Authors (including presenting author) :
Lee KF(1), Lee WY(1), Lee JWY(1), Wong TWL(2)(3),Ip YW(1),Chau HL(1),Poon CL(1),Lai YS(1),Yim PL(1),Lee SY(1),Liu YM(1),Leung YY(1),Mak WL(4),So D(4)
Affiliation :
(1)Physiotherapy Department, Princess Margaret Hospital, (2)Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, (3)School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, (4)Department of Intensive Care Unit, Princess Margaret Hospital
Introduction :
Early mobilization is beneficial to reduce ICU acquired weakness and improve functional recovery of critical care patients. PMH Physiotherapy team has commenced a “2020/21 Annual Plan Early Patient Mobilization Program” at the adult ICU collaborating with the medical and nursing teams since September 2020.
Objectives :
The program aimed to (1) provide early mobilization to adult ICU patients, (2) maintain and improve patients’ physical mobility and functional status.
Methodology :
Physiotherapy early mobilization service was enhanced by increasing frequency and intensity of the treatments, extended from weekdays to weekends and public holidays. In-bed active mobilization exercises, out-of-bed functional and mobility training were optimized. Program group was evaluated from 9-11/2020 and compared to baseline group in 7-8/2020 with standard physiotherapy. ICU Mobility Scale (ICUMS) was used to assess mobility level and Medical Research Council Sum Score (MRCSS) was used to assess muscle strength of patients. Both outcomes were compared with initial assessment and upon discharge from ICU. Paired t-test and two-way repeated measures Analysis of Variance (ANOVA) were used for data analysis.
Result & Outcome :
In program group, 21% of the total early mobilization sessions (1153 sessions) were out-of-bed exercise or above. 31% of the total patients (231 headcounts) received out-of-bed mobilization exercise. In baseline group, 162 patients served and 12% increase in out-of-bed mobilization sessions after program implementation. Mean ICUMS and MRCSS of patients in program group improved from 0.90±1.0 to 2.48±2.5 (p< 0.001) and 43.46±11.6 to 46.78±11.1 (p< 0.05). Two-way repeated measures ANOVA examined mobility level of patients between groups. There was a statistically significant interaction between 2 groups in ICUMS, F (1,289) = 55.26, p< 0.001. No adverse effects were reported by the patients who received mobilization exercises. PMH ICU early mobilization program is safe and effective in improving physical mobility and functional status upon discharge from ICU.
PMH ICU early mobilization program is safe and effective in improving physical mobility and functional status upon discharge from ICU.
