{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T13:17:25Z","timestamp":1784207845618,"version":"3.55.0"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,2,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Bed rest and immobility in patients on mechanical ventilation or in an intensive care unit (ICU) have detrimental effects. Studies in medical ICUs show that early mobilization is safe, does not increase costs, and can be associated with decreased ICU and hospital lengths of stay (LOS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The purpose of this study was to assess the effects of an early mobilization protocol on complication rates, ventilator days, and ICU and hospital LOS for patients admitted to a trauma and burn ICU (TBICU).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>This was a retrospective cohort study of an interdisciplinary quality-improvement program.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Pre\u2013 and post\u2013early mobility program patient data from the trauma registry for 2,176 patients admitted to the TBICU between May 2008 and April 2010 were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No adverse events were reported related to the early mobility program. After adjusting for age and injury severity, there was a decrease in airway, pulmonary, and vascular complications (including pneumonia and deep vein thrombosis) post\u2013early mobility program. Ventilator days and TBICU and hospital lengths of stay were not significantly decreased.<\/jats:p><\/jats:sec><jats:sec><jats:title>Limitations<\/jats:title><jats:p>Using a historical control group, there was no way to account for other changes in patient care that may have occurred between the 2 periods that could have affected patient outcomes. The dose of physical activity both before and after the early mobility program were not specifically assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Early mobilization of patients in a TBICU was safe and effective. Medical, nursing, and physical therapy staff, as well as hospital administrators, have embraced the new culture of early mobilization in the ICU.<\/jats:p><\/jats:sec>","DOI":"10.2522\/ptj.20110417","type":"journal-article","created":{"date-parts":[[2012,8,10]],"date-time":"2012-08-10T05:42:07Z","timestamp":1344577327000},"page":"186-196","source":"Crossref","is-referenced-by-count":148,"title":["Effectiveness of an Early Mobilization Protocol in a Trauma and Burns Intensive Care Unit: A Retrospective Cohort Study"],"prefix":"10.1093","volume":"93","author":[{"given":"Diane E.","family":"Clark","sequence":"first","affiliation":[{"name":"D.E. Clark, PT, DScPT, Department of Physical Therapy, School of Health Professions, University of Alabama at Birmingham, 1530 3rd Ave S, Birmingham, AL 35294-1212 (USA), and Acute Care Physical Therapy Department, UAB Hospital, Birmingham, Alabama."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D.","family":"Lowman","sequence":"additional","affiliation":[{"name":"J.D. Lowman, PT, PhD, CCS, Department of Physical Therapy, School of Health Professions, University of Alabama at Birmingham."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell L.","family":"Griffin","sequence":"additional","affiliation":[{"name":"R.L. Griffin, PhD, Department of Surgery, School of Medicine, University of Alabama at Birmingham."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen M.","family":"Matthews","sequence":"additional","affiliation":[{"name":"H.M. Matthews, Acute Care Physical Therapy Department, UAB Hospital."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald A.","family":"Reiff","sequence":"additional","affiliation":[{"name":"D.A. Reiff, MD, Department of Surgery, School of Medicine, University of Alabama at Birmingham."