Lucas Huebner1, Ines Schroeder2, Eduard Kraft3, Marcus Gutmann3, Johanna Biebl3, Amrei Christin Klamt4, Jana Frey4, Angelika Warmbein5, Ivanka Rathgeber5, Inge Eberl4, Uli Fischer5, Christina Scharf2, Stefan J Schaller6, Michael Zoller2. 1. Klinik für Anästhesiologie, LMU Klinikum, Marchioninistr. 15, 81377, München, Deutschland. lucas.huebner@med.uni-muenchen.de. 2. Klinik für Anästhesiologie, LMU Klinikum, Marchioninistr. 15, 81377, München, Deutschland. 3. Klinik für Orthopädie und Unfallchirurgie, Muskuloskelettales Universitätszentrum München (MUM), Klinikum der Universität München, LMU München, München, Deutschland. 4. Professur für Pflegewissenschaften, Katholische Universität Eichstätt-Ingolstadt, Eichstätt, Deutschland. 5. Klinische Pflegeforschung & Qualitätsmanagement, LMU Klinikum, München, Deutschland. 6. Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.
Abstract
BACKGROUND: Intensive care unit (ICU) acquired weakness is associated with reduced physical function, increased mortality and reduced quality of life, and affects about 43% of survivors of critical illness. Lacking therapeutic options, the prevention of known risk factors and implementation of early mobilization is essential. Robotic assistance devices are increasingly being studied in mobilization. OBJECTIVE: This qualitative review synthesizes the evidence of early mobilization in the ICU and focuses on the advantages of robotic assistance devices. RESULTS: Active mobilization should begin early during critical care. Interventions commencing 72 h after admission to the ICU are considered early. Mobilization interventions during critical care have been shown to be safe and reduce the time on mechanical ventilation in the ICU and the length of delirious episodes. Protocolized early mobilization interventions led to more active mobilization and increased functional independence and mobility at hospital discharge. In rehabilitation after stroke, robot-assisted training increases the chance of regaining independent walking ability, especially in more severely impaired patients, seems to be safe and increases muscle strength and quality of life in small trials. CONCLUSION: Early mobilization improves the outcome of the critically ill. Robotic devices support the gait training after stroke and are the subject of ongoing studies on early mobilization and verticalization in the intensive care setting.
BACKGROUND: Intensive care unit (ICU) acquired weakness is associated with reduced physical function, increased mortality and reduced quality of life, and affects about 43% of survivors of critical illness. Lacking therapeutic options, the prevention of known risk factors and implementation of early mobilization is essential. Robotic assistance devices are increasingly being studied in mobilization. OBJECTIVE: This qualitative review synthesizes the evidence of early mobilization in the ICU and focuses on the advantages of robotic assistance devices. RESULTS: Active mobilization should begin early during critical care. Interventions commencing 72 h after admission to the ICU are considered early. Mobilization interventions during critical care have been shown to be safe and reduce the time on mechanical ventilation in the ICU and the length of delirious episodes. Protocolized early mobilization interventions led to more active mobilization and increased functional independence and mobility at hospital discharge. In rehabilitation after stroke, robot-assisted training increases the chance of regaining independent walking ability, especially in more severely impaired patients, seems to be safe and increases muscle strength and quality of life in small trials. CONCLUSION: Early mobilization improves the outcome of the critically ill. Robotic devices support the gait training after stroke and are the subject of ongoing studies on early mobilization and verticalization in the intensive care setting.
Authors: Elizabeth A Barber; Tori Everard; Anne E Holland; Claire Tipping; Scott J Bradley; Carol L Hodgson Journal: Aust Crit Care Date: 2014-12-19 Impact factor: 2.737
Authors: Eddy Fan; Fern Cheek; Linda Chlan; Rik Gosselink; Nicholas Hart; Margaret S Herridge; Ramona O Hopkins; Catherine L Hough; John P Kress; Nicola Latronico; Marc Moss; Dale M Needham; Mark M Rich; Robert D Stevens; Kevin C Wilson; Chris Winkelman; Doug W Zochodne; Naeem A Ali Journal: Am J Respir Crit Care Med Date: 2014-12-15 Impact factor: 21.405
Authors: Chris Burtin; Beatrix Clerckx; Christophe Robbeets; Patrick Ferdinande; Daniel Langer; Thierry Troosters; Greet Hermans; Marc Decramer; Rik Gosselink Journal: Crit Care Med Date: 2009-09 Impact factor: 7.598
Authors: Th Bein; M Bischoff; U Brückner; K Gebhardt; D Henzler; C Hermes; K Lewandowski; M Max; M Nothacker; Th Staudinger; M Tryba; S Weber-Carstens; H Wrigge Journal: Anaesthesist Date: 2015-12 Impact factor: 1.041
Authors: Julie Bernhardt; Leonid Churilov; Fiona Ellery; Janice Collier; Jan Chamberlain; Peter Langhorne; Richard I Lindley; Marj Moodie; Helen Dewey; Amanda G Thrift; Geoff Donnan Journal: Neurology Date: 2016-02-17 Impact factor: 9.910
Authors: Ralf Baron; Andreas Binder; Rolf Biniek; Stephan Braune; Hartmut Buerkle; Peter Dall; Sueha Demirakca; Rahel Eckardt; Verena Eggers; Ingolf Eichler; Ingo Fietze; Stephan Freys; Andreas Fründ; Lars Garten; Bernhard Gohrbandt; Irene Harth; Wolfgang Hartl; Hans-Jürgen Heppner; Johannes Horter; Ralf Huth; Uwe Janssens; Christine Jungk; Kristin Maria Kaeuper; Paul Kessler; Stefan Kleinschmidt; Matthias Kochanek; Matthias Kumpf; Andreas Meiser; Anika Mueller; Maritta Orth; Christian Putensen; Bernd Roth; Michael Schaefer; Rainhild Schaefers; Peter Schellongowski; Monika Schindler; Reinhard Schmitt; Jens Scholz; Stefan Schroeder; Gerhard Schwarzmann; Claudia Spies; Robert Stingele; Peter Tonner; Uwe Trieschmann; Michael Tryba; Frank Wappler; Christian Waydhas; Bjoern Weiss; Guido Weisshaar Journal: Ger Med Sci Date: 2015-11-12