Authors (including presenting author) :
Tsang HC(1), Choi CM(1), Tam KL(1), Tang KL(1), To YL(1), Sun TF(2)
Affiliation :
(1)Physiotherapy Department, (2)Hospital Chief Executive Office, North District Hospital
Introduction :
Early mobilization (EM) for patients with critical illness has been reported to reduce ICU-acquired weakness, shorten hospital stay and improve functional recovery. While existing guidelines advocate the benefits and identify the ways of progression along patient’s journey in the ICU, they rarely address the practical issues faced by the mobilizing team to translate evidence into practice. We present a number of strategies for safe mobilization utilized in our unit.
Objectives :
To share some practical methods to facilitate early mobilization for patients in the ICU
Methodology :
Experience sharing
Result & Outcome :
Passive mobilization
Apart from the traditional manual passive limbs mobilization, there is an increasing use of cycle ergometer that allows patients to perform passive or active cycling on the bed. For those who are unconscious or too weak to have adequate control of the lower limbs, a theraband encircling their thighs may help to stabilize their legs on the pedals of the ergometer. Sitting
Patients could be assisted to sit out of bed even they are still intubated if their conditions are stabilized. For those with impaired conscious level or inadequate neck control due to deconditioning or neurological impairment, a tilt-in-space wheelchair with neck support could be a favorable option compared to a standard chair. The tilt-in-space feature not only provides adequate support to the body but it also allows the patient to lean backward in case of haemodynamic instability. Standing
Depending on the physical condition of the patients, standing could be achieved by using a tilt table if they are too weak or it could be assisted by using an Arjo-walker if they have certain control of the trunk and lower limbs. A pair of air-splints may help to provide extra support to both knee to facilitate trunk control training in standing position. Walking
Assisting intubated patients to walk represents a huge challenge because of all the tubes and drains on their bodies. Different types of walker are currently available in the market but they are either too bulky or do not have the capacity to accommodate the ventilator as well as those tubes and drains. A local custom-make walker as illustrated could facilitate the ambulation for this group of patients.
Co-location with:
