Effect of a structured early mobilization protocol on the level of mobilization and muscle strength in critical care patients: A randomized clinical trial.

IF 1.6 4区 医学 Q2 REHABILITATION
Physiotherapy Theory and Practice Pub Date : 2024-09-01 Epub Date: 2023-07-07 DOI:10.1080/09593985.2023.2233097
Maria Aparecida Stroppa de Paula, Erich Vidal Carvalho, Rodrigo de Souza Vieira, Cristiane Bastos-Netto, Luciana Angélica da Silva de Jesus, Caio Groetaers Stohler, Gustavo Candiá Arantes, Fernando Antonio Basile Colugnati, Maycon Moura Reboredo, Bruno Valle Pinheiro
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Abstract

Background: Few studies have evaluated the effects of structured early mobilization (EM) protocols on the level of mobilization in critical care patients.

Objective: To evaluate the impact of a structured EM protocol on the level of mobilization, muscle strength, and the level of activities of daily living (LADL) after intensive care unit (ICU) and hospital discharge.

Methods: This randomized clinical trial (U1111-1245-4840) included adults patients who were randomized into two groups: intervention (n = 40) and control (n = 45). The intervention group underwent conventional physiotherapy and structured EM protocols, and the control group underwent conventional physiotherapy. The level of mobilization from 0 (no mobilization) to 5 (walking), muscle strength (Medical Research Council scale), LADL (Katz Index), and incidence of complications were evaluated.

Results: The level of mobilization from day 1 to day 7 increased in the intervention group compared with the control group (p < .05). Muscle strength did not change during the protocol in the intervention and control groups {day 1 [effect size (r) = 0.15, p = .161], at ICU discharge [r = 0.16, p = .145], and after ICU discharge [r = 0.16, p = .191]}. The LADL did not differ between the intervention and control groups after ICU discharge [4 (1-6) vs. 3 (1-5), p = .702] or 30 days after hospital discharge [6 (5-6) vs. 6 (5-6), p = .945]. The structured EM protocol was safe, and no severe complications were observed during the protocol.

Conclusion: A structured EM protocol increased the level of mobilization without improving muscle strength and the LADL compared with conventional physiotherapy.

结构化早期动员方案对危重症患者动员水平和肌肉力量的影响:随机临床试验。
背景:很少有研究评估结构化早期动员(EM)方案对重症监护患者动员水平的影响:评估结构化早期动员方案对重症监护病房(ICU)和出院后动员水平、肌肉力量和日常生活活动水平(LADL)的影响:这项随机临床试验(U1111-1245-4840)将成人患者随机分为两组:干预组(40 人)和对照组(45 人)。干预组接受常规物理治疗和结构化电磁方案,对照组接受常规物理治疗。结果显示,干预组从第1天开始的活动度从0(无活动度)到5(行走)、肌肉力量(医学研究委员会量表)、LADL(卡茨指数)以及并发症的发生率均有所提高:结果:与对照组相比,干预组患者从第1天到第7天的活动能力均有所提高(p r) = 0.15,p = .161],ICU出院时[r = 0.16,p = .145],ICU出院后[r = 0.16,p = .191]}。干预组和对照组的 LADL 在 ICU 出院后 [4 (1-6) vs. 3 (1-5),p = .702] 或出院 30 天后 [6 (5-6) vs. 6 (5-6),p = .945] 没有差异。结构化急救方案是安全的,方案实施期间未发现严重并发症:结论:与传统物理疗法相比,结构化急救方案提高了患者的活动能力,但没有改善患者的肌力和LADL。
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来源期刊
CiteScore
3.40
自引率
10.00%
发文量
300
期刊介绍: The aim of Physiotherapy Theory and Practice is to provide an international, peer-reviewed forum for the publication, dissemination, and discussion of recent developments and current research in physiotherapy/physical therapy. The journal accepts original quantitative and qualitative research reports, theoretical papers, systematic literature reviews, clinical case reports, and technical clinical notes. Physiotherapy Theory and Practice; promotes post-basic education through reports, reviews, and updates on all aspects of physiotherapy and specialties relating to clinical physiotherapy.
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