Physiotherapists' and Physiotherapy Assistants' Perspectives on Using Three Physical Function Measures in the Intensive Care Unit: A Mixed-Methods Study.

We sought to understand physiotherapists' and physiotherapist assistants' perspectives on using three physical function measures in the intensive care unit (ICU) setting: the Activity Measure for Post-Acute Care Inpatient Mobility Short Form, the Johns Hopkins Highest Level of Mobility scale, and the Functional Status Score for the Intensive Care Unit. A six-item questionnaire was developed and administered to physiotherapists and physiotherapist assistants working in adult ICUs at one U.S.

Inter-rater reliability of the Johns Hopkins Highest Level of Mobility Scale (JH-HLM) in the intensive care unit.

Background: The Johns Hopkins Highest Level of Mobility (JH-HLM) scale is used to document the observed mobility of hospitalized patients, including those patients in the intensive care unit (ICU) setting.

Objective: To evaluate the inter-rater reliability of the JH-HLM, completed by physical therapists, across medical, surgical, and neurological adult ICUs at a single large academic hospital.

Methods: The JH-HLM is an ordinal scale for documenting a patient's highest observed level of activity, ranging from lying in bed (score = 1) to ambulating >250 feet (score = 8).

Inter-rater reliability of activity measure for post-acute care '6-Clicks' inpatient mobility short form in the intensive care unit.

Objective: Examine the inter-rater reliability of the activity measure for post-acute care (AM-PAC) inpatient mobility short form (IMSF) when completed by physical therapists (PTs), during routine clinical practice, in a variety of patients with critical illness.

Methods: A prospective observational evaluation at single, large academic hospital in the United States. Patients (n = 76) in surgical, medical and neurological intensive care units (ICUs) were evaluated as part of routine clinical practice using the AM-PAC IMSF administered by eight PTs with at least 6 months of experience using this tool.

Perceived Barriers to Mobility in a Medical ICU: The Patient Mobilization Attitudes & Beliefs Survey for the ICU.

Purpose: Early mobilization in the intensive care unit (ICU) can improve patient outcomes but has perceived barriers to implementation. As part of an ongoing structured quality improvement project to increase mobilization of medical ICU patients by nurses and clinical technicians, we adapted the existing, validated (PMABS) for the ICU setting and evaluated its performance characteristics and results.

Materials And Methods: The 26-item PMABS adapted for the ICU (PMABS-ICU) was administered as an online survey to 163 nurses, clinical technicians, respiratory therapists, attending and fellow physicians, nurse practitioners, and physician assistants in one medical ICU.

Safety and Feasibility of a Protocolized Approach to In-Bed Cycling Exercise in the Intensive Care Unit: Quality Improvement Project.

Background: In-bed, supine cycle ergometry as a part of early rehabilitation in the intensive care unit (ICU) appears to be safe, feasible, and beneficial, but no standardized protocol exists. A standardized protocol may help guide use of cycle ergometry in the ICU.

Objective: This study investigated whether a standardized protocol for in-bed cycling is safe and feasible, results in cycling for a longer duration, and achieves a higher resistance.

An evaluation of learning clinical decision-making for early rehabilitation in the ICU via interactive education with audience response system.

Purpose: Knowledge-related barriers to safely implement early rehabilitation programs in intensive care units (ICUs) may be overcome via targeted education. The purpose of this study was to evaluate the effectiveness of an interactive educational session on short-term knowledge of clinical decision-making for safe rehabilitation of patients in ICUs.

Method: A case-based teaching approach, drawing from published safety recommendations for initiation of rehabilitation in ICUs, was used with a multidisciplinary audience.

Barriers and Strategies for Early Mobilization of Patients in Intensive Care Units.

Early mobilization of patients in the intensive care unit (ICU) is safe, feasible, and beneficial. However, implementation of early mobility as part of routine clinical care can be challenging. The objective of this review is to identify barriers to early mobilization and discuss strategies to overcome such barriers.

Feasibility and Safety of Physical Therapy during Continuous Renal Replacement Therapy in the Intensive Care Unit.

Rationale: Early rehabilitation in an intensive care unit is associated with improved physical functioning and patient outcomes. However, relatively few data have been reported on physical therapy interventions during continuous renal replacement therapy (CRRT) for patients in intensive care units.

Objectives: To evaluate the feasibility and safety of physical therapy interventions, delivered as part of routine clinical care, for patients undergoing CRRT in an intensive care unit.

Feasibility and safety of in-bed cycling for physical rehabilitation in the intensive care unit.

Purpose: The purpose was to evaluate the feasibility and safety of in-bed cycle ergometry as part of routine intensive care unit (ICU) physical therapist (PT) practice.

Materials And Methods: Between July 1, 2010, and December 31, 2011, we prospectively identified all patients admitted to a 16-bed medical ICU receiving cycling by a PT, prospectively collected data on 12 different potential safety events, and retrospectively conducted a chart review to obtain specific details of each cycling session.

Results: Six hundred eighty-eight patients received PT interventions, and 181 (26%) received a total of 541 cycling sessions (median [interquartile range {IQR}] cycling sessions per patient, 2 [1-4]).