. 2019 Apr-Jun;31(2):227–239. doi: 10.5935/0103-507X.20190017

Table 3.

Description of the interventions and outcomes

Study	Intervention	Ambulation	Safety of physical therapy	Number of deaths	Effects of physical therapy
Abrams et al.⁽¹¹⁾	In-bed active-assisted exercises, in-bed and bedside sitting, and ambulation	Yes	The intervention caused no complications	12	Improvement in functional capacity^*
Bain et al.⁽¹⁹⁾	Active rehabilitation and ambulation	Yes	NI	0	The length of MV before LT and ECMO support were significantly greater in the IG than in the CG, whereas the length of MV and the length of ICU stay after LT were significantly shorter in the IG than in the CG^*
Carswell et al.⁽²⁰⁾	Bedside sitting, standing, stationary cycling, gait training, and ambulation	Yes	Desaturation and vertigo during mobilization, recovery with rest after the intervention in some patients	NI	NI
Cork et al.⁽²¹⁾	Positioning in bed, hyperinflation with mechanical ventilator, vibration, and aspiration	NI	NI	NI	Favors secretion clearance and pulmonary recovery^*
Dennis et al.⁽²²⁾	Bedside standing exercise and ambulation	Yes	The intervention caused no complications	6	Fewer complications associated with immobility^*
Hermens et al.⁽²³⁾	Training of lower limb muscles (leg press, in-bed cycling, squatting, and bed-to-chair transfer)	NI	Large swelling (n = 1) and obstructive thrombus in the return cannula (n = 1) after femoro-femoral cannulation	5	Improvement in muscle strength in the lower limbs before LT assessed via the MRC (pre-rehabilitation mean, 3.75; and pretransplantation mean, 4.25)^*
Keibun⁽²⁴⁾	Active rehabilitation	NI	NI	8	Improvement in physical function and decreases in the length of hospital and ICU stay^*
Kikukawa et al.⁽²⁵⁾	Respiratory therapy and bedside sitting	NI	The intervention caused no complications	NI	Improvement in respiratory function^*
Ko et al.⁽²⁶⁾	Passive mobilization, active exercises, FES, bedside sitting, standing, stationary gait training, and ambulation	Yes	Three sessions were interrupted because of tachycardia and tachypnea	NI	Improvement in functionality and fitness^*
Kulkarni et al.⁽²⁷⁾	Active rehabilitation and ambulation (800 feet/day)	Yes	The intervention caused no complications	0	NI
Morris et al.⁽²⁸⁾	Passive mobilization, bedside sitting, and active exercises	NI	Desaturation during the intervention, which was managed by increasing the blood flow in ECMO. No complications related to cannulation and normal cardiac response to exercise (increase in heart rate and systolic blood pressure) (n = 1)	NI	NI
Munshi et al.⁽²⁹⁾	Mobilization protocol for patients on ECMO support: passive and active mobilization, bedside sitting, assisted or active standing, stationary gait training, bed-to-chair transfer, corridor ambulation, and treadmill exercise. Patients reached orthostasis	No	The intervention caused no complications	IG: 1 CG 7 (ICU and hospital)	The IG presented lower ICU and hospital mortality and shorter ECMO time^*
Norrenberg et al.⁽³⁰⁾	Mobilization of all joints except for the limb used for ECMO cannulation.	NI	The intervention caused no complications	4	NI
Pastva et al.⁽³¹⁾	FES cycling in quadriceps, hamstrings, and buttocks bilaterally, progressive mobilization	NI	The intervention caused no complications	0	Maintenance of the muscle mass ^† of the rectus femoris (1.5 - 1.6cm) and vastus intermedius (0.95 - 1.15cm) during hospitalization and increase in muscle mass after hospital discharge of more than 2cm in both muscles. Improvement in muscle strength at ICU discharge (MRC sum score of 58/60 and hand grip strength of 60 pounds)^*
Pruijsten et al.⁽³²⁾	Bedside sitting, standing, and ambulation	Yes	The intervention caused no complications	2	NI
Rahimi et al.⁽³³⁾	Therapeutic exercises in the supine position and active cycling in bed and assisted bedside sitting.	NI	The intervention caused no complications	1	NI
Rehder et al.⁽³⁴⁾	Stretching and resisted exercises, sitting, standing, and ambulation (mean distance of 780m)	Yes	The intervention caused no complications	0	Reduction in the MV time after LT and in the total lengths of hospital and ICU stay after LT. None of the IG patients had myopathy after LT, whereas two of the three CG patients presented this complication^*
Salam et al.⁽³⁵⁾	Active exercises with elastic bands, mini-leg press, bedside sitting, and ambulation	Yes	Cannula fracture during ambulation (n = 1)	0	Improvement in fitness before LT^*
Turner et al.⁽³⁶⁾	Resisted exercises, progressive mobilization, gait training, and ambulation	Yes	The intervention caused no complications	0	NI
Wells et al.⁽³⁷⁾	Functional mobilization, sitting, and ambulation	Yes (n = 5)	The intervention caused no complications	NI	NI

IG - intervention group; MV - mechanical ventilation; ECMO - extracorporeal membrane oxygenation; CG - control group; ICU - intensive care unit; LT - lung transplantation; MRC - Medical Research Council; NI - not informed.

Potential benefits of physical therapy as reported in the studies;

^†

Muscle thickness assessed by ultrasonography.