Table 2.
Details on study interventions and comparators
| Study | Group | Intervention description | Time to first intervention | Intervention frequency | Intervention duration | Intervention continuation |
|---|---|---|---|---|---|---|
| (i) Systematic early vs. late mobilization | ||||||
| Schweickert et al. [23] | Comparator | Standard care: therapy as ordered by the primary care team | Median 7.4 days (IQR 6.0–10.9) after intubation | N/A | Median 0.0 h (IQR 0.0–0.0) per day during ventilation; 0.2 h (IQR 0.0–0.4) per day without ventilation | Not specified |
| Intervention | Passive range of motion, active range of motion, including bed mobility exercises, activities of daily living and other exercises increasing independency, transfer training (sit to stand, bed to chair, bed to commode), pre-gait exercises, walking | Median 1.5 days (IQR 1.0–2.1) after intubation | Once daily | Median 0.3 h (IQR 0.2–0.5) per day during ventilation; 0.2 h (IQR 0.1–0.3) per day without ventilation | Until hospital discharge | |
| Morris et al. [32] | Comparator | Usual care: weekday physical therapy when ordered by the team | Median 7 days (IQR 4–10) after ICU admission | N/A | N/A | Not specified |
| Intervention | Passive range of motions, physical therapy and progressive resistance exercises | Median 1 days (IQR 0–2) after ICU admission | 3 times daily, 7 days a week | N/A | Until hospital discharge | |
| (ii) Systematic early vs. standard early mobilization | ||||||
| Dantas et al. [24] | Comparator | Conventional physical therapy: passive mobilization of the four limbs five times a week and active-assisted exercises according patients’ improvements | N/A (all participants completed first session within 48 h after admissionb) | 5 times per week | N/A | Until ICU discharge |
| Intervention | Passive stretching and mobilization of the four limbs, positioning of the joints, active assisted exercises of the four limbs, transfer from lying to sitting position, active resistive exercises (against gravity or with weight) of upper limbs, cycle ergometry for lower limbs, transfer from sitting to chair, orthostatic posture, counter-resistance exercise on upper limbs, balance exercises, walking | N/A (all participants completed first session within 48 h after admissionb) | Twice daily | N/A | Until ICU discharge | |
| Denehy et al. [25] | Comparator | Usual care: active bed exercises, sitting out of bed, marching or walking | N/A (enrollment earliest at day 5b) | N/A | N/A | Until hospital discharge |
| Intervention | ICU: arm and leg active and active resistance movements, moving from sitting to standing, marching in place; ward: cardiovascular, progressive resistance strength training and functional exercise; Outpatient: cardiovascular, progressive resistance strength training and functional exercise | N/A (enrollment earliest at day 5) | Once daily while ventilated; twice daily after weaning | 15 min per day in mechanically ventilated; 2 times 15 min per day in weaned; 2 times 30 min per day on ward; 2 times 60 min per week as outpatients for 8 weeks | Beyond hospital stay | |
| Brummel et al. [26]a | Comparator | Usual care: existing ICU mobility protocol | Median 3 days (IQR 2–6) after enrollment | 1–2 times per week | N/A | Not specified |
| Intervention (1) | Physical therapy: passive range of motion, sit at the edge of bed, stand, walk, activities of daily living | Median 1 days (IQR 1–1) after enrollment | Once daily | Median 15 min (IQR 10–20) for physicians & nurses; median 23 min (IQR 16–26) for physiotherapy | Until hospital discharge | |
| Intervention (2) | Cognitive plus physical therapy: same as in physical therapy only + orientation, digit span forward, matric puzzle, real world, digit span reverse, noun list recall, letter-number sequences, pattern recognition | Median 1 days (IQR 1–1) after enrollment, 3 days (IQR 2–4) after ICU admission | Cognitive therapy twice daily; Physical therapy once daily | Cognitive therapy median 20 min; Physical therapy median 15 min for physicians & nurses, median 23 min for physiotherapy | Beyond hospital stay | |
| Dong et al. [27] | Comparator | Control (not further described) | N/A | N/A | N/A | Not specified |
| Intervention | Heading up actively, transferring from supine to sitting position, to sitting at the edge of bed, to sitting in a chair, from sitting to standing, walking bedside | N/A | Twice daily | Tailored depending on the condition of patients | Until hospital discharge | |
| Kayambu et al. [28] | Comparator | Standard care: same as in intervention group but less | N/A (4% completed first session within 48 hoursb) | N/A | N/A | Until ICU discharge |
| Intervention | NMES, passive range of motion, active range of motion, active resistance exercises, sitting up in bed, sitting out of bed, sit to stand, marching on the spot, sitting and standing balance exercises, arm or leg ergometry, tilt table therapy, ambulation | N/A (46% completed first session within 48 hoursb) | 1–2 times daily | 30 min | Until ICU discharge | |
| Dong et al. [29] | Comparator | Therapy only after ICU | N/A | N/A | N/A | Not specified |
| Intervention | Head up, transferring from supine to sitting position, sitting at the edge of bed, sitting in a chair, transferring from sitting to standing, walking along the bed | N/A (100% completed first step in first session) | Twice daily | N/A | Not specified | |
| Hodgson et al. [31] | Comparator | Passive movements, same equipment would have been available | Median 4 days (IQR 3–5)b | Once daily | 5–10 min per day | Until ICU discharge |
| Intervention | Functional activities, active bed exercises, comprising walking as long as possible, standing as long as possible, balance exercises, sitting in or out of bed, sitting balance, sit to stand, rolling | Median 3 days (IQR 2–4) | Once daily | 30–60 min depending on the condition of patients | Until ICU discharge | |
| Schaller et al. [33] | Comparator | In line with the individual centers’ practice guidelines for mobilization and physical therapy | N/A | N/A | N/A | Not specified |
| Intervention | Mobilization according to mobility algorithm: passive range of motion, sitting, standing, ambulation. Interprofessional mobility goal setting and identification of barriers | N/A | Once daily | Tailored depending on the condition of patients | Not specified | |
| Eggmann et al. [34] | Comparator | Usual care as per the European standard physiotherapy and individually tailored but subject to medical prescription | Median 2.2 days (IQR 1.5–2.9) after ICU admission | Once daily, 5 days per week | Median 18 min (IQR 14–21) | Until hospital discharge |
| Intervention | Motor-assisted bed-cycle, resistant training for upper and lower limbs, sitting on bedside, sitting in a chair, standing, walking | Median 2.0 days (IQR 1.4–2.8) after ICU admission | Up to 3 times daily, 7 days per week | Median 25 min (IQR 19.5–27) | Not specified | |
| (iii) Systematic early vs. no mobilization | ||||||
| Fischer et al. [30] | Comparator | Sham NMES | First postoperative day | Twice daily, 7 days per week | 30 min per session (60 min daily) | Until ICU discharge |
| Intervention | NMES | First postoperative day | Twice daily, 7 days per week | 30 min per session (60 min daily) | Until ICU discharge | |
ICU intensive care unit, IQR interquartile range, N/A not available, NMES neuromuscular electro-stimulation
aThree-arm trial
bInformation retrieved via personal communication with authors