High-Intensity Early Mobilization for Patients on Mechanical Ventilation

Physical therapists and physical therapist assistants who treat patients in intensive care units, step-down units, and acute care settings, along with clinicians who receive patients after an ICU stay and want to understand what early mobilization did and did not change.

Physical therapists and physical therapist assistants working in acute care, critical care, and post-acute rehabilitation.

Intended audience

Physical Therapy

Level

Introductory

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 parallel randomized controlled trial conducted in an intensive care unit in China, which compared a high-intensity early mobility program against conventional physiotherapy in adults receiving invasive mechanical ventilation. Patients were screened between November 2020 and February 2023, and the primary outcome was functional status three months after ICU discharge.

Scope of this course

Every finding described here comes from that trial and the background literature the trial’s authors summarized. The course does not add outside evidence, and it does not issue practice recommendations of its own. Where recommendations appear, they are the study authors’ own statements and are attributed as such.

Source: A randomized controlled trial of high-intensity early mobility in adults receiving invasive mechanical ventilation in the intensive care unit, examining functional status, capacity of mobility, muscle strength, ICU-acquired weakness, delirium, mortality, complications, ICU length of stay, and duration of ventilation. Ethical approval was granted by the Ethics Committee of the First Affiliated Hospital of Chongqing Medical University, and reporting followed a CONSORT checklist.

After completing this course, you will be able to:

1. Describe the population enrolled in this randomized controlled trial and the way the high-intensity early mobility program differed from the conventional physiotherapy the control group received.
2. State what the trial found for functional status three months after ICU discharge, for muscle strength and ICU-acquired weakness, and for the outcomes that showed no clear difference between the groups.
3. Explain the limitations the authors acknowledged, including the higher number of deaths in the control group before ICU discharge and the outcomes the trial did not measure.

1. Start Here: how this course works and what it covers
2. Podcast: High-Intensity Early Mobilization in Ventilated ICU Patients (about nine minutes)
3. ICU-Acquired Weakness and Why the Investigators Ran This Trial
4. Who Was Enrolled and How the Two Mobility Programs Differed
5. Function, Strength, and Delirium: What the Trial Measured at Discharge and at Three Months
6. Deaths, Safety Events, and the Questions This Trial Could Not Settle
7. What the Authors Concluded for Bedside Practice
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 parallel randomized controlled trial conducted in an intensive care unit in China, which compared a high-intensity early mobility program against conventional physiotherapy in adults receiving invasive mechanical ventilation. Patients were screened between November 2020 and February 2023, and the primary outcome was functional status three months after ICU discharge.
2. Scope of this course
3. Every finding described here comes from that trial and the background literature the trial's authors summarized. The course does not add outside evidence, and it does not issue practice recommendations of its own. Where recommendations appear, they are the study authors' own statements and are attributed as such.
4. Source: A randomized controlled trial of high-intensity early mobility in adults receiving invasive mechanical ventilation in the intensive care unit, examining functional status, capacity of mobility, muscle strength, ICU-acquired weakness, delirium, mortality, complications, ICU length of stay, and duration of ventilation. Ethical approval was granted by the Ethics Committee of the First Affiliated Hospital of Chongqing Medical University, and reporting followed a CONSORT checklist.