Abstract
The dose of progressive active mobilization is still uncertain. The purpose of this study is to identify if the addition of a protocol of progressive active mobilization with dose and training load control to usual care is effective in reducing the length of stay in intensive care unit (ICU) and the improvement of the functioning, incidence of ICU-acquired weakness (ICUAW), mechanical ventilation duration and mortality rate in patients hospitalized in ICU. It is Double-blind randomised clinical trial. The setting for this trial will be medical and surgical ICU of a university hospital. The study participants will be 118 patients aged> 18 years admitted to ICU for less than 72 hours. Participants will be randomized to either an experimental or control group. The experimental group will undertake addition of a protocol of progressive active mobilization with dose and training load control to usual care, while the control group will undertake only usual care. The primary outcome will be length of ICU stay. The secondary outcomes will be Cross-sectional area and muscle thickness of the rectus femoris and biceps brachii, Change in muscle strength from the baseline, Functional Status, incidence of ICUAW, Days with mechanical ventilation and Mortality. All statistical analyses will be conducted following intention-to-treat principles. It has a detailed description of the dose of exercise, was designed with the strictest methodological criteria. These characteristics allow to investigate with greater certainty the results progressive active mobilization in critical patients, allowing replication and future combinations in meta-analyzes.
Highlights
Physical rehabilitation strategies involving active and progressive mobilization protocols have been recommended for the management of critical illness-related morbidity [1]
This is a study of superiority that adhered to the Consolidated Standards of Reporting Trials (CONSORT) recommendations [9] and to Standard Protocol Items for Clinical Trial (SPIRIT) [10]
Patients admitted to the intensive care unit (ICU) of the Universitary Hospital Professor Edgard Santos of the Federal University of Bahia (UFBA), Salvador, Bahia, Brazil, who met the eligibility criteria will be recruited in the study
Summary
Physical rehabilitation strategies involving active and progressive mobilization protocols have been recommended for the management of critical illness-related morbidity [1]. It is well documented that the exercise dose is a determining factor for the results of exercise programs Variables such as intensity, execution time and rest, number of repetitions, and progression may influence strength gain and cardiorespiratory capacity [7,8]. The most important factor influencing outcomes such as LOS, strength, and function may be the addition of a training dose control protocol based on the major international protocols [5] and involving variables of intensity, frequency, number of repetitions, rest time, and progression scheme. The primary endpoint of this RCT will be to identify if the addition of a protocol of progressive active mobilization with dose and training load control to usual care is effective in reducing the length of stay in ICU. The secondary outcomes will be cross-sectional area and muscle thickness of the rectus femoris and biceps brachii, change in muscle strength, functional status, incidence of ICU-acquiredweakness (ICUAW), days with mechanical ventilation, and mortality
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