EARLY MOBILIZATION AND THE ELASTIC BAND, AN EFFICIENT SOLUTION FOR AN INTUBATED SUBJECT: A CASE STUDY
DOI:
https://doi.org/10.24193/subbeag.68(2).15Keywords:
early mobilization, elastic band, handgrip, ventilated subject, intensive care unit.Abstract
Introduction: In severely ill patients, weakness acquired in the intensive care unit is a frequent consequence. The advantages of early mobilization for adult intensive care unit patients include shorter stays in the intensive care unit and hospitals, a shorter need for mechanical ventilation, fewer days of harmful bedrest, fewer negative or dangerous occurrences, and increased walking distance. Early mobilization and rehabilitation programs using elastic bands for patients with severe illnesses in intensive care units enhance the weaning success and shorten ventilation times while also enhancing arm muscular power. Objective: This study case aimed to present the fact that early mobilization and elastic band exercises were efficient solutions for an intubated subject from the intensive care unit. Methods: A mechanically ventilated subject postoperatively for hiatal hernia and suspected phrenic nerve paresis, benefited from early mobilization and elastic band exercises and was assessed for the state of consciousness with the Richmond Agitation Scale, and muscle strength for the upper limb with the EH101 digital dynamometer. Results: Muscle strength at the level of the upper limbs increased from weak to normal and the subject was successfully extubated. Conclusions: In this case study we consider that early mobilization and the elastic band exercises program were effective, safe, inexpensive, and suitable for an intensive care unit, and it was the right solution for the success of weaning from the ventilator.
REZUMAT. Mobilizarea precoce și banda elastică, o soluție eficientă pentru un subiect intubat: studiu de caz. Introducere: Slăbiciunea musculară dobândită în unitatea de terapie intensivă este o complicație frecventă la subiecții în stare critică. Beneficiile mobilizării precoce sunt: durata redusă în unitatea de terapie intensivă și a spitalizării, a ventilației mecanice, a zilelor de repaus la pat, efecte adverse minime și o distanță parcursă la mers mai mare. Mobilizarea precoce și exercițiile cu banda elastică îmbunătățesc succesul extubării subiecților și reduc durata ventilației mecanice, de asemenea îmbunătățesc forța musculară la nivelul membrelor superioare. Obiective: Obiectivul acestui studiu de caz a fost, de a prezenta faptul că, mobilizarea precoce și exercițiile cu banda elastică au fost soluții eficiente pentru un subiect intubat din secția de terapie intensivă. Metode: Un subiect ventilat mecanic post-operator pentru hernie hiatală și suspect de pareza de nerv frenic a beneficiat de mobilizare precoce și exerciții cu banda elastică, fiind evaluat pentru starea de conștientă cu Richmand Agitation Scale și forță musculară pentru membrele superioare cu dinamometrul digital EH101. Rezultate: Forța musculară la nivelul membrelor superioare a crescut de la nivel slab la normal iar subiectul a fost extubat cu succes. Concluzii: În acest studiu de caz considerăm că, mobilizarea precoce și programul de exerciții cu bandă elastică au fost eficiente, sigure, necostisitoare și potrivite pentru o unitate de terapie intensivă, si a fost soluția potrivită pentru succesul extubării subiectului.
Cuvinte cheie: mobilizare precoce, bandă elastică, dinamometru digital, subiect ventilat, unitate de terapie intensivă.
Received 2023 January 18; Revised 2023 June 15; Accepted 2023 June 16; Available online 2023 July 30; Available print 2023 August 30.
References
Aboodarda, S. J., Page, P. A., & Behm, D. G. (2016). Muscle activation comparisons between elastic and isoinertial resistance: A meta-analysis. Clinical biomechanics (Bristol, Avon), 39, 52–61. https://doi.org/10.1016/j.clinbiomech.2016.09.008
Chang, Y.J. (2020). Respiratory Muscle Training and Elastic Band Resistance Exercise to Duration of Mechanical Ventilation in Respiratory Care Center (RCC): A Preliminary Study in Taiwan Medical Center. Respiratory Care, 65 (Suppl 10) 3438499
Cottereau, G., Messika, J., Megarbane, B., Guérin, L., da Silva, D., Bornstain, C., Santos, M., Ricard, J. D., & Sztrymf, B. (2021). Handgrip strength to predict extubation outcome: a prospective multicenter trial. Annals of intensive care, 11(1), 144. https://doi.org/10.1186/s13613-021-00932-3
Decha, P., Khanittha,W., Chanya,U., Tula,W., Suranee,C., Potchanee,J., Orachon,C., Kannika,W., Niramon,P., Sutthipong, I. (2020). The Effect of Early Mobilization with Elastic Band Exercise on the Duration of Mechanical Ventilator Weaning of Critically Ill Patients. Indian Journal of Public Health Research & Development, 11(8), 237–243. https://doi.org/10.37506/ijphrd.v11i8.10929
