Acute and Critical Care

Review Article

Trauma
Mobilization phases in traumatic brain injury: Tommy Alfandy Nazwar, Ivan Triangto, Gutama Arya Pringga, Farhad Bal’afif, Donny Wisnu Wardana; Acute Crit Care. 2023;38(3):261-270. Published online August 1, 2023; DOI: https://doi.org/10.4266/acc.2023.00640

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Mobilization in traumatic brain injury (TBI) have shown the improvement of length of stay, infection, long term weakness, and disability. Primary damage as a result of trauma’s direct effect (skull fracture, hematoma, contusion, laceration, and nerve damage) and secondary damage caused by trauma’s indirect effect (microvasculature damage and pro-inflammatory cytokine) result in reduced tissue perfusion & edema. These can be facilitated through mobilization, but several precautions must be recognized as mobilization itself may further deteriorate patient’s condition. Very few studies have discussed in detail regarding mobilizing patients in TBI cases. Therefore, the scope of this review covers the detail of physiological effects, guideline, precautions, and technique of mobilization in patients with TBI.

Citations

Citations to this article as recorded by

Benchmarking mobilization practice and functional outcomes in traumatic brain injury patients admitted to the intensive care unit: a three-year service evaluation
Fiona Howroyd, James Hodson, Anne Preece, Tammy Lea, Samantha Rooney, Hon Sing Geoffrey Wu, Simran Rahania, Fang Gao Smith, Tonny Veenith, Niharika A. Duggal, Zubair Ahmed, Jonathan Weblin
Frontiers in Neurology.2026;[Epub] CrossRef
The Impact of a Prior Traumatic Brain Injury and Injury Characteristics on Frailty in the Canadian Longitudinal Study on Aging
Molly K. Courish, Myles W. O’Brien, Madeline E. Shivgulam, Emily E. MacDonald, Said Mekari, Olga Theou
Archives of Physical Medicine and Rehabilitation.2026;[Epub] CrossRef
Reversing Persistent PTEN Activation after Traumatic Brain Injury Fuels Long‐Term Axonal Regeneration via Akt/mTORC1 Signaling Cascade
Ziyu Shi, Leilei Mao, Shuning Chen, Zhuoying Du, Jiakun Xiang, Minghong Shi, Yana Wang, Yuqing Wang, Xingdong Chen, Zhi‐Xiang Xu, Yanqin Gao
Advanced Science.2025;[Epub] CrossRef
Falls in a single brain rehabilitation center: a 3-year retrospective chart review
Yoo Jin Choo, Jun Sung Moon, Gun Woo Lee, Wook-Tae Park, Min Cheol Chang
Frontiers in Neurology.2025;[Epub] CrossRef
Effects of using conventional assistive devices on spatiotemporal gait parameters of adults with neurological disorders: A systematic review protocol
Jordana de Paula Magalhães, Sheridan Ayessa Ferreira de Brito, Merrill Landers, Aline Alvim Scianni, Poliana do Amaral Yamaguchi Benfica, Carolina Luisa de Almeida Soares, Christina Danielli Coelho de Morais Faria, Anne E. Martin
PLOS ONE.2025; 20(4): e0321019. CrossRef
Impact of Early Mobilisation on the Clinical Outcomes of Patients With Traumatic Brain Injury
Fei Xia, Caiyun Li, Yiwen Liu
Nursing in Critical Care.2025;[Epub] CrossRef
Acute orthostatic responses during early mobilisation of patients with acquired brain injury - Innowalk pro versus standing frame
Matthijs F Wouda, Espen I Bengtson, Ellen Høyer, Alhed P Wesche, Vivien Jørgensen
Journal of Rehabilitation and Assistive Technologies Engineering.2024;[Epub] CrossRef
Aktuelle Aspekte der intensivmedizinischen Versorgung bei Schädel-Hirn-Trauma – Teil 2
André Hagedorn, Helge Haberl, Michael Adamzik, Alexander Wolf, Matthias Unterberg
AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie.2024; 59(07/08): 466. CrossRef

Original Article

Nursing
Improving mobility in the intensive care unit with a protocolized, early mobilization program: observations of a single center before-and-after the implementation of a multidisciplinary program: Laptin Ho, Joe Hin Cheung Tsang, Emmanuel Cheung, Wing Yan Chan, Ka Wai Lee, Sweetie R Lui, Chung Yau Lee, Alfred Lok Hang Lee, Philip Koon Ngai Lam; Acute Crit Care. 2022;37(3):286-294. Published online June 29, 2022; DOI: https://doi.org/10.4266/acc.2021.01564

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647 Download
2 Web of Science
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Abstract PDF Supplementary Material

Background
Early intensive care unit (ICU) protocolized rehabilitative programs have been described previously, yet with differing starting time points and mostly on mechanically ventilated patients. We extended the concept to all admitted ICU patients and investigate the efficacy of early mobilization in improving mobility of the critically ill, address issues surrounding the timing and intensity of an early rehabilitative program.
Methods
Prospective cohorts of patients admitted consecutively before-and-after (control, n=92; intervention, n=90) the introduction of an early mobilization program in a single center, general hospital ICU. Improvement in mobility as assessed by ICU mobility score, on ICU admission and upon ICU discharge, was measured as a primary outcome.
Results
Those receiving early mobilization in the intensive care unit had higher ICU mobility score (2.63; 95% confidence interval, 0.65–4.61; P<0.001) upon discharge from the intensive care, with earlier out of bed mobilization on day 5 compared to the control group of day 21 (P<0.001). No differences were found in terms of mortality, intensive care hospitalization and subsequent hospitalization duration after discharge from ICU.
Conclusions
Here, we report that improvement in mobility score earlier in the course of intensive care hospitalization with the introduction of a protocolized early rehabilitative program.

Citations

Citations to this article as recorded by

Accelerating Postoperative Recovery: The Impact of Early Mobility Protocols in Surgical Intensive Care Unit (SICU) Patients After Open Cholecystectomy
Binu Xavier, Sasi Vaithilingan, Latha R
Cureus.2025;[Epub] CrossRef
From bedside to beyond: The long-term impact of early mobilization in the ICU
Elisabetta Roberti, Michele Bertoni, Nicola Latronico, Simone Piva
Clinical Nutrition Open Science.2025; 64: 170. CrossRef
Physical Therapist-Led Therapeutic Exercise and Mobility in Adult Intensive Care Units: A Scoping Review of Operational Definitions, Dose Progression, Safety, and Documentation
Kyeongbong Lee
Journal of Clinical Medicine.2025; 14(24): 8948. CrossRef
Early mobilization and its impact on recovery in ICU patients with severe COVID-19: A randomized controlled trial
J Saravankumar, Rathna Paramaswamy, Buvanesh Annadurai, Iswarya S, Santhana Lakshmi S S, Surya Vishnuram, Jeslin G N, Shenbaga Sundaram Subramanian, Senthilkumar N
Fizjoterapia Polska.2024; 24(4): 222. CrossRef
Early Active Mobilization during Mechanical Ventilation in the ICU

New England Journal of Medicine.2023; 388(6): 572. CrossRef
Yoğun Bakım Hastası İçin Erken Mobilizasyonun Önemi
Ebubekir Kaplan, Aylin Aktaş Özakgül, Özkan Sir
Sakarya Üniversitesi Holistik Sağlık Dergisi.2023; 6(3): 510. CrossRef

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