Mild physical therapist-led exercise programs are good for critically ill patients as it has been found to increase functional mobility and reduce hospital stay in intensive care units(ICU).
In a quality improvement project implemented in a medical intensive care unit at Johns Hopkins Hospital, researchers focused on reducing the use of prescription sedatives to reduce patient drowsiness and increase patients' ability to exercise more frequently.
The project included 57 patients who were on a mechanical ventilator for 4 or more days.
The health care team found that this quality improvement process resulted in lower median daily doses of sedatives, improved patient alertness, and reduced delirium.
These factors contributed to a greater number of rehabilitation treatments per patient with a higher level of functional mobility in the ICU, and a decrease in ICU and hospital length of stay by 2.1 and 3.1 days, respectively.
"Historically, patients in ICUs have been heavily sedated and immobile, which contributes to neuromuscular weakness that can, in turn, lead to physical impairments and decreased quality of life. The results of our quality improvement project show that rehabilitation of patients who are critically ill is safe and effective in improving mobility and returning patients to their homes sooner," said Dr. Jennifer Zanni, a co-author of the report.
The rehabilitation-based exercise sessions typically lasted 30-45 minutes and consisted of arm and leg movements while lying in bed, sitting, or standing, or walking slowly in the ICU hallways.
"This report underscores the integral role that physical therapists, who are experts in restoring and improving motion, play in speeding recovery time for patients in ICUs. We hope these results encourage other critical care experts to consider early mobilization in this patient population," said Dr. R. Scott Ward.
The study has been published in a recent issue of the Archives of Physical Medicine and Rehabilitation.