Being Awake, Upright and Moving as the Basis for Early ICU Physiotherapy
Condition: Critical Illness
MeSH terms: Critical Illness
Study type: Interventional

Summary: 
      Patients who have been admitted to Intensive Care Units (ICU) and are intubated and
      mechanically ventilated for longer than 48 hours have impaired physical, psychological and
      social health and well-being six to twelve months after discharge. The advocacy of intensive
      physiotherapy and mobilization early in the course of critical illness has been established.
      It is of great importance to study the long-term outcomes (physical function and quality of
      life) in intubated and ventilated patients who start exercising and ambulating mobilizing) as
      soon as possible during ICU stay because the most effective mode, intensity or frequency of
      exercise needs to be identified.

      The aim is to study the short- and long-term outcomes of enhanced early physiotherapy and
      upright position in critically ill patients on prolonged invasive ventilation and to develop
      principles to guide physiotherapists in their clinical decision making in the ICU.
    

Detailed description: 
      Mobilization is an intervention prescribed by physiotherapists, for critically ill patients
      in the ICU, to prevent as well as remediate a range of multisystem problems and
      complications. Mobilization which refers to low levels of exercise and progressive position
      changes from being supine to being upright and moving, is both a gravitational and an
      exercise stimulus. Given the hemodynamic status of patients in the ICU can change suddenly,
      physiotherapists gauge the patient's status moment by moment, and change the parameters of an
      intervention accordingly, i.e., the type and level of an intervention, its duration and rest
      periods. The aim of this research is to study the short- and long-term outcomes of enhanced
      early physiotherapy, with mobilization and upright position, in critically ill patients on
      prolonged invasive ventilation. This is a prospective, randomized, single blind trial where
      the intervention permits variation in the physiotherapist's clinical decision making to
      simulate the general practice. This study started in November 2011, data collection and
      intervention will continue until November 2014 with 12 months follow up until november 2015.
    

Intervention name(s): Usual Physiotherapy; Enhanced Physiotherapy
Intervention type(s): Other; Other
Intervention description(s): o Patients will receive the usual physiotherapy treatment in ICU in Iceland from day 5 after intubation, which adheres to international standards of practice, including the potential for no treatment. Usual physiotherapy once daily for 20 minutes.; o Patients will receive the intervention physiotherapy treatment consisting of exercises and a progressive upright positioning and mobilization (20 minutes) twice daily from day 3 (>48 hours) after intubation including the potential for no treatment, if they are stable, even though they are not completely alert, Total treatment time of 40 minutes.
Other intervention name(s): Intensive care unit; Physiotherapy; Long term follow up of ICU survivors; Intensive care unit; Physiotherapy; Upright position; Exercise; Long term follow up of ICU survivors
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Intensive care unit; Physiotherapy; Upright position; Exercise; Long term follow up of ICU survivors