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","reference":[{"key":"2019123011380191300_B1","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1097\/01.CCM.0000251130.69568.87","article-title":"Early activity is feasible and safe in respiratory failure patients","volume":"35","author":"Bailey","year":"2007","journal-title":"Crit Care Med"},{"key":"2019123011380191300_B2","doi-asserted-by":"crossref","first-page":"1685","DOI":"10.1001\/jama.300.14.1685","article-title":"Mobilizing patients in the intensive care unit: improving neuromuscular weakness and physical function","volume":"300","author":"Needham","year":"2008","journal-title":"JAMA"},{"key":"2019123011380191300_B3","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1016\/j.apmr.2010.01.002","article-title":"Early physical medicine and rehabilitation for patients with acute respiratory failure: a quality improvement project","volume":"91","author":"Needham","year":"2010","journal-title":"Arch Phys Med Rehabil"},{"key":"2019123011380191300_B4","first-page":"400","article-title":"The feasibility of early physical activity in intensive care unit patients: a prospective observational one-center study","volume":"55","author":"Bourdin","year":"2010","journal-title":"Respir Care"},{"key":"2019123011380191300_B5","doi-asserted-by":"crossref","first-page":"2238","DOI":"10.1097\/CCM.0b013e318180b90e","article-title":"Early intensive care unit mobility therapy in the treatment of acute respiratory failure","volume":"36","author":"Morris","year":"2008","journal-title":"Crit Care Med"},{"key":"2019123011380191300_B6","doi-asserted-by":"crossref","first-page":"2089","DOI":"10.1097\/CCM.0b013e3181f270c3","article-title":"Feasibility of physical and occupational therapy beginning from initiation of mechanical ventilation","volume":"38","author":"Pohlman","year":"2010","journal-title":"Crit Care Med"},{"key":"2019123011380191300_B7","doi-asserted-by":"crossref","first-page":"1874","DOI":"10.1016\/S0140-6736(09)60658-9","article-title":"Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial","volume":"373","author":"Schweickert","year":"2009","journal-title":"Lancet"},{"key":"2019123011380191300_B8","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1177\/000313481007600824","article-title":"Surgical intensive care unit mobility is increased after institution of a computerized mobility order set and intensive care unit mobility protocol: a prospective cohort analysis","volume":"76","author":"Hildreth","year":"2010","journal-title":"Am Surg"},{"key":"2019123011380191300_B9","doi-asserted-by":"crossref","first-page":"S442","DOI":"10.1097\/CCM.0b013e3181b6f9c0","article-title":"Clinical trials of early mobilization of critically ill patients","volume":"37","author":"Kress","year":"2009","journal-title":"Crit Care Med"},{"key":"2019123011380191300_B10","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1055\/s-0029-1242635","article-title":"Rehabilitation in the intensive care unit","volume":"30","author":"Rochester","year":"2009","journal-title":"Semin Respir Crit Care Med"},{"key":"2019123011380191300_B11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ccc.2006.11.003","article-title":"Moving our critically ill patients: mobility barriers and benefits","volume":"23","author":"Morris","year":"2007","journal-title":"Crit Care Clin"},{"key":"2019123011380191300_B12","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.ccc.2006.11.010","article-title":"Early intensive care unit mobility: future directions","volume":"23","author":"Morris","year":"2007","journal-title":"Crit Care Clin"},{"key":"2019123011380191300_B13","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1177\/0269215507072084","article-title":"Return to work after major trauma","volume":"21","author":"Holtslag","year":"2007","journal-title":"Clin Rehabil"},{"key":"2019123011380191300_B14","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1097\/01.ta.0000224124.47646.62","article-title":"Determinants of long-term functional consequences after major trauma","volume":"62","author":"Holtslag","year":"2007","journal-title":"J Trauma"},{"key":"2019123011380191300_B15","doi-asserted-by":"crossref","first-page":"1328","DOI":"10.1097\/01.ta.0000197621.94561.4e","article-title":"Determinants of quality of life and role-related disability after injury: impact of acute psychological responses","volume":"59","author":"O'Donnell","year":"2005","journal-title":"J Trauma"},{"key":"2019123011380191300_B16","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/1757-7241-19-22","article-title":"Health related quality of life in trauma patients. Data from a one-year follow up study compared with the general population","volume":"19","author":"Toien","year":"2011","journal-title":"Scand J Trauma Resusc Emerg Med"},{"key":"2019123011380191300_B17","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1111\/j.1399-6576.2007.01533.x","article-title":"Quality of life 2\u20137 years after major trauma","volume":"52","author":"Ulvik","year":"2008","journal-title":"Acta Anaesthesiol Scand"},{"key":"2019123011380191300_B18","unstructured":"UAB Office of Planning and Analysis. Facts & Figures 2008\u20132009. Available at: http:\/\/www.uab.edu\/opa\/images\/factbook\/ff0809.pdf. Accessed April 18, 1012."