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Physical Therapy on the Wards After Early Physical Activity and Mobility in the Intensive Care Unit.
MedLine Citation:
PMID:  22491481     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background.Weakness and debilitation are common following critical illness. Studies that assess whether early physical activity initiated in the intensive care unit (ICU) continues after a patient is transferred to a ward are lacking.Design and Objective.This cohort study assessed whether physical activity and mobility initiated during ICU treatment were maintained after the patient was discharged from a single ICU to a ward. METHODS:Consecutive patients diagnosed with respiratory failure admitted to the Respiratory ICU (RICU) at LDS Hospital underwent early physical activity and mobility as part of usual care. We collected medical data, the number of requests for physical therapy consultation or nursing to ambulate patients at ICU discharge, and mobility data on the first two full days on the ward. RESULTS: Sixty-five of 72 study patients had either physical therapy consultation or request for nursing to ambulate the patient at ward transfer. Activity level decreased in 40 (55%) patients on the first full ward day. Of the 61 patients who ambulated ≥100 feet on the last full RICU day, 14 patients did not ambulate, 22 patients ambulated <100 feet, and 25 patients ambulated ≥100 feet on the first ward day.Limitations.Limitations include lack of data regarding why activity was not performed on the ward, lack of longitudinal follow-up to assess effects of activity, and lack of generalizability to patients not transferred to a ward or not treated in an ICU with an early mobility program. CONCLUSIONS:Despite the majority of patients having a physical therapy consultation or request for nursing to ambulate the patient at the time of transfer to the medical ward, physical activity levels decreased in over half of patients on the first full ward day. Our data suggest a need for education of ward staff regarding ICU debilitation, enhanced communication among care providers, and focus on the importance of patient-centered outcomes during and following ICU treatment.
Authors:
Ramona O Hopkins; Russell R Miller; Larissa Rodriguez; Vicki Spuhler; George E Thomsen
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-5
Journal Detail:
Title:  Physical therapy     Volume:  -     ISSN:  1538-6724     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0022623     Medline TA:  Phys Ther     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
R.O. Hopkins, PhD, Department of Medicine, Pulmonary and Critical Care, Intermountain Medical Center, 5121 S Cottonwood St, Murray, UT 84107 (USA), and Psychology Department and Neuroscience Center, Brigham Young University, Provo, Utah.
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