Resource-efficient mobilization programs in the intensive care unit: who stands to win?

Area of Science:

• Critical Care Medicine
• Physical Therapy
• Rehabilitation

Background:

• Early mobilization in intensive care units (ICUs) can enhance functional outcomes but often demands substantial resources.
• Existing literature lacks detailed information on resource allocation and therapeutic delivery methods for such programs.
• This study introduces a novel, team-based, resource-efficient mobility program (REMP) designed for ICUs.

Purpose of the Study:

• To describe and evaluate the effectiveness of a resource-efficient mobility program (REMP) in an intensive care unit (ICU) setting.
• To assess the feasibility and impact of a team-based approach to early mobilization on patient functional outcomes.

Main Methods:

• A consecutive cohort of ICU admissions from November 2009 to March 2010 participated in the REMP, undergoing physical therapist evaluation.
• Key functional outcomes including sitting balance (SB), bed-to-chair transfers, and ambulation were assessed using the Functional Independence Measure (FIM) scale.
• Patients were evaluated at initial assessment, ICU discharge, and hospital discharge, with comparisons made to a control group.

Main Results:

• Twenty-eight patients were enrolled in the REMP, compared with 31 control patients; baseline characteristics and initial FIM scores were similar between groups.
• While both groups showed improvement over time, REMP patients demonstrated significantly better sitting balance at both ICU and hospital discharge.
• Initial bed-to-chair transfer ability was higher in the control group, suggesting a potential baseline difference in this specific function.

Conclusions:

• A team-based, resource-efficient mobility program is a feasible and effective strategy for implementing early mobilization in the ICU.
• The REMP model successfully improved key functional outcomes, particularly sitting balance, in critically ill patients.
• This approach offers a practical solution for resource-constrained environments seeking to optimize patient recovery through early mobility.