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Chair positioning is one of a series of early mobilization techniques. At present, this technique, which involves moving a patient out of the resuscitation bed, can be performed passively or actively. It does not constitute a rehabilitative act as such, but it is considered in common paradigms as a technique to improve "the patient's breathing and strength".
However, recommendations issued in 2013 by the Society of intensive care physiotherapy and the society "Société de réanimation de langue française (SRLF)", reveal that this chair position cannot be recommended with a high grade.
The aim of the investigators is therefore to break down this early mobilization process in intensive care, to find out whether the armchair is an indispensable tool for improving functional and muscular processes.
The research hypothesis is therefore as follows:
"Early armchairing of the resuscitation patient, improves functional recovery compared to a conservative positioning strategy (sitting in bed)."
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| sitting out of bed in an arm-chair position | Experimental |
| |
| No chair position | No Intervention |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| sitting out of bed in an arm-chair position | Other | Once the patient has been awake with a RASS score between -1 and +1 for more than 12 hours, he or she must be placed in a chair (by any means) every day for a minimum of 30 minutes until "discharge" from intensive care (or until D28, depending on which comes first), unless there are transient contraindications. If the patient is unable to signal his or her wish to stop the chair session, the criteria for intolerance will be sought and the patient placed in the chair, but in all cases the chair session will not exceed 4 hours. |
| Measure | Description | Time Frame |
|---|---|---|
| Functional level on "discharge" from intensive care | Functional level at "discharge" from the intensive care unit measured by the Physical Function ICU Test scored (PFIT-s). Minimum value = 0 , meaning worse functionnal status Maximum value = 12, meaning better functionnal status | On discharge from intensive care or day 28 (depending on which comes first) |
| Measure | Description | Time Frame |
|---|---|---|
| ICU Mobility scale | Maximum level of mobility achieved Minimum value = 0, meaning "no mobility" Maximum value = 10, meaning "walking without assistance" | Day 28 |
| MRC sum score | Presence of muscular weakness acquired in intensive care Minimum value = 0, meaning "no muscular contraction" Maximum value = 60, meaning "normal muscular force" |
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Inclusion Criteria:
Exclusion Criteria:
Patient with an absolute and non-resolving contraindication to chair positioning
Patient using a wheelchair for mobility (i.e. paraplegic patient or patient with progressive neurological pathology).
Patient treated with veno-venous or veno-arterial ECMO at the time of screening.
Moribund patient
Encephalic death
Acute polyradiculoneuritis (Guillain-Barré syndrome)
Myasthenia
Patient treated by continuous hemodialysis or hemofiltration for more than 72 hours following the onset of awakening.
Complete transmetatarsal or higher amputation of one or both lower limbs.
Protected person (under guardianship or curatorship)
Person under court protection
Person not affiliated to a social security scheme
Pregnant or breast-feeding woman
Patient already included in the study
Patient taking part in an interventional clinical study, the aim of which is to show an improvement in functional level on discharge from the intensive care unit or which focuses on the theme of early rehabilitation in the intensive care unit.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Guillaume FOSSAT | Contact | +33238651318 | guillaume.fossat@chu-orleans.fr |
| Name | Affiliation | Role |
|---|---|---|
| Guillaume FOSSAT | CHU Orléans | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre Hospitalier Universitaire d'Orléans | Recruiting | Orléans | Centre-Val de Loire | 45067 | France |
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| Day 28 |
| Length of stay in intensive care unit | Day 28 |
| Ventilator free days | Number of days without invasive mechanical ventilation | Day 28 |
| Mortality rate | Day 28 |
| Total length of hospital stay | Day 28 |
| Mortality | Month 6 |
| Hopital Nord Franche Comte | Recruiting | Belfort | France |
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| CHU Clermont Ferrand | Recruiting | Clermont-Ferrand | France |
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| CH de DAX | Not yet recruiting | Dax | 40100 | France |
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| CHU de DIJON | Recruiting | Dijon | France |
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| CH Chartres | Recruiting | Le Coudray | 28630 | France |
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| Ch Du Mans | Recruiting | Le Mans | 72037 | France |
|
| CHI Mont de Marsan | Recruiting | Mont-de-Marsan | 40012 | France |
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| CH de Saint-Lô | Not yet recruiting | Saint-Lô | France |
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| Hopital Foch | Not yet recruiting | Suresnes | France |
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| CHRU de TOURS | Recruiting | Tours | France |
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