Effects of the Intensity and Activity Time of Early Rehabilitation on Activities of Daily Living Dependence in Mechanically Ventilated Patients

Watanabe, Shinichi; Morita, Yoko; Suzuki, Shinichi; Kochi, Kaito; Ohno, Mika; Liu, Keibun; Iida, Yasuhiko

doi:10.2490/prm.20210054

Cited by 10 publications

(6 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In previous studies on early rehabilitation, there have been some reports that examined single factors such as the start time and exercise intensity [13,14]. Additionally, in a previous study that focused on the number of days until mobilization in ICU patients, the percentage of independent walking at discharge was significantly higher in the group that achieved mobilization within 7 days in the ICU compared to the group that did not.…”

Section: Discussionmentioning

confidence: 99%

Impact of Extra-Corporeal Membrane Oxygenation and Blood Purification Therapy on Early Mobilization in the Intensive Care Unit: Retrospective Cohort Study

et al. 2023

Self Cite

View full text Add to dashboard Cite

Objective: To investigate the effect on early mobilization in patients undergoing extra-corporeal membrane oxygenation (ECMO) and acute blood purification therapy in the intensive care unit (ICU).Methods: We conducted this multicenter retrospective cohort study by collecting data from six ICUs in Japan. Consecutive patients who were admitted to the ICU, aged ≥18 years, and received mechanical ventilation for >48 hours were eligible. The analyzed were divided into two groups: ECMO/blood purification or control group. Clinical outcomes; time to first mobilization, number of total ICU rehabilitations, mean and highest ICU mobility scale (IMS); and daily barrier changes were also investigated.Results: A total of 204 patients were included in the analysis, 43 in the ECMO/blood purification group and 161 in the control group. In comparison of clinical outcome, the ECMO/blood purification group had a significantly longer time to first mobilization: ECMO/blood purification group 6 vs. control group 4 (p=0.003), higher number of total ICU rehabilitations: 6 vs. 5 (p=0.042), lower mean: 0 vs. 1 (p=0.043) and highest IMS: 2 vs. 3 (p=0.039) during ICU stay. Circulatory factor were most frequently described as barriers to early mobilization on days 1 (51%), 2 (47%), and 3 (26%). On days 4 to 7, the most frequently described barrier was consciousness factors (21%, 16%, 19%, and 21%, respectively)Conclusion: The results of this study comparing the ECMO/blood purification group and the untreated group in the ICU showed that the ECMO/blood purification group had significantly longer days to mobilization and significantly lower mean and highest IMS.

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of Extra-Corporeal Membrane Oxygenation and Blood Purification Therapy on Early Mobilization in the Intensive Care Unit: Retrospective Cohort Study

et al. 2023

Self Cite

View full text Add to dashboard Cite

show abstract

“…To assess the association between the highest IMS and independence in ADL at hospital discharge, multivariable logistic regression was performed, adjusting for covariates such as age, BMI, CCI, BI before hospitalization, ICU admission diagnosis (sepsis of non-pulmonary origin status), and SOFA score at ICU admission. These variables were selected based on the results of previous studies and our clinical interest [9,11,12,15,16]. Results are reported as odds ratio (OR) and 95% confidence interval (95% CI).…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, BI was measured at discharge. As in previous studies, ADL dependence was defined as BI<70 points [7,11,12,19], and mobilization was defined as being able to sit on the edge of the bed or a higher degree of mobility [9,11,12,19,20]. In this study, early rehabilitation was defined as within the first 72 hours after ICU admission [3].…”

Section: Data Collectionmentioning

confidence: 99%

“…The effects of early rehabilitation are widely reported, including the prevention of delirium [7], shortening the length of mechanical ventilation [8] and shortening the length of stay in the ICU [9,10]. Although relatively short-term results have been increasingly reported recently, data on the relationship between the mobilization level in critically ill patients and activity of daily living (ADL) independence at hospital discharge are still lacking [11][12][13]. Previous studies examined the mobilization level of ICU patients and reported that patients discharged home had higher ICU mobility score (IMS) scores at discharge from the ICU than patients discharged to the facility.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Association Between Mobilization Level And Activity of Daily Living Independence in Critically Ill Patients

Watanabe,

Liu,

Kozu

et al. 2023

Ann Rehabil Med

Self Cite

View full text Add to dashboard Cite

Objective: To examine the association between the mobilization level during intensive care unit (ICU) admission and independence in activity of daily living (ADL), defined as Barthel Index (BI)≥70. Methods: This was a post-hoc analysis of the EMPICS study involving nine hospitals. Consecutive patients who spend >48 hours in the ICU were eligible for inclusion. Mobilization was performed at each hospital according to the shared protocol and the highest ICU mobility score (IMS) during the ICU stay, baseline characteristics, and BI at hospital discharge. Multiple logistic regression analysis, adjusted for baseline characteristics, was used to deter-mine the association between the highest IMS (using the receiver operating characteristic [ROC]) and ADL. Results: Of the 203 patients, 143 were assigned to the ADL independence group and 60 to the ADL dependence group. The highest IMS score was significantly higher in the ADL independence group than in the dependence group and was a predictor of ADL independence at hospital discharge (odds ratio, 1.22; 95% confidence interval, 1.07–1.38; adjusted p=0.002). The ROC cutoff value for the highest IMS was 6 (specificity, 0.67; sensitivity, 0.70; area under the curve, 0.69). Conclusion: These results indicate that, in patients who were in the ICU for more than 48 hours, that patients with good function in the ICU also exhibit good function upon discharge. However, prospective, multicenter trials are needed to confirm this conclusion.

show abstract

“…Study outcomes. The primary outcome measured in this study was ADL independence at hospital discharge, which was defined as a score of 70 or higher on the Barthel index 4,7 . This widely used and reliable scale measures a patient's ability to perform daily activities 34 .…”

Section: Data Collectionmentioning

confidence: 99%

Association between the early mobilization of mechanically ventilated patients and independence in activities of daily living at hospital discharge

Watanabe

Hirasawa

Naito

et al. 2023

Sci Rep

View full text Add to dashboard Cite

Physical dysfunction after discharge from the intensive care unit (ICU) is recognized as a common complication among ICU patients. Early mobilization (EM), defined as the ability to sit on the edge of the bed within 5 days, may help improve physical dysfunction. However, the barriers to, and achievement of, EM and their impact on physical dysfunction have not been fully investigated. This study aimed to investigate the achievement of EM and barriers to it and their impact on patient outcomes in mechanically ventilated ICU patients. We conducted this multicenter retrospective cohort study by collecting data from six ICUs in Japan. Consecutive patients who were admitted to the ICU between April 2019 and March 2020, were aged ≥ 18 years, and received mechanical ventilation for > 48 h were eligible. The primary outcome was the rate of independent activities of daily living (ADL), defined as a score ≥ 70 on the Barthel index at hospital discharge. Daily changes in barriers of mobilization, including consciousness, respiratory, circulatory, medical staff factors, and device factors (catheter, drain, and dialysis), along with the clinical outcomes were investigated. The association among barriers, mobilization, and Barthel index ≥ 70 was analyzed using multivariable logistic regression analysis. During the study period, 206 patients were enrolled. EM was achieved in 116 patients (68%) on the fifth ICU day. The primary outcome revealed that achieving EM was associated with a Barthel index ≥ 70 at hospital discharge [adjusted odds ratio (AOR), 3.44; 95% confidence interval (CI), 1.70–6.96]. Device factors (AOR, 0.31; 95% CI, 0.13–0.75, respectively) were significantly associated with EM achievement. EM was associated with independent ADL at hospital discharge. Time to first mobilization and barriers to achieving mobilization can be important parameters for achieving ADL independence at discharge. Further research is required to determine the most common barriers so that they can be identified and removed.

show abstract

Effects of the Intensity and Activity Time of Early Rehabilitation on Activities of Daily Living Dependence in Mechanically Ventilated Patients

Cited by 10 publications

References 34 publications

Impact of Extra-Corporeal Membrane Oxygenation and Blood Purification Therapy on Early Mobilization in the Intensive Care Unit: Retrospective Cohort Study

Impact of Extra-Corporeal Membrane Oxygenation and Blood Purification Therapy on Early Mobilization in the Intensive Care Unit: Retrospective Cohort Study

Association Between Mobilization Level And Activity of Daily Living Independence in Critically Ill Patients

Association between the early mobilization of mechanically ventilated patients and independence in activities of daily living at hospital discharge

Contact Info

Product

Resources

About