Skip to main content

Table 2 Details on study interventions and comparators

From: Systematic early versus late mobilization or standard early mobilization in mechanically ventilated adult ICU patients: systematic review and meta-analysis

Study

Group

Intervention description

Time to first intervention

Intervention frequency

Intervention duration

Intervention continuation

(i) Systematic early vs. late mobilization

Schweickert et al. [23]

Comparator

Standard care: therapy as ordered by the primary care team

Median 7.4 days (IQR 6.0–10.9) after intubation

N/A

Median 0.0 h (IQR 0.0–0.0) per day during ventilation; 0.2 h (IQR 0.0–0.4) per day without ventilation

Not specified

Intervention

Passive range of motion, active range of motion, including bed mobility exercises, activities of daily living and other exercises increasing independency, transfer training (sit to stand, bed to chair, bed to commode), pre-gait exercises, walking

Median 1.5 days (IQR 1.0–2.1) after intubation

Once daily

Median 0.3 h (IQR 0.2–0.5) per day during ventilation; 0.2 h (IQR 0.1–0.3) per day without ventilation

Until hospital discharge

Morris et al. [32]

Comparator

Usual care: weekday physical therapy when ordered by the team

Median 7 days (IQR 4–10) after ICU admission

N/A

N/A

Not specified

Intervention

Passive range of motions, physical therapy and progressive resistance exercises

Median 1 days (IQR 0–2) after ICU admission

3 times daily, 7 days a week

N/A

Until hospital discharge

(ii) Systematic early vs. standard early mobilization

Dantas et al. [24]

Comparator

Conventional physical therapy: passive mobilization of the four limbs five times a week and active-assisted exercises according patients’ improvements

N/A (all participants completed first session within 48 h after admissionb)

5 times per week

N/A

Until ICU discharge

Intervention

Passive stretching and mobilization of the four limbs, positioning of the joints, active assisted exercises of the four limbs, transfer from lying to sitting position, active resistive exercises (against gravity or with weight) of upper limbs, cycle ergometry for lower limbs, transfer from sitting to chair, orthostatic posture, counter-resistance exercise on upper limbs, balance exercises, walking

N/A (all participants completed first session within 48 h after admissionb)

Twice daily

N/A

Until ICU discharge

Denehy et al. [25]

Comparator

Usual care: active bed exercises, sitting out of bed, marching or walking

N/A (enrollment earliest at day 5b)

N/A

N/A

Until hospital discharge

Intervention

ICU: arm and leg active and active resistance movements, moving from sitting to standing, marching in place; ward: cardiovascular, progressive resistance strength training and functional exercise; Outpatient: cardiovascular, progressive resistance strength training and functional exercise

N/A (enrollment earliest at day 5)

Once daily while ventilated; twice daily after weaning

15 min per day in mechanically ventilated; 2 times 15 min per day in weaned; 2 times 30 min per day on ward; 2 times 60 min per week as outpatients for 8 weeks

Beyond hospital stay

Brummel et al. [26]a

Comparator

Usual care: existing ICU mobility protocol

Median 3 days (IQR 2–6) after enrollment

1–2 times per week

N/A

Not specified

Intervention (1)

Physical therapy: passive range of motion, sit at the edge of bed, stand, walk, activities of daily living

Median 1 days (IQR 1–1) after enrollment

Once daily

Median 15 min (IQR 10–20) for physicians & nurses; median 23 min (IQR 16–26) for physiotherapy

Until hospital discharge

Intervention (2)

Cognitive plus physical therapy: same as in physical therapy only + orientation, digit span forward, matric puzzle, real world, digit span reverse, noun list recall, letter-number sequences, pattern recognition

Median 1 days (IQR 1–1) after enrollment, 3 days (IQR 2–4) after ICU admission

Cognitive therapy twice daily; Physical therapy once daily

Cognitive therapy median 20 min; Physical therapy median 15 min for physicians & nurses, median 23 min for physiotherapy

Beyond hospital stay

Dong et al. [27]

Comparator

Control (not further described)

N/A

N/A

N/A

Not specified

Intervention

Heading up actively, transferring from supine to sitting position, to sitting at the edge of bed, to sitting in a chair, from sitting to standing, walking bedside

N/A

Twice daily

Tailored depending on the condition of patients

Until hospital discharge

Kayambu et al. [28]

Comparator

Standard care: same as in intervention group but less

N/A (4% completed first session within 48 hoursb)

N/A

N/A

Until ICU discharge

Intervention

NMES, passive range of motion, active range of motion, active resistance exercises, sitting up in bed, sitting out of bed, sit to stand, marching on the spot, sitting and standing balance exercises, arm or leg ergometry, tilt table therapy, ambulation

N/A (46% completed first session within 48 hoursb)

1–2 times daily

30 min

Until ICU discharge

Dong et al. [29]

Comparator

Therapy only after ICU

N/A

N/A

N/A

Not specified

Intervention

Head up, transferring from supine to sitting position, sitting at the edge of bed, sitting in a chair, transferring from sitting to standing, walking along the bed

N/A (100% completed first step in first session)

Twice daily

N/A

Not specified

Hodgson et al. [31]

Comparator

Passive movements, same equipment would have been available

Median 4 days (IQR 3–5)b

Once daily

5–10 min per day

Until ICU discharge

Intervention

Functional activities, active bed exercises, comprising walking as long as possible, standing as long as possible, balance exercises, sitting in or out of bed, sitting balance, sit to stand, rolling

Median 3 days (IQR 2–4)

Once daily

30–60 min depending on the condition of patients

Until ICU discharge

Schaller et al. [33]

Comparator

In line with the individual centers’ practice guidelines for mobilization and physical therapy

N/A

N/A

N/A

Not specified

Intervention

Mobilization according to mobility algorithm: passive range of motion, sitting, standing, ambulation. Interprofessional mobility goal setting and identification of barriers

N/A

Once daily

Tailored depending on the condition of patients

Not specified

Eggmann et al. [34]

Comparator

Usual care as per the European standard physiotherapy and individually tailored but subject to medical prescription

Median 2.2 days (IQR 1.5–2.9) after ICU admission

Once daily, 5 days per week

Median 18 min (IQR 14–21)

Until hospital discharge

Intervention

Motor-assisted bed-cycle, resistant training for upper and lower limbs, sitting on bedside, sitting in a chair, standing, walking

Median 2.0 days (IQR 1.4–2.8) after ICU admission

Up to 3 times daily, 7 days per week

Median 25 min (IQR 19.5–27)

Not specified

(iii) Systematic early vs. no mobilization

Fischer et al. [30]

Comparator

Sham NMES

First postoperative day

Twice daily, 7 days per week

30 min per session (60 min daily)

Until ICU discharge

Intervention

NMES

First postoperative day

Twice daily, 7 days per week

30 min per session (60 min daily)

Until ICU discharge

  1. ICU intensive care unit, IQR interquartile range, N/A not available, NMES neuromuscular electro-stimulation
  2. aThree-arm trial
  3. bInformation retrieved via personal communication with authors