The feasibility study of early mobilization for ICU patients in critical conditions

Objective To investigate the feasibility and efficacy of providing early physical activities for ICU patients and to serve as a reference for practicing early activities in ICU. Methods We sampled 32 patients who hospitalized in ICU for over 24 hours from August, 2014 to February, 2015.All patients met the standards for engaging in early physical activities, and they participated in a total of 81 early activities following standard protocols.Physical activity levels (a total of 4classes from sitting up in bed with nurses' assistance to autonomous walking) were gradually increased per patients' level of resilience and changes in vital signs.Pre and post vital functions including HR, RR, SpO₂, and BP were measured and compared.Patients' subjective feelings including dizziness, fatigue, and pain were recorded.Adverse events such as tumbling, slipping, and sudden worsening of symptoms were also observed. Results Among the 81 early activities (64 first class, 6 second class, 10 third class, 1 fourth class), patients reported positive feelings in 51 cases, moderate but tolerable discomfort in 26 cases, and intolerable experience in 4 cases.There was one case of thrombophlebitis, but no tumbling or slipping was observed.No statistical significant difference was found between pre-and post-activity HR, RR, SpO₂, or DBP measures (P > 0.05).There was a statistically significant increase in post-activity SBP (P < 0.01). Conclusion Following a standardized protocol, it is safe and feasible to provide early physical activities for ICU patients.Although the class of activity is mostly constrained to sitting up in bed, the protocol is tolerable for patients and free from adverse events.Further investigations on methods to improve class of activity are needed in future clinical practices on early activities.