Thaís Borgheti de Figueiredo1, Key Fujisaki Utsunomiya2, Amanda Maria Ribas Rosa de Oliveira3, Ruy Camargo Pires-Neto4, Clarice Tanaka5. 1. Department of Physiotherapy, Communication Science and Disorders, Occupational Therapy, University of São Paulo, Rua Cipotânea, 51, Cidade Universitária - CEP 05360-000, São Paulo, SP, Brazil. Electronic address: thaisfigueiredo@usp.br. 2. Department of Physiotherapy, Communication Science and Disorders, Occupational Therapy, University of São Paulo, Rua Cipotânea, 51, Cidade Universitária - CEP 05360-000, São Paulo, SP, Brazil. Electronic address: key.utsu@gmail.com. 3. Burn ICU, Hospital das Clínicas da Faculdade de Medicina, University of São Paulo, Rua Dr. Ovídio Pires de Campos, 225 - Cerqueira César - CEP 05403-010, São Paulo, SP, Brazil. Electronic address: amandaribasrosa@gmail.com. 4. Department of Physiotherapy, Communication Science and Disorders, Occupational Therapy, University of São Paulo, Rua Cipotânea, 51, Cidade Universitária - CEP 05360-000, São Paulo, SP, Brazil. Electronic address: pires.ruy@gmail.com. 5. Department of Physiotherapy, Communication Science and Disorders, Occupational Therapy, University of São Paulo, Rua Cipotânea, 51, Cidade Universitária - CEP 05360-000, São Paulo, SP, Brazil. Electronic address: cltanaka@usp.br.
Abstract
PURPOSE: Patients with burn usually undergo prolonged hospitalization due partially to the treatment of wounds and scars. Although the benefits of early mobilization are well-known in critical care patients, there are a lack of studies reporting mobilization practices and functional status for patients with burn. MATERIALS: Clinical and physiotherapy data were daily collected, including ICU mobility scale (IMS) and reported barriers to mobilization therapy during a one-year period. At hospital discharge, the 6-min walking test (6MWT), Medical Research Council scale (MRCS) and handgrip strength test were applied to evaluate the patients' functionality. RESULTS: Of the 74 patients admitted, 66% were placed on mechanical ventilation (MV). Mobilization therapy was administered in 67.2% of physiotherapy sessions, with passive mobilization being the most prevalent (53.2%) followed by active in-bed exercises (13.6%). Reported barriers for mobilization included hemodynamic instability followed by limited time for assistance. At hospital discharge, the 6MWD was 270(136) meters. A positive correlation was found between handgrip evaluation and 6MWD and a negative correlation with hospital length of stay. CONCLUSIONS: Mobilization therapy of patients with burns in the ICU was characterized by a low mobility level during MV with a low functional status at hospital discharge.
PURPOSE:Patients with burn usually undergo prolonged hospitalization due partially to the treatment of wounds and scars. Although the benefits of early mobilization are well-known in critical care patients, there are a lack of studies reporting mobilization practices and functional status for patients with burn. MATERIALS: Clinical and physiotherapy data were daily collected, including ICU mobility scale (IMS) and reported barriers to mobilization therapy during a one-year period. At hospital discharge, the 6-min walking test (6MWT), Medical Research Council scale (MRCS) and handgrip strength test were applied to evaluate the patients' functionality. RESULTS: Of the 74 patients admitted, 66% were placed on mechanical ventilation (MV). Mobilization therapy was administered in 67.2% of physiotherapy sessions, with passive mobilization being the most prevalent (53.2%) followed by active in-bed exercises (13.6%). Reported barriers for mobilization included hemodynamic instability followed by limited time for assistance. At hospital discharge, the 6MWD was 270(136) meters. A positive correlation was found between handgrip evaluation and 6MWD and a negative correlation with hospital length of stay. CONCLUSIONS: Mobilization therapy of patients with burns in the ICU was characterized by a low mobility level during MV with a low functional status at hospital discharge.
Authors: Tony Chao; Ingrid Parry; Alen Palackic; Soman Sen; Heidi Spratt; Ronald P Mlcak; Jong O Lee; David N Herndon; Steven E Wolf; Ludwik K Branski; Oscar E Suman Journal: Clin Rehabil Date: 2022-04-27 Impact factor: 2.884