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Objectives
Discuss current practice and investigate why current
dysfunction
Impaired strength
Physiologic impairments
Increased risk for skin
breakdown
Decreased quality of life
Sleep deprivation
Prolonged sedation
Delirium
2,
4-8
Improved respiratory function
Maintains strength and joint range of
motion
Fewer physiologic impairments
Repositioning allows for other
interventions
Improved quality of life
needed
Determine what phase of the Early Mobilization
Phase 1
Patient presentation: considerable weakness,
minutes
Standing Frame
Chair sitting
Phase 2
Includes patients that have the strength
functional training
Progression: weight shift steps in place
Phase 3
Phase 4 6
Includes patients that are no
maximum independence by
discharge.
crucial!
occur
1,2,7
prevent/treat neuromuscular
complications of critical illness.
Early Mobilization Requires a Culture
Change
Questions
References
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2.
Bourdin G, Barbier J, Burle JF, et al. The Feasibility of Early Physical Activity in Intensive Care Unit
Patients: A Prospective Observational One-Center Study. Respiratory Care 2010;55(4):400-407.
3.
Choi J, Tasota FJ, Hoffman LA. Mobility Interventions to Improve Outcomes in Patients Undergoing
Prolonged Mechanical Ventilation: A Review of the Literature. Biological Research for Nursing
2008;10(1):21-33.
4.
Frownfelter D, Dean E. Cardiovascular and Pulmonary Physical Therapy. (4th ed). St. Louis: Mosby. 2006.
5.
Kisner C, Colby LA. Therapeutic Exercise. (5th ed.). Philadelphia: F.A. Davis Company. 2007.
6.
Perme C, Chandrashekar R. Early Mobility and Walking Program for Patients in the Intensive Care Units:
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7.
Schweickert WD, Pohlman MC, Pohlman AS, et al. Early physical and occupational therapy in
mechanically ventilated, critically ill patients: a randomized controlled trial. Lancet 2009;373:1874-82.
8.
West L. Early Mobilization: How one multidisciplinary team initiated an activity protocol to decrease ICU
lengths of stay. Advance for Physical Therapy and Rehab Medicine May 30, 2011:12-14.