The association of early passive mobilization with intracranial pressure in the adult intensive care unit: A prospective, cohort study.
Ahmet Oğuzhan Küçük, Neslihan Hatınoğlu, Umut Apaydin and 2 others
PMID 39449552WHAT IT FOUND
Passive range of motion exercises did not increase intracranial pressure or destabilize heart rate and blood pressure in twenty mechanically ventilated, sedated ICU patients.
The findings suggest routine passive mobilization is safe for these selected patients, though the study was small.
Key findings
01There was no statistically significant change in optic nerve sheath diameter (a proxy for intracranial pressure) during or after passive range of motion exercises compared to baseline.
02Haemodynamic parameters including heart rate, systolic and diastolic blood pressure, saturation, and respiratory rate showed no statistically significant change during or after the procedure.
03The study included a highly sedated (RASS -2 to -4), mechanically ventilated population with high severity scores (median APACHE II 21) and frequent vasopressor use (65%).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPsWhat it means for RNs
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What it does not show
The sample size was very small (20 patients), limiting the generalizability of the findings. The study used optic nerve sheath diameter (ONSD) as a surrogate for intracranial pressure rather than direct invasive monitoring, which is the gold standard. Patients were deeply sedated (RASS -2 to -4) and mechanically ventilated, so results may not apply to more alert or less critically ill patients. The cohort had heterogeneous diagnoses (respiratory, cardiac, sepsis, etc.), making it difficult to isolate effects in specific subgroups. The study excluded patients with acute neurological events, so it does not address safety in patients with known elevated intracranial pressure.
Declared interests
The author declares no conflicts of interest.
The easy way to misread this
Do not interpret these results as evidence that passive mobilization is safe for patients with acute neurological injuries or known elevated intracranial pressure. The study specifically excluded patients with acute neurological events, and the sample was too small to detect rare adverse events or apply findings to broader ICU populations.