Abstract
Early mobilization of critically ill patients improves functional recovery, but is often hampered by tubes, drains, monitoring devices and muscular weakness. A mobile treadmill with bodyweight support facilitates early mobilization and may shorten recovery time to independent ambulation as compared to usual care physiotherapy alone. Single center RCT, comparing daily bodyweight supported treadmill training (BWSTT) with usual care physiotherapy, in patients who had been or were mechanically ventilated (≥48 h) with ≥MRC grade 2 quadriceps muscle strength. BWSTT consisted of daily treadmill training in addition to usual care physiotherapy (PT). Primary outcome was time to independent ambulation measured in days, using the Functional Ambulation Categories (FAC-score: 3). Secondary outcomes included hospital length of stay and serious adverse events. The median (IQR) time to independent ambulation was 6 (3 to 9) days in the BWSTT group (n = 19) compared to 11 (7 to 23) days in the usual care group (n = 21, p = 0.063). Hospital length of stay was significantly different in favour of the BWSTT group (p = 0.037). No serious adverse events occurred. BWSTT seems a promising intervention to enhance recovery of ambulation and shorten hospital length of stay of ICU patients, justifying a sufficiently powered multicenter RCT. Dutch Trial Register ID: NTR6943.
Highlights
Introduction and rationaleThere is an increasing amount of evidence stating that early mobilization and activation of patients admitted to the intensive care unit (ICU) improves functional recovery [1,2,3,4,5,6,7]
Kwakman et al Trials (2020) 21:409 (Continued from previous page). This will be the first study comparing the effects of Body weight-supported treadmill training (BWSTT) and conventional physiotherapy for critically ill patients during and after ICU stay
BWSTT has shown to be an effective modality for ambulatory function in different rehabilitation populations with muscle weakness [12,13,14]
Summary
There is an increasing amount of evidence stating that early mobilization and activation of patients admitted to the intensive care unit (ICU) improves functional recovery [1,2,3,4,5,6,7]. Innovation and new technological developments may facilitate ambulation training in patients experiencing these difficulties and may improve the feasibility, safety and effectiveness of early mobilization in the intensive care unit [10, 11]. Mobilization has been proven effective for patients in intensive care units (ICUs) to improve functional recovery. The aim of this study is to assess the effectiveness of weight-supported treadmill training in critically ill patients during and after ICU stay on time to independent functional ambulation
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