{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:13:04Z","timestamp":1790802784952,"version":"4.1.0"},"reference-count":34,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2012,6]]},"abstract":"<jats:sec>\n                    <jats:title>Object<\/jats:title>\n                    <jats:p>The detrimental effects of immobility on intensive care unit (ICU) patients are well established. Limited studies involving medical ICUs have demonstrated the safety and benefit of mobility protocols. Currently no study has investigated the role of increased mobility in the neurointensive care unit population. This study was a single-institution prospective intervention trial to investigate the effectiveness of increased mobility among neurointensive care unit patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All patients admitted to the neurointensive care unit of a tertiary care center over a 16-month period (April 2010 through July 2011) were evaluated. The study consisted of a 10-month (8025 patient days) preintervention observation period followed by a 6-month (4455 patient days) postintervention period. The intervention was a comprehensive mobility initiative utilizing the Progressive Upright Mobility Protocol (PUMP) Plus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Implementation of the PUMP Plus increased mobility among neurointensive care unit patients by 300% (p &lt; 0.0001). Initiation of this protocol also correlated with a reduction in neurointensive care unit length of stay (LOS; p &lt; 0.004), hospital LOS (p &lt; 0.004), hospital-acquired infections (p &lt; 0.05), and ventilator-associated pneumonias (p &lt; 0.001), and decreased the number of patient days in restraints (p &lt; 0.05). Additionally, increased mobility did not lead to increases in adverse events as measured by falls or inadvertent line disconnections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among neurointensive care unit patients, increased mobility can be achieved quickly and safely with associated reductions in LOS and hospital-acquired infections using the PUMP Plus program.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2012.2.jns111881","type":"journal-article","created":{"date-parts":[[2012,3,30]],"date-time":"2012-03-30T10:13:16Z","timestamp":1333102396000},"page":"1379-1388","source":"Crossref","is-referenced-by-count":132,"title":["The effect of increased mobility on morbidity in the neurointensive care unit"],"prefix":"10.3171","volume":"116","author":[{"given":"W. Lee","family":"Titsworth","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannette","family":"Hester","sequence":"additional","affiliation":[{"name":"Nursing and Patient Services, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Correia","sequence":"additional","affiliation":[{"name":"Nursing and Patient Services, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Reed","sequence":"additional","affiliation":[{"name":"Nursing and Patient Services, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peggy","family":"Guin","sequence":"additional","affiliation":[{"name":"Nursing and Patient Services, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lennox","family":"Archibald","sequence":"additional","affiliation":[{"name":"Infection Prevention and Control, Shands Hospital at the University of Florida, Gainesville, Florida; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Joseph","family":"Layon","sequence":"additional","affiliation":[{"name":"System Director, Critical Care Medicine, Geisinger Health System, Danville, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Mocco","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns111881","series-title":"Progressive Mobility Guidelines for Critically Ill Patients","author":"Ahrens"},{"key":"b2-jns111881","series-title":"Lancet","first-page":"1229","article-title":"Bed rest: a potentially harmful treatment needing more careful evaluation","volume":"354","author":"Allen","year":"1999"},{"key":"b3-jns111881","series-title":"JAMA","first-page":"865","article-title":"Pressure ulcer risk factors among hospitalized patients with activity limitation","volume":"273","author":"Allman","year":"1995"},{"key":"b4-jns111881","series-title":"Crit Care Med","first-page":"139","article-title":"Early activity is feasible and safe in respiratory failure patients","volume":"35","author":"Bailey","year":"2007"},{"key":"b5-jns111881","series-title":"Intensive Crit Care Nurs","first-page":"146","article-title":"The development of a pressure area scoring system for critically ill patients: a pilot study","volume":"9","author":"Batson","year":"1993"},{"key":"b6-jns111881","series-title":"Rheum Dis Clin North Am","first-page":"791","article-title":"Disabling effects of inactivity and importance of physical conditioning. 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critical illness: recommendations of the European Respiratory Society and European Society of Intensive Care Medicine Task Force on Physiotherapy for Critically Ill Patients","volume":"34","author":"Gosselink","year":"2008"},{"key":"b17-jns111881","series-title":"Crit Care Med","first-page":"2163","article-title":"Health-related quality of life before, 1 month after, and 9 months after intensive care in medical cardiovascular and pulmonary patients","volume":"31","author":"Graf","year":"2003"},{"key":"b18-jns111881","series-title":"N Engl J Med","first-page":"683","article-title":"One-year outcomes in survivors of the acute respiratory distress syndrome","volume":"348","author":"Herridge","year":"2003"},{"key":"b19-jns111881","series-title":"Am J Infect Control","first-page":"309","article-title":"CDC\/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care 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