},{"key":"2019123011380191300_B19","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.1016\/j.suc.2006.07.004","article-title":"Critical care issues in the early management of severe trauma","volume":"86","author":"Garcia","year":"2006","journal-title":"Surg Clin North Am"},{"key":"2019123011380191300_B20","unstructured":"American College of Surgeons. National Trauma Data Bank Report 2008. Available at: http:\/\/www.facs.org\/trauma\/ntdb\/docpub.html. Accessed November 12, 2011."},{"key":"2019123011380191300_B21","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1016\/S0025-6196(11)61194-4","article-title":"Basics of quality improvement in health care","volume":"82","author":"Varkey","year":"2007","journal-title":"Mayo Clin Proc"},{"key":"2019123011380191300_B22","unstructured":"Gorenflo G , MoranJW. The ABCs of PDCA. April 2010. Available at: http:\/\/www.phf.org\/resourcestools\/Pages\/The_ABCs_of_PDCA.aspx. Accessed November 11, 2011."},{"key":"2019123011380191300_B23","doi-asserted-by":"crossref","first-page":"212","DOI":"10.4037\/ajcc2009598","article-title":"Early mobility and walking program for patients in intensive care units: creating a standard of care","volume":"18","author":"Perme","year":"2009","journal-title":"Am J Crit Care"},{"key":"2019123011380191300_B24","doi-asserted-by":"crossref","first-page":"S11","DOI":"10.4037\/ccn2010118","article-title":"Safety and barriers to care","volume":"30","author":"Ross","year":"2010","journal-title":"Crit Care Nurs"},{"key":"2019123011380191300_B25","first-page":"10","article-title":"Managing the patient on mechanical ventilation in ICU: Early mobility and walking program","volume":"17","author":"Perme","year":"2008","journal-title":"Acute Care Perspectives"},{"key":"2019123011380191300_B26","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1097\/01592394-201001020-00010","article-title":"Early mobilization in trauma ICU decreases length of stay and complications","volume":"1","author":"Clark","year":"2010","journal-title":"J Acute Care Phys Ther"},{"key":"2019123011380191300_B27","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.ccc.2006.11.011","article-title":"Mobilizing the patient in the intensive care unit: the role of early tracheotomy","volume":"23","author":"Clum","year":"2007","journal-title":"Crit Care Clin"},{"key":"2019123011380191300_B28","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.ccc.2006.11.004","article-title":"Transforming ICU culture to facilitate early mobility","volume":"23","author":"Hopkins","year":"2007","journal-title":"Crit Care Clin"},{"key":"2019123011380191300_B29","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1097\/CCM.0b013e318168f986","article-title":"Patients with respiratory failure increase ambulation after transfer to an intensive care unit where early activity is a priority","volume":"36","author":"Thomsen","year":"2008","journal-title":"Crit Care Med"},{"key":"2019123011380191300_B30","doi-asserted-by":"crossref","first-page":"S429","DOI":"10.1097\/CCM.0b013e3181b6e227","article-title":"Culture of early mobility in mechanically ventilated patients","volume":"37","author":"Bailey","year":"2009","journal-title":"Crit Care Med"},{"key":"2019123011380191300_B31","doi-asserted-by":"crossref","first-page":"2499","DOI":"10.1097\/CCM.0b013e3181a38937","article-title":"Early exercise in critically ill patients enhances short-term functional recovery","volume":"37","author":"Burtin","year":"2009","journal-title":"Crit Care Med"},{"key":"2019123011380191300_B32","first-page":"277","article-title":"Strategies for promoting early activity in critically ill mechanically ventilated patients","volume":"20","author":"Hopkins","year":"2009","journal-title":"AACN Adv Crit Care"},{"key":"2019123011380191300_B33","doi-asserted-by":"crossref","first-page":"1824","DOI":"10.1016\/S0140-6736(09)60866-7","article-title":"Physical and occupational therapy during sedation