Early Mobilization Interventions in the Intensive Care Unit: Ongoing and Unpublished Randomized Trials

Area of Science:

• Critical Care Medicine
• Rehabilitation Science
• Clinical Trials Research

Background:

• Early mobilization (EM) is recommended in intensive care units (ICUs) by critical care societies.
• However, randomized controlled trial (RCT) evidence supporting EM's effectiveness is limited.
• This study aimed to identify ongoing or completed RCTs evaluating EM in the ICU.

Purpose of the Study:

• To systematically identify and analyze randomized controlled trials (RCTs) assessing the effectiveness of early mobilization (EM) in the intensive care unit (ICU).
• To understand the current landscape of research on EM interventions and outcomes in critical care settings.

Main Methods:

• Searched ClinicalTrials.gov and the Australian New Zealand Clinical Trials Registry for RCTs.
• Included studies were in an ICU setting with objective outcome measures.
• Focused on ongoing or completed but unpublished RCTs.

Main Results:

• 14 RCTs were identified, all in general or mixed ICUs.
• Studies varied in size (small: N=7, medium: N=7) and focused on patients requiring mechanical ventilation.
• Interventions included physiotherapy, cycling, and electrical muscle stimulation; nurse-led EM was rare. The 6-minute walk test was a common outcome measure.

Conclusions:

• The identified RCTs will contribute to the evidence base for early mobilization (EM) effectiveness.
• There is a need for research targeting specific patient groups, such as older adults and cardiac patients.
• Further investigation into novel EM delivery strategies, like nurse-led approaches, is warranted.