Table 2.
Intervention Strategies for early targeted rehabilitation for the critically ill.
| Ramsay Sedation Scale | Stages of exercise progression |
Conditions | Type of Intervention | Recommended Exercise Prescription |
|---|---|---|---|---|
| 6-4 | Stage 1 | Sedated | Passive Range of Motion with stretch reflex to upper and lower limbs | 30 Mins/day |
| Electrical Muscle Stimulation to major muscle groups | 30 Mins/day | |||
| 3-2 | Stage 2 | Inotropic Dependence | Active Range of Motion/Lightly resisted with upper and lower limb | 10 Mins × 2/day |
| Electrical Muscle Stimulation to major muscle groups | 30 Mins/day | |||
| Sitting up in Bed with assistance as tolerated | 30 Mins × 2/day | |||
| Sitting on Edge of Bed | 10 Mins × 2/day | |||
| 2 | Stage 3 | Weight | Active Range of Motion/Lightly resisted with upper and lower limb | 10 Mins × 2/day |
| Bearing | Electrical Muscle Stimulation to major muscle groups | 30 Mins/day | ||
| Muscle Strength | Sitting On Edge of Bed | 10 Mins × 2/day | ||
| Grade < 3 | Sitting Out of Bed with assistance | 60 Mins × 2/day | ||
| Lower Limb Ergometry | 15 Mins × 2/day | |||
| Tilt Table Therapy | 30 Mins/day | |||
| 2 | Stage 4 | Weight | Active Range of Motion/Lightly resisted with upper and lower limb | 10 Mins × 2/day |
| Bearing | Electrical muscle stimulation to major muscle groups | 30 Mins/day | ||
| Muscle Strength | Sitting On Edge of Bed | 10 Mins/day | ||
| Grade > 3 | Sitting Out of Bed | 30 Mins/day | ||
| Upper Limb Ergometry (low level resistance) | 15 Mins/day | |||
| Lower Limb Ergometry | 15 Mins × 2/day | |||
| Ambulation with assistive device and therapist | 30 Mins × 2/day |
The Intervention strategies act as a guide for the execution of early exercises for the patients with sepsis syndromes based on the level of alertness according to the Ramsay Sedation Scale