Implementation of the physical function ICU test tool in a resource constrained intensive care unit to promote early mobilisation of critically ill patients- a feasibility study.

The study had no control group, so the improvement in PFIT-s scores cannot be separated from natural recovery, sedation changes, or the passage of time in ICU. Patients also received chest physiotherapy with percussions, vibrations and suctioning, so the study cannot separate the contribution of mobility from that or from usual ICU care. Only 35 patients were recruited at one public hospital, so the results may not apply to other units. The sample was small, and the authors recommended a larger randomised trial before causal conclusions can be drawn. Five patients died during the ICU stay, and only 30 patients had a final PFIT-s measurement. Only 94 of 219 possible exercise sessions were delivered, and mobilisation was often delayed by sedation or cardiovascular instability. The lack of mobile ventilators and a pulse oximeter meant ventilated patients could only march by the bedside. The trial was registered after the study had been carried out. No ICU severity score, such as APACHE, was used to describe how sick the patients were.

Do not read the rise in PFIT-s scores from 5.3 to 7.1 as proof that early mobilisation caused better outcomes. Patients also received chest physiotherapy with percussions, vibrations and suctioning, and this was a single-group cohort with 35 patients and no control, so the contribution of mobilisation cannot be separated.