Early mobilization: Why, what for and how?

Med Intensiva. 2017 Oct;41(7):429-436. doi: 10.1016/j.medin.2016.10.003. Epub 2017 Mar 7.
[Article in English, Spanish]

Abstract

Early mobilization strategies in the intensive care unit may result in the prevention and reduction of polyneuromyopathy in the critical patient, improved quality of life, shortened ICU and hospital stay, and lesser mortality during hospitalization. However, it is well known that factors such as the protocol used, the population included in the studies, the timing of the strategy, the severity of the patients and different barriers directly influence the outcomes. This study examines the main protocols described in the literature and their associated results. The main techniques used were kinesitherapy, transfer and locomotion training, as well as neuromuscular electrical stimulation and cycle ergometry. Although two trials and a meta-analysis found no positive results with mobilization, programs that focus on specific populations, such as patients with weakness due to immobility and with preserved neuromuscular excitability can derive more positive effects from such treatment.

Keywords: Early mobilization; Fisioterapia; Intensive care unit; Movilización precoz; Physical therapy; Unidad de cuidados intensivos.

Publication types

  • Review

MeSH terms

  • Clinical Protocols
  • Clinical Trials as Topic
  • Contraindications, Procedure
  • Critical Care / methods*
  • Early Ambulation* / methods
  • Humans
  • Intensive Care Units
  • Length of Stay / statistics & numerical data
  • Meta-Analysis as Topic
  • Muscle Strength
  • Muscular Atrophy / prevention & control
  • Neuromuscular Diseases / prevention & control
  • Quality of Life
  • Recovery of Function
  • Treatment Outcome