Supervisors info:
Αντ. Κουτσούκου, Καθηγήτρια Ιατρικής Σχολής ΕΚΠΑ
Ν. Ροβίνα, Επίκουρη Καθηγήτρια Ιατρικής Σχολής ΕΚΠΑ
Ι. Βασιλειάδης, Επίκουρος Καθηγητής Ιατρικής Σχολής ΕΚΠΑ
Summary:
During last decades it has been understood that both critical illness and intensive care unit (ICU) hospitalization may cause locomotor, cognitive and psychological deficits, whose consequences in patients’ functional capacity and quality of life may last even for years. For this reason, treatment goal is not only survival of patients, but their return in pre-critical illness functional capacity.
The present thesis is a systematic review of literature with the goal to research the effects of early mobilization in critically ill patients’ functional capacity, morbidity and mortality, ICU and hospital length of stay, as well as in their quality of life after hospital discharge.
The method followed included search of randomized controlled trials through Pubmed, Cochrane Library and PEDro (Physiotherapy Evidence Database) databases for the 2000-2019 period. Inclusion criteria for the selection of studies were their implementation in adult patients (≥18 years) and the use of active mobilization interventions. Exclusion criterion was the exclusive use of passive mobilization interventions (i.e. Electrical Muscle Stimulation, passive cycle ergometry).
In total, thirteen studies fulfilled the inclusion criteria, twelve randomized controlled trials and a well- designed non-randomized controlled trial. All studies were written in English. Quality assessment of studies was done using Pedro scale. All studies were of high methodological quality.
From analysis of studies it appears that the statistically significant positive effects of early mobilization are related to the outcomes that have to do with the successful implementation of early mobilization interventions, such as number of patients who are able to be mobilized during ICU stay, time until first mobilization out of bed and level of patient mobilization. In contrast, results concerning the rest of the outcomes (duration of mechanical ventilation, ICU and hospital length of stay, ICU-acquired weakness, functional independence, anxiety/depression, health related quality of life, mortality) are contradictory, with the majority of studies not resulting in statistically significant results.
In conclusion, early mobilization implementation in ICU is safe and has positive effects, helping patients to acquire a greater level of functional capacity during their hospitalization, thus preparing them to return in pre-critical illness functional status in a shorter period of time with continuation of rehabilitation interventions after ICU and hospital discharge.
Key words: Intensive Care Unit, critical illness, early mobilization, physiotherapy, rehabilitation
Keywords:
Intensive Care Unit, Critical illness, Early mobilization, Physiotherapy, Rehabilitation
