Effectiveness of Progressive Mobilization on Functional and Hemodynamic Status in Bedrest Patients in the ICU: Randomized Controlled Trial

Dina Aryanti(1*), Dudut Tanjung(2), Asrizal Asrizal(3),

(1) Fakultas Keperawatan, Universitas Sumatera Utara
(2) universitas sumatera utara
(3) Universitas Sumatera Utara
(*) Corresponding Author
DOI: https://doi.org/10.23917/bik.v15i2.17937

Abstract

Patients with health problems who undergo bed rest for a long time can experience various health problems. Problems that can be felt by patients on functional and hemodynamic status. This study aims to identify the effectiveness of progressive mobilization on functional status and hemodynamics in bed rest patients. The research method used a qualitative design with a randomized controlled trial method. The number of samples in this study was 70 people for each group. The sample in this study was taken by simple random sampling method with a total of 70 people in the control group and 70 people in the intervention group. Bivariate statistical test used Friedman and Mann Whitney test, while multivariate test used logistic regression. The results of this study showed that there was a significant effect of progressive mobilization on functional and hemodynamic status (p<0.05). The conclusion of this study is that progressive mobilization is effective on the functional and hemodynamic status of the patient so that it can be applied in the ICU of the hospital as a nursing intervention


Keywords

Bedrest, Hemodynamic; Progressive Mobilization; Functional status

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References

Amidei, C. (2012). Measurement of physiologic responses to mobilisation in critically ill adults. Intensive and Critical Care Nursing, 28(2), 58-72. DOI: 10.1016/j.iccn.2011.09.002

Bassett, R. D., Vollman, K. M., Brandwene, L., & Murray, T. (2012). Integrating a multidisciplinary mobility programme into intensive care practice (IMMPTP): a multicentre collaborative. Intensive and Critical Care Nursing, 28(2), 88-97. DOI: 10.1016/j.iccn.2011.12.001

Bailey, P., Thomsen, G. E., Spuhler, V. J., Blair, R., Jewkes, J., Bezdjian, L., ... & Hopkins, R. O. (2007). Early activity is feasible and safe in respiratory failure patients. Critical care medicine, 35(1), 139-145. DOI: 10.1097/01.CCM.0000251130.69568.87

Burtin C1, Clerckx B, Robbeets C, Ferdinande P, Langer D, Troosters T, Hermans G, Decramer M, Gosselink R. Early exercise in critically ill patients enhances short-term functional recovery N Engl J Med. 2009 Mar 26;360(13):1329-35. doi: 10.1056/NEJMct0804632.

Zorowitz, R.D. (2016). ICU-Acquired Weakness: A Rehabilitation Perspective of Diagnosis, Treatment, and Functional Management. Chest. 2016 Oct;150(4):966-971. doi: 10.1016/j.chest.2016.06.006

Hodgson C, et al. Expert consensus and recommendations on safety criteria for active mobilization of mechanically ventilated critically ill adults. Crit Care. 2014;18(5):658. DOI: 10.1186/s13054-014-0658-y

Sugiarto, N., & Darmawan, E. S. (2014). The Factors affecting the length of stay in the Intensive Care Units of Pertamina Central Hospital in Indonesia related to healthcare associated Infections. Journal of US-China Medical Science, 11, 195-204. DOI:10.17265/1548-6648/2014.04.004

Parry, S.M., & Puthucheary, Z.A. (2015). The impact of extended bed rest on the musculoskeletal system in the critical care environment. Extrem Physiol Med 4, 16 https://doi.org/10.1186/s13728-015-0036-7

Potter Patricia, A., & Perry Anne, G. (2010). Nursing Fundamental 7th edition (Fundamental Keperawatan Edisi 7) Buku 1. Jakarta: Salemba Medika.