stops","volume":"373","author":"Jakob","year":"2009","journal-title":"Lancet"},{"key":"2019123011380191300_B34","first-page":"290","article-title":"Should we mobilise critically ill patients? A review","volume":"11","author":"O'Connor","year":"2009","journal-title":"Crit Care Resusc"},{"key":"2019123011380191300_B35","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1186\/cc7885","article-title":"Bench-to-bedside review: mobilizing patients in the intensive care unit\u2013from pathophysiology to clinical trials","volume":"13","author":"Truong","year":"2009","journal-title":"Crit Care"},{"key":"2019123011380191300_B36","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1310\/tsr1704-271","article-title":"Rehabilitation quality improvement in an intensive care unit setting: implementation of a quality improvement model","volume":"17","author":"Needham","year":"2010","journal-title":"Top Stroke Rehabil"},{"key":"2019123011380191300_B37","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/j.jcrc.2009.10.010","article-title":"Rehabilitation therapy and outcomes in acute respiratory failure: an observational pilot project","volume":"25","author":"Zanni","year":"2010","journal-title":"J Crit Care"},{"key":"2019123011380191300_B38","first-page":"2","article-title":"Early mobility and walking for patients with femoral arterial catheters in intensive care unit: a case series","author":"Perme","year":"2011","journal-title":"J Acute Care Phys Ther"},{"key":"2019123011380191300_B39","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.pmrj.2010.12.022","article-title":"Early mobilization in critically ill patients: patients' mobilization level depends on health care provider's profession","volume":"3","author":"Garzon-Serrano","year":"2011","journal-title":"PM&R"},{"key":"2019123011380191300_B40","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/S0031-9406(10)61093-0","article-title":"Oxygen Transport: A physiologically-based conceptual framework for the practice of cardiopulmonary physiotherapy","volume":"80","author":"Dean","year":"1994","journal-title":"Physiotherapy"},{"key":"2019123011380191300_B41","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1080\/00325481.1989.11704496","article-title":"Managing smoke inhalation injuries","volume":"86","author":"Desai","year":"1989","journal-title":"Postgrad Med"},{"key":"2019123011380191300_B42","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.cps.2009.05.013","article-title":"Airway management and smoke inhalation injury in the burn patient","volume":"36","author":"Cancio","year":"2009","journal-title":"Clin Plast Surg"},{"key":"2019123011380191300_B43","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.1001\/archinte.161.10.1268","article-title":"Deep vein thrombosis and its prevention in critically ill adults","volume":"161","author":"Attia","year":"2001","journal-title":"Arch Intern Med"},{"key":"2019123011380191300_B44","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1097\/00003465-200603000-00001","article-title":"Deep vein thrombosis in hospitalized patients: a review of evidence-based guidelines for prevention","volume":"25","author":"Kehl-Pruett","year":"2006","journal-title":"Dimens Crit Care Nurs"},{"key":"2019123011380191300_B45","doi-asserted-by":"crossref","first-page":"1682","DOI":"10.1016\/j.resuscitation.2010.06.026","article-title":"Traumatic pericardial effusion: impact of diagnostic and surgical approaches","volume":"81","author":"Huang","year":"2010","journal-title":"Resuscitation"}],"container-title":["Physical Therapy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ptj\/article-pdf\/93\/2\/186\/31640399\/ptj0186.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ptj\/article-pdf\/93\/2\/186\/31640399\/ptj0186.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,26]],"date-time":"2022-01-26T03:46:07Z","timestamp":1643168767000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ptj\/article\/93\/2\/186\/2735509"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,2,1]]},"references-count":45,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2013,2,1]]}},"URL":"https:\/\/doi.org\/10.2522\/ptj.20110417","relation":{},"ISSN":["0031-9023","1538-6724"],"issn-type":[{"value":"0031-9023","type":"print"},{"value":"1538-6724","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,2,1]]}}}