Exercise physiologists can provide safe and effective early mobilization in intensive care units (ICUs), according to a study published in the September issue of the American Journal of Critical Care. Claudia DiSabatino Smith, Ph.D., R.N., from University of Texas Health Science Center at Houston, and colleagues used the 12 point Activity Mobilization Evaluation Scale and delirium prevention bundle in three medical-surgical ICUs to track patient mobilization progress with the use of exercise physiologists.
Effectiveness of exercise physiologists
The authors sought to assess the effectiveness of exercise physiologists in promoting; also providing aggressive and progressive early mobilization. Eighty two percent of patients admitted to the ICU during the study period receive the mobilization intervention. The researchers found that most of the 216 include patients achieved a 1.6 point change in activity level via the intervention.
After receiving a minimum of one session with an exercise physiologist; almost all of the study population maintain or increased the level of activity during the three-month study period. Exercise physiology is a relatively new discipline; but is gaining visibility in health care; particularly in the inpatient hospital setting. Exercise physiologists have historically practiced in clinical settings; where they focus on the science of exercise in order to improve patients’ physical capabilities.
The minimum educational preparation for an EP is a bachelor’s degree. Many, however, choose to obtain a master’s degree, which provides further competence in the art and science of human biomechanics. Graduate core curricula include courses related to neuromuscular function, cardiopulmonary function, nutrition, and physiology as they relate to special populations.
Mobility for patients in ICU
Graduate students receive advanced education in kinesiology and biomechanics; which contributes to the EP’s clinical expertise and has been shown to decrease recovery time among patients in inpatient and outpatient settings. The focus of EPs on strength, endurance, exercise, and mobility; which mirrors that of PTs makes them the ideal team members to manage early mobility for patients in the ICU. Yet few studies have explored the role of EPs in the ICU.
“Our study demonstrates that adding exercise physiologists to the interdisciplinary team can drive early, aggressive and progressive ICU patient mobility,” Smith said in a statement. As valuable members of the interdisciplinary team, EPs provide safe and effective early mobilization in the ICU. They not only help patients activate, build, and strengthen muscles that support early mobilization, they also assist patients in maintaining or increasing their activity level throughout their ICU stay.
Exercise physiologists provide much need skills for a population of patients who, despite research; so have remained on bed rest for too long; in the process, EPs support their interprofessional colleagues by reducing the burden place on nurses and PTs. Exercise physiologists play a key role in providing safe and effective early mobilization in the ICU. They are a feasible solution to the immobility dilemma that has frustrated ICU clinicians and hospital staff globally for years.