Johnson, K.L & Bruch, G. (2007). Neuromuscular Complications In The Intensive Care Unit: Critical Illness Polyneuromyopathy. AACN. DOI: 10.1097/01.AACN.0000269260.99169.70

Dunn, H., Quinn, L., Corbridge, S. J., Eldeirawi, K., Kapella, M., & Collins, E. G. (2017). Mobilization of prolonged mechanical ventilation patients: An integrative review. Heart & Lung, 46(4), 221-233. DOI: 10.1016/j.hrtlng.2017.04.033

Rebel, A., Marzano, V., Green, M., Johnston, K., Wang, J., Neeman, T., ... & Bissett, B. (2018). Mobilisation is feasible in intensive care patients receiving vasoactive therapy: An observational study. Australian Critical Care. DOI: 10.1016/j.aucc.2018.03.004

Chen, S., Su, C. L., Wu, Y. T., Wang, L. Y., Wu, C. P., Wu, H. D., & Chiang, L. L. (2011). Physical training is beneficial to functional status and survival in patients with prolonged mechanical ventilation. Journal of the Formosan Medical Association, 110(9), 572-579. DOI: 10.1016/j.jfma.2011.07.008

Vasilevskis, E. E., Ely, E. W., Speroff, T., Pun, B. T., Boehm, L., & Dittus, R. S. (2010). Reducing iatrogenic risks: ICU-acquired delirium and weakness—crossing the quality chasm. Chest, 138(5), 1224-1233. DOI: 10.1378/chest.10-0466

Morris, P. E. (2007). Moving our critically ill patients: mobility barriers and benefits. Critical care clinics, 23(1), 1-20. DOI: 10.1016/j.ccc.2006.11.003

Needham, D. M., Korupolu, R., Zanni, J. M., Pradhan, P., Colantuoni, E., Palmer, J. B., ... & Fan, E. (2010). Early physical medicine and rehabilitation for patients with acute respiratory failure: a quality improvement project. Archives of physical medicine and rehabilitation, 91(4), 536-542. DOI: 10.1016/j.apmr.2010.01.002

Hassan, A., Rajamani, A., & Fitzsimons, F. (2017). The MOVIN’project (Mobilisation Of Ventilated Intensive care patients at Nepean): A quality improvement project based on the principles of knowledge translation to promote nurse-led mobilisation of critically ill ventilated patients. Intensive and Critical Care Nursing, 42, 36-43. DOI: 10.1016/j.iccn.2017.04.011

Needham D. (2012). Improving long-term outcomes after discharge from intensive care unit: report from a stakeholders’ conference. Crit Care Med.;40:502–9. DOI: 10.1097/CCM.0b013e318232da75

Ningtyas, N. W. R., Pujiastuti, R. S. E., & Indriyawati, N. (2017). Effectiveness Of Progressive Mobilization Level I and II On Hemodynamic Status and Decubitus Ulcer Risk in Critically Ill patients. Belitung Nursing Journal, 3(6), 662-669. https://doi.org/10.33546/bnj.289

Deaton, A., & Cartwright, N. (2018). Understanding and misunderstanding randomized controlled trials. Social Science & Medicine, 210, 2-21. https://doi.org/10.1016/j.socscimed.2017.12.005

Sastroasmoro, S., & Ismael, S. (2011). Basic Metodology of Clinical Research (Dasar-Dasar Metodologi Penelitian Klinis). Jakarta: Sagung Seto, 372.

Schweickert, W. D., Pohlman, M. C., Pohlman, A. S., Nigos, C., Pawlik, A. J., Esbrook, C. L., ... & Schmidt, G. A. (2009). Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet (London, England), 373(9678), 1874-1882. DOI: 10.1016/S0140-6736(09)60658-9

Casaburi R, ZuWallack R. (2009). Pulmonary rehabilitation for management of chronic obstructive pulmonary disease. N Engl J Med 2009; 360(13):1329-1335. DOI: 10.1056/NEJMct0804632

Vollman, K. M. (2010). Introduction to progressive mobility. Critical Care Nurse, 30(2), S3-S5. 26. DOI: 10.4037/ccn2010803

Johnson, K.L & Bruch, G. (2007). Neuromuscular Complications In The Intensive Care Unit: Critical Illness Polyneuromyopathy. AACN. DOI: 10.1097/01.AACN.0000269260.99169.70

Vollman, K. M. (2013). Advancing Early Mobility in Critical Care : Evidance Based Strategies for Making it Happen. Critical Care Research and Practice.

Cooper, K., & Gosnell, K. (2015). Study Guide for Foundations of Nursing. Elsevier Health Sciences. https://www.elsevierhealth.com.au/catalog/product/view/id/6509/s/study-guide-for-foundations-of-nursing-9780323524537/category/505/

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