Mild exercise good  for the critically ill people

The use of prescribed sedatives goes down by half if mild exercise programmes are introduced among critically ill patients in the intensive care unit (ICU), research says.

Mild exercise, Johns Hopkins experts say, should be performed 30-45 minutes by patients under the guidance of specially-trained physical and occupational therapists.

It can include any combination of either leg or arm movements while laying flat in bed, sitting up or standing, or even walking slowly in the corridors of the ICU.

In its latest exercise report, the Johns Hopkins team closely monitored the progress of 57 patients admitted to The Johns Hopkins Hospital's medical intensive care unit (or MICU) in 2007. Their treatment encompassed 794 days spent in the unit.

Members of the MICU team checked the patients' records daily for several months before and after the physical rehabilitation project began.

Each patient was mechanically ventilated for at least four days, with half receiving no more than one exercising session before the enhanced exercise plan started, while half received at least seven physical therapy sessions after the plan's implementation.

“Our work challenges physicians to rethink how they treat critically ill patients and shows the downstream benefits of early mobilisation exercises,” says critical care specialist Dale Needham, who spearheaded the project.

“Our patients keep telling us that they do not want to be confined to their beds, they want to be awake, alert and moving,” says Mr. Needham, associate professor at the Johns Hopkins University School of Medicine.

“Patients are not afraid of exercising when they are in the ICU, and they are embracing this new approach to their care in the ICU. It actually motivates them to get well and reminds them that they have a life outside the four walls surrounding their hospital beds,” he adds.

Mr. Needham and colleagues found that the use of drowsiness-causing benzodiazepines declined to only 26 percent of patient days spent in the MICU in the four months, following introduction of early mobilisation practices, compared to 50 percent of patient days in the three months leading up to the project.

Daily episodes of delirium, when a patient may hallucinate, be unable to think straight, or simply be unaware of their surroundings, were sharply curtailed, a Johns Hopkins release said.

The findings were published in the online edition of Physical Medicine and Rehabilitation Friday.