A First View of the Effect of a Trial of Early Mobilization on the Muscle Strength and Activities of Daily Living in Mechanically Ventilated Patients With COVID-19.
Manabu Nankaku, Ryosuke Ikeguchi, Tomoki Aoyama and 5 others
PMID 35702651WHAT IT FOUND
In 28 mechanically ventilated COVID-19 patients, starting rehabilitation during intubation or after extubation led to similar functional recovery at discharge.
Both groups improved, but most remained functionally dependent. This small study cannot confirm which timing is superior.
Key findings
01Functional recovery was similar whether rehabilitation started during intubation or after extubation.
02Both groups showed significant improvement in daily living abilities, muscle strength, and mobility from admission to discharge.
03Despite improvements, most patients were not functionally independent at discharge.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was small (28 patients analyzed out of 73 enrolled), single-center, and retrospective, which limits the strength of the conclusions. The two groups had significantly different baseline ages (68.5 vs 59.7 years), which is a major confounder that was not adjusted for. Data on multimorbidities, vaccination status, and specific reasons for transfer were not collected. There was no long-term follow-up; outcomes were measured only at hospital discharge. The number of rehabilitation sessions varied widely and was influenced by bed availability for transfer, not just clinical need.
Declared interests
No specific conflicts of interest or funding sources are declared in the provided text.
The easy way to misread this
Do not conclude that early mobilization during intubation is proven to be as effective or safe as post-extubation mobilization. The study was underpowered, non-randomized, and had significant baseline differences in age between groups, meaning the 'similar recovery' finding could easily be due to chance or confounding rather than a true equivalence.