Grigoriadis, K., Efstathiou, I., Dimitriadis, Z., Konstantopoulou, G., Grigoriadou, A., Vasileiadis, G., Micha, M., Tsagaris, I., & Armaganidis, A. (2021). Handgrip Force and Maximum Inspiratory and Expiratory Pressures in Critically Ill Patients with a Tracheostomy. American journal of critical care: an official publication, American Association of Critical-Care Nurses, 30(2), e48–e53. https://doi.org/10.4037/ajcc2021248
Haraldsson, B. T., Andersen, C. H., Erhardsen, K. T., Zebis, M. K., Micheletti, J. K., Pastre, C. M., & Andersen, L. L. (2021). Submaximal Elastic Resistance Band Tests to Estimate Upper and Lower Extremity Maximal Muscle Strength. International Journal of Environmental Research and Public Health, 18(5), 2749. MDPI AG. Retrieved from http://dx.doi.org/10.3390/ijerph18052749
Hodgson, C. L., Schaller, S. J., Nydahl, P., Timenetsky, K. T., & Needham, D. M. (2021). Ten strategies to optimize early mobilization and rehabilitation in intensive care. Critical care (London, England), 25(1), 324. https://doi.org/10.1186/s13054-021-03741-z
Huang, L., Liu, Y., Lin, T., Hou, L., Song, Q., Ge, N., & Yue, J. (2022). Reliability and validity of two hand dynamometers when used by community-dwelling adults aged over 50 years. BMC geriatrics, 22(1), 580. https://doi.org/10.1186/s12877-022-03270-6
Lee, J. H., Kim, H. T., Choi, I. J., Heo, Y. R., & Jung, Y. W. (2021). An unusual anatomical variant of the left phrenic nerve encircling the transverse cervical artery. Folia morphologica, 80(4), 1027–1031. https://doi.org/10.5603/FM.a2020.0131
Lupton-Smith, A., Fourie, K., Mazinyo, A., Mokone, M., Nxaba, S., & Morrow, B. (2022). Measurement of hand grip strength: A cross-sectional study of two dynamometry devices. The South African journal of physiotherapy, 78(1), 1768. https://doi.org/10.4102/sajp.v78i1.1768
Paramasivan, M., Kiruthigadevi, S., & Amal, K.F. (2019). Teste-retest reliability of electronic hand dynamometer in healthy adults. Int. J. of Adv. Res. 7 (May). 325-331 (ISSN 2320-5407).
Perme, C., Nawa, R. K., Winkelman, C., & Masud, F. (2014). A tool to assess mobility status in critically ill patients: the Perme Intensive Care Unit Mobility Score. Methodist DeBakey cardiovascular journal, 10(1), 41–49. https://doi.org/10.14797/mdcj-10-1-41
Polastri, M., Oldani, S., Pisani, L., & Nava, S. (2018). Elastic Band Exercises for Patients with Intensive Care Unit-Acquired Weakness: A Case Report. Tanaffos, 17(2), 132–137.
Pucci, G., D’Abbondanza, M., Curcio, R., Alcidi, R., Campanella, T., Chiatti, L., Gandolfo, V., Veca, V., Casarola, G., Leone, M. C., Rossi, R., Alberti, A., Sanesi, L., Cavallo, M., & Vaudo, G. (2022). Handgrip strength is associated with adverse outcomes in patients hospitalized for COVID-19-associated pneumonia. Internal and emergency medicine, 17(7), 1997–2004. https://doi.org/10.1007/s11739-022-03060-3
Saiphoklang, N., & Keawon, T. (2021). Correlation between Handgrip Strength and Rapid Shallow Breathing Index for Assessment of Weaning from Mechanical Ventilation. Critical care research and practice, 2021, 4637528. https://doi.org/10.1155/2021/4637528
Samosawala, N. R., Vaishali, K., & Kalyana, B. C. (2016). Measurement of muscle strength with a handheld dynamometer in the Intensive Care Unit. Indian journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine, 20(1), 21–26. https://doi.org/10.4103/0972-5229.173683
Sessler, C. N., Gosnell, M. S., Grap, M. J., Brophy, G. M., O’Neal, P. V., Keane, K. A., Tesoro, E. P., & Elswick, R. K. (2002). The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients. American journal of respiratory and critical care medicine, 166(10), 1338–1344. https://doi.org/10.1164/rccm.2107138
Skals, S., Vinstrup, J., Sundstrup, E., Jakobsen, M. D., Andersen, C. H., & Andersen, L. L. (2018). Shoulder and arm muscle activity during elastic band exercises performed in a hospital bed. The Physician and sports medicine, 46(2), 233–241.
Team Study Investigators and the ANZICS Clinical Trials Group, Hodgson, C. L., Bailey, M., Bellomo, R., Brickell, K., Broadley, T., Buhr, H., Gabbe, B. J., Gould, D. W., Harrold, M., Higgins, A. M., Hurford, S., Iwashyna, T. J., Serpa Neto, A., Nichol, A. D., Presneill, J. J., Schaller, S. J., Sivasuthan, J., Tipping, C. J., Webb, S., … Young, P. J. (2022). Early Active Mobilization during Mechanical Ventilation in the ICU. The New England journal of medicine, 387(19), 1747–1758. https://doi.org/10.1056/NEJMoa2209083
Wang, T. (2020). Early Mobilization on Patients with Mechanical Ventilation in the ICU. In M. Bernardo-Filho, D. U. de Sá-Caputo, & R. Taiar (Eds.), Physical Therapy Effectiveness. IntechOpen. https://doi.org/10.5772/intechopen.89984
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