Early Mobilization Dose Reporting in Randomized Clinical Trials With Patients Who Were Mechanically Ventilated: A Scoping Review.
Felipe González-Seguel, Renato Letelier-Bernal
PMID 38519113WHAT IT FOUND
Most ICU mobilization trials report what exercise was done but fail to report how hard it was or how it was adjusted for the patient.
Control groups are described even more poorly than intervention groups, making it hard to know if the 'usual care' was actually comparable.
Key findings
01Intervention groups had adequate dose reporting (86%), but control groups had poor reporting (50%).
02The least reported items were intensity (4%) and individualization (22%) for control groups.
03Only 8 of 23 trials (35%) reported all applicable exercise prescription items for the intervention group, and no control group reported all items.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The review only included RCTs where all patients were on mechanical ventilation, so the findings may not apply to studies including patients who were not ventilated or had mixed populations. The CERT tool was not originally designed for the ICU setting, which may limit how accurately it captures the nuances of critical care mobilization. Some included trials were published before the CERT guidelines existed (pre-2016), which may explain some of the poor reporting rather than a current lack of practice. The review did not analytically compare intervention groups directly against control groups or between different mobilization modalities (e.g., NMES vs. progressive mobility) in terms of outcomes.
Declared interests
None declared in the provided text.
The easy way to misread this
Do not interpret the poor reporting in control groups as evidence that those patients received no mobilization. It is possible they were mobilized but the details were not published, which means the difference between groups might be smaller than the trials suggest.