muscle
trial Dupuis Lozeron8, is essential to carry passive cycle- that muscle work occurred. work. Longer-term
Eric Frenoy9, out the exercises ergometry, FES cycling thus constitutes studies
Medrinal et al. Critical Olivier Contal10 that have the quadriceps electrical an effective early of the effect of FES
Care (2018) 22:110 and Bouchra highest intensity. stimulation rehabilitation intervention. cycling on functional
https://doi.org/ Lamia5,6,11,12 The aim of this study and functional No muscle or outcomes should be
10.1186/s13054-018- was to compare the electrical stimulation systemic effects were carried out.
2030-0 Bmc, CRITICAL physiological effects (FES) cycling) on induced by the passive Trial registration:
CARE JURNAL of four common cardiac output. Each techniques. ClinicalTrials.gov,
(Medrinal et al., 2018) types of bed exercise was carried NCT02920684.
 exercise in out for ten minutes Registered on 30
intubated, sedated in ventilated, September 2016.
patients confined to sedated patients. Prospectively registered.
bed in the ICU, in Cardiac output was
order to determine recorded using
which was the most cardiac Doppler
intensive. ultrasound. The
secondary aims
were to evaluate
right heart function
and pulmonary and
systemic artery
pressures during the
exercises, and the
microcirculation of
the vastus lateralis
muscle.
9 A comparison of Catherine 2017 Background: Methods: The study Discussion: This
earlier and enhanced Snelson1* Mortality from design is a study will evaluate the
rehabilitation of , Charlotte critical illness is randomised feasibility of providing an
mechanically Jones2, Gemma improving, but controlled study to earlier and enhanced
ventilated Atkins2, James survivors suffer from explore the rehabilitation intervention
patients in critical care Hodson3, Tony prolonged weakness feasibility of to
compared to Whitehouse1, and providing earlier and mechanically
standard care Tonny Veenith1, psychological and enhanced ventilated patients in
(REHAB): study David Thickett4, cognitive rehabilitation to critical care. We will
protocol for a Emma Reeves5, impairments. mechanically identify strengths and
single-site randomised Aisling Maximising the ventilated patients at weaknesses of the
controlled feasibility McLaughlin5, recovery after critical high risk of ICU- proposed protocol
trial Lauren Cooper5 illness has been acquired weakness and the utility and
and David highlighted as within the characteristics of the
Snelson et al. Pilot and McWilliams2 a research priority, ICU. The outcome measures. The
Feasibility Studies especially in relation rehabilitation results from this study will
(2017) 3:19 to an ageing intervention involves inform the design of a
DOI 10.1186/s40814- population who a structured phase III
017-0131-1 present with higher programme, with multicentre trial of
rates of pre-morbid progression along a enhanced rehabilitation for
disability. Small functionally critically ill adults.
studies have shown based mobility Trial registration:
that starting protocol according ISRCTN90103222,
rehabilitation early to set safety criteria. 13/08/2015;
within the intensive The overall aim of retrospectively registered.
care unit (ICU) the intervention is to
improves short- commence
term outcomes. mobilisation at an
Systematic reviews earlier time point in
have highlighted the the patient’s illness
need for robust and increase
multicentre mobility of the
randomised patient through their
controlled trials with recovery
longer term follow- trajectory.
up. Participants will be
randomised to
enhanced
rehabilitation or
standard care, with
the aim of recruiting
at
least 100 patients
over 16 months. The
trial design will
assess recruitment
and consent rates
from eligible
patients,
compliance with the
intervention, and
assess a range of
possible outcome
measures for use in a
definitive trial, with
follow-up continuing
for 12 months post
hospital discharge.
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Ho, L., Tsang, J. H. C., Cheung, E., Chan, W. Y., Lee, K. W., Lui, S. R., Lee, C. Y., Lee, A. L. H., & Lam, P. K. N. (2022). Improving mobility in the intensive care unit
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