Early Mobilisation & Physical Activity

ICU acquired weakness is a common complication in critically ill patients, and where Physiotherapists play an important role in prevention and treatment of these complications

Often its said that atophy can be around 4-5% per week, critically ill patients may lose up to 20% per week, Also
– Strong association between bed rest and prolonged mechanical ventilation
– Mobility level significantly associated with length of stay post critical care

**The Evidence**

NICE have several recommendations
• Early assessment to determine patients at risk of physical morbidity
• Functional ability assessment
• Short, Medium and Long term goals
• Rehabilitation as early as clinically possible
**Schweikert et al 2009 Assessor blinded RCT**
-Experimental group received early intervention and daily mobilisation in between sedation periods
-Control group received standard care with physical and occupational therapy as directed by the primary care physician.
– Experimental group Improvement return to pre-morbid level of function and shorter period of ICU associated delirium.

**Useful resources**
The safety of early mobilisation in critically ill patients (Stiller 2004)
Critical Care Podcast 58 Early Mobilisation
ACPRC Guidelines for mobilisation of the critically ill patient
Johns Hopkins Critical Care Rehabilitation @icurehab
David Mcwilliams @davido744

**Outcome Measures**
Manchester Mobility Score
Chelsea Critical Care Activity Assessment Tool
Apache II Score

Thanks for reading
George 🙂

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