title: Early mobilization: Why, what for and how?
abstract: Early mobilization strategies in the intensive care unit may result in the prevention and reduction of polyneuromyopathy in the critical patient, improved quality of life, shortened ICU and hospital stay, and lesser mortality during hospitalization. However, it is well known that factors such as the protocol used, the population included in the studies, the timing of the strategy, the severity of the patients and different barriers directly influence the outcomes. This study examines the main protocols described in the literature and their associated results. The main techniques used were kinesitherapy, transfer and locomotion training, as well as neuromuscular electrical stimulation and cycle ergometry. Although two trials and a meta-analysis found no positive results with mobilization, programs that focus on specific populations, such as patients with weakness due to immobility and with preserved neuromuscular excitability can derive more positive effects from such treatment.
authors.affiliation: Rehabilitation Division, Hélvio Auto Hospital, Alagoas, Brazil; University Center Cesmac, Alagoas, Brazil. Electronic address: angelo_r_rocha@yahoo.com.br.
authors.forename: A R
authors.initials: AR
authors.lastname: Miranda Rocha
authors.affiliation: State University of Bahia (UNEB), Bahia, Brazil; Federal University of Bahia (UFBA), Bahia, Brazil.
authors.forename: B P
authors.initials: BP
authors.lastname: Martinez
authors.affiliation: Escola Superior de Ciências da Saúde (ESCS) - Federal District, Brazil.
authors.forename: V Z
authors.initials: VZ
authors.lastname: Maldaner da Silva
authors.affiliation: Postgraduate Program in Rehabilitation and Inclusion, Methodist University Center (IPA), Rio Grande do Sul, Brazil; Postgraduate Program in Biosciences and Rehabilitation, Rio Grande do Sul, Brazil.
authors.forename: L A
authors.initials: LA
authors.lastname: Forgiarini Junior
mesh_terms: D002985:Clinical Protocols; D002986:Clinical Trials as Topic; D000075204:Contraindications, Procedure; D003422:Critical Care / Q000379:methods*; D004434:Early Ambulation / Q000379:methods; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D015201:Meta-Analysis as Topic; D053580:Muscle Strength; D009133:Muscular Atrophy / Q000517:prevention & control; D009468:Neuromuscular Diseases / Q000517:prevention & control; D011788:Quality of Life; D020127:Recovery of Function; D016896:Treatment Outcome
keywords: Early mobilization; Fisioterapia; Intensive care unit; Movilización precoz; Physical therapy; Unidad de cuidados intensivos