Effect of Early Mobility as a Physiotherapy Treatment for Pneumonia: A Systematic Review and Meta-Analysis.

Abstract

Purpose: We conducted a systematic review of the effect of early mobility on length of stay (LOS), mortality, and clinical outcomes as a treatment for adults hospitalized with pneumonia. Method: An electronic search of four databases was conducted. Inclusion criteria were (1) acute medical condition of pneumonia in adults and (2) early mobility intervention. Quality appraisal was conducted using the Physiotherapy Evidence Database scale and the Newcastle-Ottawa Scale. Results: Four studies (three randomized controlled trials and one retrospective cohort study) met the inclusion criteria. Meta-analysis demonstrated that early mobility did not reduce the risk of mortality compared with usual care (risk ratio 0.9 [95% CI: 0.27, 2.97]; p = 0.86) but did reduce the mean LOS (-1.1 days [95% CI: 2.21, -0.04]; p = 0.04). Early mobility also did not affect the rate of hospital readmissions or emergency department visits. One study demonstrated an improvement in functional exercise capacity and quality of life related to physical function and faster completion of a measure of activities of daily living. Conclusions: Early mobility reduced LOS in adults hospitalized with community-acquired pneumonia, although there was no effect on mortality or rate of hospital readmissions. Further research is needed to determine the effect of early mobility in this population and establish guidelines.