The effect of range of motion exercises on delirium prevention among patients aged 65 and over in intensive care units

Karadas, Canan; Özdemir, Leyla

doi:10.1016/j.gerinurse.2015.12.003

Cited by 27 publications

(68 citation statements)

References 26 publications

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“…In a second trial, the mean number of hospital days with delirium was 3.4 (standard deviation, SD 2.2) in the intervention group compared with 2.0 (SD 0.7) in the control group, but this was not significant ( P = 0.18) . In the third trial, the median number of hours with delirium was 15 (range 3‐144) in the intervention group compared with 38 (range 9‐120) in the control group, but this finding was also not significant ( P > 0.05) …”

Section: Resultsmentioning

confidence: 87%

“…Strategies incorporating physical training may have more benefit to those at risk of delirium compared to those with established delirium in the hospital setting. Of the four trials that presented results related to patients with established delirium, there were individual findings relating to duration of delirium, length of stay and cognition at 6 months, despite numerous other outcome measures of interest across all trials (Table ). While it is possible that strategies incorporating physical training have minimal impact on established delirium, available evidence for non‐pharmacological strategies to manage established delirium is generally weaker than evidence for non‐pharmacological strategies to prevent delirium .…”

Section: Discussionmentioning

confidence: 99%

“…One trial was limited by a low incidence of delirium in both the intervention and control groups during the study period . The other trial investigated range of motion exercises in an intensive care setting, so it is not possible to generalise results to other physical training interventions (eg mobilisation) in non‐intensive care hospital settings. This lack of identified trials limits the ability to draw strong conclusions from the review.…”

Section: Discussionmentioning

confidence: 99%

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Delirium management: Let's get physical? A systematic review and meta‐analysis

et al. 2019

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Objective To investigate whether physical training (alone or in a multi‐component intervention) is effective in preventing delirium or improving outcomes for adult patients with delirium in the hospital setting. Methods A systematic review, qualitative synthesis and meta‐analysis of randomised controlled trials identified by searches of electronic databases, combining key concepts of delirium and physical training (the target intervention). Outcomes were incidence of delirium (for prevention trials) and delirium duration, delirium severity and hospital outcomes (for management trials). Results Seven trials were included, five of which were multi‐component. The odds of developing delirium were lower for patients who received physical training compared with a control intervention [odds ratio 0.46 (95% confidence interval 0.32‐0.65), P < 0.01] (moderate‐quality evidence). There was insufficient evidence to draw conclusions about managing established delirium. Conclusions Strategies incorporating physical training appear to prevent delirium in the hospital setting. More research is required regarding management of established delirium.

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Section: Resultsmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Delirium management: Let's get physical? A systematic review and meta‐analysis

et al. 2019

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“…Risks of bias fell into five major groups (selection bias, performance bias, detection bias, attrition bias, and reporting bias), and based on a study's scores in each of these groups it was labeled as having an overall high, low, or unclear risk of bias. Four were considered low risk of bias [21,31,39,45], two had a high risk of bias [29,41], and five had an unclear risk of bias [28,32,33,35,40]. The most common source of bias was performance bias due to the impossibility of blinding participants or personnel to certain treatments.…”

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

“…The study by Karadas and Ozdemir assessed the effect of range of motion exercises on delirium in elderly patients (≥65 years) [35]. Interventional care included range of motion exercises for 30 minutes daily after establishing the patient's ability to complete 10 repetitions on each of the four extremities while lying in bed.…”

Section: Early Mobilitymentioning

confidence: 99%

The Effect of Non-Pharmacologic Strategies on Prevention or Management of Intensive Care Unit Delirium: A Systematic Review

Hashemighouchani

Cupka

Lipori

et al. 2020

Preprint

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Objective: The aim of this systematic review is to examine and report on recently available literature evaluating the relationship between non-pharmacologic interventions and the reduction of delirium in the intensive care unit. Methods: Six major research databases were systematically searched for articles analyzing the efficacy of non-pharmacologic delirium interventions in the past five years. Search results were restricted to adult human patients aged 18 years or older in the intensive care unit setting, excluding terminally ill subjects and withdrawal-related delirium. Following title, abstract, and full text review, 27 articles fulfilled the inclusion criteria and are included in this report. Results: The 27 reviewed articles consist of 12 interventions with a single-component investigational approach, and 15 with multi-component bundled protocols. Delirium incidence was the most assessed outcome followed by duration. Family visitation was the most effective individual intervention and mobility interventions were the least effective. Two of the three family studies significantly reduced delirium incidence, while one in five mobility studies did the same. Multi-component bundle approaches were the most effective of all; of the reviewed studies, eight of 11 bundles significantly improved delirium incidence and seven of eight bundles decreased the duration of delirium. Conclusions: Multi-component, bundled interventions were more effective at managing intensive care unit delirium than those utilizing an approach with a single interventional element. Although better management of this condition suggests a decrease in resource burden and improvement in patient outcomes, comparative research should be performed to identify the importance of specific bundle elements.

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Neurocognitive Disorders

Maldonado,

Sher

2023

Tasman’s Psychiatry

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The effect of range of motion exercises on delirium prevention among patients aged 65 and over in intensive care units

Cited by 27 publications

References 26 publications

Delirium management: Let's get physical? A systematic review and meta‐analysis

Delirium management: Let's get physical? A systematic review and meta‐analysis

The Effect of Non-Pharmacologic Strategies on Prevention or Management of Intensive Care Unit Delirium: A Systematic Review

Neurocognitive Disorders

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