title: Examining the positive effects of exercise in intubated adults in ICU: a prospective repeated measures clinical study.
abstract: BACKGROUND
  Determining the optimal timing and progression of mobility exercise has the potential to affect functional recovery of critically ill adults. This study compared standard care with care delivered using a mobility protocol. We examined the effects of exercise on vital signs and inflammatory biomarkers and the effects of the nurse-initiated mobility protocol on outcomes.
  
  
  METHODS
  Prospective, repeated measures study with a control (standard care) and intervention (protocol) period.
  
  
  RESULTS
  75 heterogeneous subjects admitted to a Medical or Surgical intensive care unit (ICU) were enrolled. In <5% of exercise periods, there was a concerning alteration in respiratory rate or peripheral oxygen saturation; no other adverse events occurred. Findings suggested the use of a protocol with one 20 minute episode of exercise daily for 2 or more days reduced ICU length of stay. Duration of exercise was linked to increased IL-10, suggesting brief episodes of low intensity exercise positively altered inflammatory dysregulation in this sample.
  
  
  CONCLUSIONS
  A growing body of evidence demonstrates that early, progressive exercise has significant benefits to intubated adults. These results should encourage clinicians to add mobility protocols to the care of ICU adults and lead to future studies to determine optimal "dosing" of exercise in ICU patients.
authors.affiliation: Case Western Reserve University, Frances Payne Bolton School of Nursing, 10900 Euclid Ave, Cleveland, OH 44016, USA. cxw26@case.edu
authors.forename: Chris
authors.initials: C
authors.lastname: Winkelman
authors.forename: Kimberly D
authors.initials: KD
authors.lastname: Johnson
authors.forename: Rana
authors.initials: R
authors.lastname: Hejal
authors.forename: Nahida H
authors.initials: NH
authors.lastname: Gordon
authors.forename: James
authors.initials: J
authors.lastname: Rowbottom
authors.forename: Janis
authors.initials: J
authors.lastname: Daly
authors.forename: Karen
authors.initials: K
authors.lastname: Peereboom
authors.forename: Alan D
authors.initials: AD
authors.lastname: Levine
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002985:Clinical Protocols; D003422:Critical Care / Q000379:methods; D015444:Exercise / Q000523:psychology; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D007362:Intensive Care Units; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D011446:Prospective Studies; D020127:Recovery of Function; D012121:Respiration, Artificial
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators