Early Progressive Out-of-Bed Mobilization After Moderate-to-Severe Traumatic Brain Injury: A Trauma ICU Randomized Controlled Trial

Physical therapists working in trauma, surgical, and neurologic intensive care units, acute care therapists who receive these patients on the floor, and physical therapist assistants who carry out mobility interventions under the direction of a physical therapist. Therapists in inpatient rehabilitation who inherit patients after the ICU stay will also find the functional outcome data relevant.

Physical therapists and physical therapist assistants in acute care, critical care, trauma, and neurologic rehabilitation settings.

Intended audience

Physical Therapy

Level

Intermediate

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

This course reports on a single randomized controlled trial conducted in a trauma intensive care unit at a medical center in Taiwan. Every finding, figure, and conclusion described in the lessons comes from that report.

Yen HC, Chuang HJ, Hsiao WL, Tsai YC, Hsu PM, Chen WS, Han YY. Assessing the impact of early progressive mobilization on moderate-to-severe traumatic brain injury: a randomized controlled trial. Crit Care. 2024;28(1):172. doi:10.1186/s13054-024-04940-0. PMID: 38778416. PMCID: PMC11112875.

Trial registration: ClinicalTrials.gov NCT04810273, registered 13 March 2021.

Scope note

This is an appraisal of one trial, not a technique course and not a practice guideline. The trial was run at a single center with a modest number of patients, and the authors themselves called for larger trials before their protocol is treated as settled.

After completing this course, you will be able to:

1. Describe the two rehabilitation protocols compared in this trauma ICU trial and how they differed in when out-of-bed activity began.
2. State what the trial reported for mobility, functional independence, skeletal muscle index, phase angle, ICU length of stay, and ventilation duration.
3. Explain the limits the authors placed on their own findings, including the single-center setting, the modest number of patients, and the three-month follow-up window.

1. Start Here: How This Course Works
2. Podcast: Getting Patients Out of Bed in the First Week After Severe TBI (about nine minutes)
3. The Question Behind the Trial and the Patients Who Entered It
4. Two Protocols Side by Side: How the Trial Was Run
5. Mobility, Function, Muscle Mass, and Days on the Ventilator
6. Where the Findings Run Out: Limits the Authors Named
7. What a Trauma ICU Team Might Take From This Trial
8. Key Takeaways
9. Post-Test and Course Evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 0.5 contact hours (30 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. This course reports on a single randomized controlled trial conducted in a trauma intensive care unit at a medical center in Taiwan. Every finding, figure, and conclusion described in the lessons comes from that report.
2. Yen HC, Chuang HJ, Hsiao WL, Tsai YC, Hsu PM, Chen WS, Han YY. Assessing the impact of early progressive mobilization on moderate-to-severe traumatic brain injury: a randomized controlled trial. Crit Care. 2024;28(1):172. doi:10.1186/s13054-024-04940-0. PMID: 38778416. PMCID: PMC11112875.
3. Trial registration: ClinicalTrials.gov NCT04810273, registered 13 March 2021.
4. Scope note
5. This is an appraisal of one trial, not a technique course and not a practice guideline. The trial was run at a single center with a modest number of patients, and the authors themselves called for larger trials before their protocol is treated as settled.