Progressive Mobility Program and Technology to Improve the Level of Physical Activity and Functionality of ICU Patients

Using a Progressive Mobility Program and Technology to Increase the Level of Physical Activity and Its Benefits in Respiratory, Muscular System and Functionality of ICU Patients: a Randomized Clinical Trial

The purpose of this study is to verify if a protocol of early and progressive mobility which includes the use of technology is able to increase the level of physical activity and improve functionality and respiratory and muscular function of Intensive Care Unit patients compared with conventional Physical Therapy.

The evolution of treatment in the Intensive Care Unit (ICU) has increased the survival and morbidity post hospital. Functional disability in these patients has its main factor in the weakness and loss of muscle mass, which is the major complications reported by these patients. The most negative result in long-term post ICU is the impact on quality of life and functional decline due to muscle disorders and fitness. This is achieved by the period of inactivity and prolonged rest, leading to losses and changes in various body systems. Given these facts, interventions for greater mobility in bed and out of it are very important. Early mobility programs has proved beneficial, however, as in other types of rehabilitation, the exercises should be prescribed with its specific characteristics, including the intensity. However, little has been described in the researches abut the activity level in the ICU, and using a quantitative measure. The use of technology seems to facilitate the offering of this type of therapy, supplying the limitations. Therefore, there are little evidences about these topics and randomized controlled studies to investigate these factors.

Inclusion Criteria:

• admitted to the Emergency Intensive Care Unit of Clinical Hospital, Medical School, University os Sao Paulo
• inspired oxygen fraction ≤ 60%
• positive end expiratory pressure ≤ 10 points
• peripheral oxygen saturation ≥ 90%
• respiratory rate ≤ 35
• without cardiac arrhythmia or acute ischaemia
• heart rate > 50 bpm and < 140 bpm
• without high or raising dose of vasoactive drugs
• mean body pressure > 60 mmHg and < 120 mmHg
• without active bleeding
• without prescribed bedrest

Exclusion Criteria:

• transference from other hospital
• diagnosis of neurological disorders
• intensive care unit stay < 4 days
• contraindication to mobilization