Impact of Early Mobilization Protocols in ICU Patients
Keywords:
Acute Care Physiotherapy, Early Mobilization, Intensive Care Units, Muscle Weakness, Physical Rehabilitation, Recovery, Critical IllnessAbstract
Background:
Prolonged immobilization in intensive care units contributes to rapid muscle weakness, delayed functional recovery, and increased length of stay. Early mobilization has been proposed as an effective acute care physiotherapy strategy to counteract these adverse effects, yet its routine implementation remains inconsistent, particularly in resource-limited settings. Local evidence evaluating the real-world impact of structured early mobilization protocols is limited.
Objective:
To evaluate the impact of implementing an early mobilization protocol on functional and clinical outcomes in ICU patients admitted to a tertiary care hospital in Lahore.
Methods:
A before-and-after study was conducted in the medical and surgical ICUs of a tertiary care hospital in Lahore between March and October 2022. Adult ICU patients admitted for more than 48 hours were included and assessed during a pre-implementation phase of usual care and a post-implementation phase following introduction of a standardized early mobilization protocol. Functional mobility was measured using the ICU Mobility Scale, and muscle strength was assessed using the Medical Research Council sum score. Clinical outcomes included duration of mechanical ventilation and ICU length of stay. Data were analyzed using independent sample t-tests and chi-square tests, assuming normal distribution.
Results:
A total of 120 patients were included, with 60 patients in each study phase. Post-implementation patients demonstrated significantly higher ICU Mobility Scale scores at discharge compared with pre-implementation patients (6.3 vs 4.1, p < 0.001). Mean Medical Research Council scores were higher following protocol implementation (46.2 vs 41.5, p = 0.002), and the incidence of ICU-acquired weakness was reduced (26.7% vs 45.0%, p = 0.03). Duration of mechanical ventilation and ICU length of stay were also significantly shorter in the post-implementation phase.
Conclusion:
Implementation of an early mobilization protocol was associated with improved functional mobility and reduced ICU-acquired weakness, alongside shorter ICU stays. These findings support early mobilization as an essential component of acute care physiotherapy in ICU settings.
Keywords:
Acute Care Physiotherapy, Early Mobilization, Intensive Care Units, Muscle Weakness, Physical Rehabilitation, Recovery, Critical Illness
