{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T19:48:53Z","timestamp":1765828133340,"version":"3.48.0"},"reference-count":18,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T00:00:00Z","timestamp":1626307200000},"content-version":"unspecified","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,3,23]]},"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Several factors contribute to the reduction of the mobility in ICU), such as the use of sedatives, severity, invasive devices, acute clinical instability, lack of resources, the culture of immobility, architectural barriers and the own weakness developed in the ICU. The need for ventilatory support is common in most of patients, and weaning from mechanical ventilation (MV) is an arduous process that requires the commitment of the entire team. Instruments that objectively assess the mobility of patients admitted to the ICU can be useful to identify the existence or not of an association between mobility and prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate the association between the level of mobility and successful extubation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>Prospective cohort study with the beginning of follow-up when the patient completes 24 hours of invasive MV in the ICU and ends on the date the patient\u2019s hospital discharge. Adult patients (\u226518 years old) admitted to the ICU will be included in the first invasive MV event in this hospitalisation. Patients should be independently able to mobilise before current hospital admission. Predictor variables will be collected (age, sex, body mass index, Simplified Acute Physiological Score III (SAPS III), ICU admission type: clinic, elective or emergency surgery postoperative, Charlson Index, number of physiotherapists per patient in each ICU, use of sedation, vasoactive drugs and neuromuscular blocker, ICU mobility scale, time of invasive MV, ICU admission and hospital admission, and outcome. The primary outcome is the result of extubation (success or failure).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>\n                      This study was approved by the Ethics Committee, certificate number 92878218.1.0000.5505. The protocol was registered on the\n                      <jats:italic>Registro Brasileiro de Ensaios Cl\u00ednicos<\/jats:italic>\n                      (ReBEC) (registration number RBR-8k4f68). The results will be published in specialised journals and disseminated to the medical society and the general public.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-040693","type":"journal-article","created":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T12:38:28Z","timestamp":1626352708000},"page":"e040693","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Association of the mobility level of critically ill adult patients with the success of extubation: protocol for a cohort study"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6373-8980","authenticated-orcid":false,"given":"Camila","family":"Pal","sequence":"first","affiliation":[{"name":"Human Movement Sciences, Universidade Federal de S\u00e3o Paulo, Sao Paulo, Brazil"},{"name":"Hospital S\u00edrio-Liban\u00eas, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Speech Therapy and Occupational Therapy, Universidade de S\u00e3o Paulo, Sao Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos Roberto Ribeiro","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Discipline of Pulmonology, Heart Institute (InCor), Hospital das Cl\u00ednicas, Faculty of Medicine, University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Ot\u00e1vio Costa","family":"Auler J\u00fanior","sequence":"additional","affiliation":[{"name":"Surgery Department, Universidade de S\u00e3o Paulo, Sao Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liria Yuri","family":"Yamauchi","sequence":"additional","affiliation":[{"name":"Human Movement Sciences, Universidade Federal de S\u00e3o Paulo, Sao Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,7,15]]},"reference":[{"doi-asserted-by":"publisher","key":"2025121511374139000_11.7.e040693.1","DOI":"10.1186\/cc7885"},{"key":"2025121511374139000_11.7.e040693.2","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1097\/01823246-201223010-00005","article-title":"What are the barriers to mobilizing intensive care patients?","volume":"23","author":"Leditschke","year":"2012","journal-title":"Cardiopulm Phys Ther J"},{"doi-asserted-by":"publisher","key":"2025121511374139000_11.7.e040693.3","DOI":"10.1186\/s13054-0144-0658-y"},{"doi-asserted-by":"publisher","key":"2025121511374139000_11.7.e040693.4","DOI":"10.1186\/s13054-015-0765-4"},{"doi-asserted-by":"publisher","key":"2025121511374139000_11.7.e040693.5","DOI":"10.1097\/CCM.0000000000000040"},{"key":"2025121511374139000_11.7.e040693.6","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1186\/cc11820","article-title":"Clinical review: early patient mobilization in the ICU","volume":"17","author":"Hodgson","year":"2013","journal-title":"Crit Care"},{"doi-asserted-by":"publisher","key":"2025121511374139000_11.7.e040693.7","DOI":"10.1097\/CCM.0000000000001643"},{"doi-asserted-by":"publisher","key":"2025121511374139000_11.7.e040693.8","DOI":"10.1164\/rccm.200712-1829OC"},{"key":"2025121511374139000_11.7.e040693.9","doi-asserted-by":"crossref","first-page":"R229","DOI":"10.1186\/cc13052","article-title":"Clinical predictive value of manual muscle strength testing during critical illness: an observational cohort study","volume":"17","author":"Connolly","year":"2013","journal-title":"Crit Care"},{"doi-asserted-by":"publisher","key":"2025121511374139000_11.7.e040693.10","DOI":"10.1001\/jama.2013.278481"},{"key":"2025121511374139000_11.7.e040693.11","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1016\/j.chest.2016.03.003","article-title":"Early mobilization and rehabilitation of patients who are critically ill","volume":"150","author":"Hashem","year":"2016","journal-title":"Chest"},{"key":"2025121511374139000_11.7.e040693.12","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1007\/s00134-016-4612-0","article-title":"The effects of active mobilisation and rehabilitation in ICU on mortality and function: a systematic review","volume":"43","author":"Tipping","year":"2017","journal-title":"Intensive Care Med"},{"doi-asserted-by":"publisher","key":"2025121511374139000_11.7.e040693.13","DOI":"10.1186\/s13054-015-0829-5"},{"key":"2025121511374139000_11.7.e040693.14","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1513\/AnnalsATS.201510-717OC","article-title":"The ICU mobility scale has construct and predictive validity and is responsive. 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