Prospective observation of physical activity in critically ill patients who were intubated for more than 48 hours

Critical illness can result in impaired physical function. Increased physical activity, additional to rehabilitation, has demonstrated improved functional independence at hospital discharge. The purpose of this study was to measure patterns of physical activity in a group of critically ill patients.

This was a single-center, open, observational behavioral mapping study performed in a quaternary intensive care unit (ICU) in Melbourne, Australia. Observations were collected every 10 minutes for 8 hours between 8:00 am and 5:00 pm with the highest level of physical activity, patient location, and persons present at the bedside recorded.

Two thousand fifty observations were collected across 8 days. Patients spent more than 7 hours in bed (median [interquartile range] of 100% [69%-100%]) participating in little or no activity for approximately 7 hours of the day (median [interquartile range] 96% [76%-96%]). Outside rehabilitation, no activities associated with ambulation were undertaken. Patients who were ventilated at the time of observation compared with those who were not were less likely to be out of bed (98% reduction in odds). Patients spent up to 30% of their time alone.

Outside rehabilitation, patients in ICU are inactive and spend approximately one-third of the 8-hour day alone. Strategies to increase physical activity levels in ICU are required.