title: Early mobilization practice in a single Brazilian intensive care unit.
abstract: OBJECTIVE
  To characterize the provision of early mobilization therapy in critically ill patients in a Brazilian medical intensive care unit (ICU) and to investigate the relationship between physical activity level and clinical outcomes.
  
  
  METHODS
  Intensive care unit and physiotherapy data were collected retrospectively from 275 consecutive patients. Here we report on the subset of patients (n = 120) who were mechanically ventilated during their ICU stay (age, 49 ± 18 years; Simplified Acute Physiology Score 3, 45 [25]).
  
  
  RESULTS
  Median (interquartile range) time of mechanical ventilation and ICU length of stay were 3 (4) and 8 (10) days, respectively. Intensive care unit and 1-year mortality were 31% and 50%, respectively. During the ICU stay, these patients all received respiratory physiotherapy and 90% (n = 108) received mobilization therapy. When intubated and ventilated, mobilization therapy was performed in 76% (n = 92) of the patients with no adverse events. The most common activity was in-bed exercises (55%), and the number of out-of-bed activities (sitting out of bed, standing, or walking) was small (29%) and more prevalent in patients with tracheostomy than with an endotracheal tube (27% × 2%, respectively).
  
  
  CONCLUSIONS
  In our Brazilian ICU, mobilization therapy in critically ill patients was safe and feasible; however, similar to other countries, in-bed exercises were the most prevalent activity. During mechanical ventilation, only a small percentage of activities involved standing or mobilizing away from the bed.
authors.affiliation: Department of Pathology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil. Electronic address: ruy@usp.br.
authors.forename: Ruy Camargo
authors.initials: RC
authors.lastname: Pires-Neto
authors.affiliation: Physiotherapy Service, Instituto Central do Hospital das Clínicas da Faculdade de Medicina de São Paulo, São Paulo, SP, Brazil.
authors.forename: Natalia Pontes
authors.initials: NP
authors.lastname: Lima
authors.affiliation: Physiotherapy Service, Instituto Central do Hospital das Clínicas da Faculdade de Medicina de São Paulo, São Paulo, SP, Brazil.
authors.forename: Gregorio Marques
authors.initials: GM
authors.lastname: Cardim
authors.affiliation: Intensive Care Unit, Clinical Emergency Department, Instituto Central do Hospital das Clínicas da Faculdade de Medicina de São Paulo, São Paulo, SP, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Park
authors.affiliation: Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Parkville, Melbourne, Australia.
authors.forename: Linda
authors.initials: L
authors.lastname: Denehy
mesh_terms: D001938:Brazil; D016638:Critical Illness / Q000534:rehabilitation*; D004434:Early Ambulation / Q000379:methods*; D005081:Exercise Therapy / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D012121:Respiration, Artificial / Q000401:mortality; D012189:Retrospective Studies; D014139:Tracheostomy / Q000379:methods
keywords: Early mobilization; Intensive care unit; Mechanical ventilation; Physiotherapy