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| Effect of a structured early mobilization protocol on the level of mobilization and muscle strength in critical care patients: a randomized clinical trial |
| de Paula MAS, Carvalho EV, de Souza Vieira R, Bastos-Netto C, de Jesus LADS, Stohler CG, Arantes GC, Colugnati FAB, Reboredo MM, Pinheiro BV |
| Physiotherapy Theory and Practice 2023:1-10 |
| clinical trial |
| 4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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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 < 0.05). Muscle strength did not change during the protocol in the intervention and control groups (day 1 (effect size (r) = 0.15, p = 0.161), at ICU discharge (r = 0.16, p = 0.145), and after ICU discharge (r = 0.16, p = 0.191)). The LADL did not differ between the intervention and control groups after ICU discharge (4 (1 to 6) versus 3 (1 to 5), p = 0.702) or 30 days after hospital discharge (6 (5 to 6) versus 6 (5 to 6), p = 0.945). 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.
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