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

Autor:	de Paula MAS; Pulmonary and Critical Care Division, University Hospital of Federal University of Juiz de Fora - Catulo Breviglieri S/nº - Santa Catarina, Juiz de Fora, Brazil., Carvalho EV; Pulmonary and Critical Care Division, University Hospital of Federal University of Juiz de Fora - Catulo Breviglieri S/nº - Santa Catarina, Juiz de Fora, Brazil.; School of Medicine, Federal University of Juiz de Fora - Av. Eugênio do Nascimento S/nº - Dom Bosco, Juiz de Fora, Brazil., de Souza Vieira R; Pulmonary and Critical Care Division, University Hospital of Federal University of Juiz de Fora - Catulo Breviglieri S/nº - Santa Catarina, Juiz de Fora, Brazil., Bastos-Netto C; Pulmonary and Critical Care Division, University Hospital of Federal University of Juiz de Fora - Catulo Breviglieri S/nº - Santa Catarina, Juiz de Fora, Brazil., de Jesus LADS; Pulmonary and Critical Care Division, University Hospital of Federal University of Juiz de Fora - Catulo Breviglieri S/nº - Santa Catarina, Juiz de Fora, Brazil., Stohler CG; Pulmonary and Critical Care Division, University Hospital of Federal University of Juiz de Fora - Catulo Breviglieri S/nº - Santa Catarina, Juiz de Fora, Brazil., Arantes GC; Pulmonary and Critical Care Division, University Hospital of Federal University of Juiz de Fora - Catulo Breviglieri S/nº - Santa Catarina, Juiz de Fora, Brazil., Colugnati FAB; Pulmonary and Critical Care Division, University Hospital of Federal University of Juiz de Fora - Catulo Breviglieri S/nº - Santa Catarina, Juiz de Fora, Brazil., Reboredo MM; Pulmonary and Critical Care Division, University Hospital of Federal University of Juiz de Fora - Catulo Breviglieri S/nº - Santa Catarina, Juiz de Fora, Brazil.; School of Medicine, Federal University of Juiz de Fora - Av. Eugênio do Nascimento S/nº - Dom Bosco, Juiz de Fora, Brazil., Pinheiro BV; Pulmonary and Critical Care Division, University Hospital of Federal University of Juiz de Fora - Catulo Breviglieri S/nº - Santa Catarina, Juiz de Fora, Brazil.; School of Medicine, Federal University of Juiz de Fora - Av. Eugênio do Nascimento S/nº - Dom Bosco, Juiz de Fora, Brazil.
Jazyk:	angličtina
Zdroj:	Physiotherapy theory and practice [Physiother Theory Pract] 2023 Jul 07, pp. 1-10. Date of Electronic Publication: 2023 Jul 07.
DOI:	10.1080/09593985.2023.2233097
Abstrakt:	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.
Databáze:	MEDLINE
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