Objective To examine the association between the mobilization level during intensive care unit (ICU) admission and independence in activity of daily living (ADL), defined as Barthel Index (BI)≥70.
Methods This was a post-hoc analysis of the EMPICS study involving nine hospitals. Consecutive patients who spend >48 hours in the ICU were eligible for inclusion. Mobilization was performed at each hospital according to the shared protocol and the highest ICU mobility score (IMS) during the ICU stay, baseline characteristics, and BI at hospital discharge. Multiple logistic regression analysis, adjusted for baseline characteristics, was used to deter-mine the association between the highest IMS (using the receiver operating characteristic [ROC]) and ADL.
Results Of the 203 patients, 143 were assigned to the ADL independence group and 60 to the ADL dependence group. The highest IMS score was significantly higher in the ADL independence group than in the dependence group and was a predictor of ADL independence at hospital discharge (odds ratio, 1.22; 95% confidence interval, 1.07–1.38; adjusted p=0.002). The ROC cutoff value for the highest IMS was 6 (specificity, 0.67; sensitivity, 0.70; area under the curve, 0.69).
Conclusion These results indicate that, in patients who were in the ICU for more than 48 hours, that patients with good function in the ICU also exhibit good function upon discharge. However, prospective, multicenter trials are needed to confirm this conclusion.
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Impact of Preexisting Diabetes on Activities of Daily Living Independence at Hospital Discharge in Critically Ill Patients: A Prospective Cohort Study Shinichi Watanabe, Kota Yamauchi, Yuji Naito, Ayato Shinohara, Yasunari Morita, Yuki Iida Diabetology.2026; 7(2): 27. CrossRef
Factors associated with functional recovery after intensive care unit discharge in patients with mechanical ventilation: A multi-centre prospective observational study Kota Yamauchi, Shinichi Watanabe, Yuji Naito, Kei Goto, Shota Tanaka, Tokuaki Shinya, Yoshihisa Fujino, Kazuki Ogawa, Tomohiro Yoshikawa, Yoshie Hirota Clinical Rehabilitation.2025; 39(7): 945. CrossRef
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Objective To investigate the effect on early mobilization in patients undergoing extra-corporeal membrane oxygenation (ECMO) and acute blood purification therapy in the intensive care unit (ICU).
Methods We conducted this multicenter retrospective cohort study by collecting data from six ICUs in Japan. Consecutive patients who were admitted to the ICU, aged ≥18 years, and received mechanical ventilation for >48 hours were eligible. The analyzed were divided into two groups: ECMO/blood purification or control group. Clinical outcomes; time to first mobilization, number of total ICU rehabilitations, mean and highest ICU mobility scale (IMS); and daily barrier changes were also investigated.
Results A total of 204 patients were included in the analysis, 43 in the ECMO/blood purification group and 161 in the control group. In comparison of clinical outcome, the ECMO/blood purification group had a significantly longer time to first mobilization: ECMO/blood purification group 6 vs. control group 4 (p=0.003), higher number of total ICU rehabilitations: 6 vs. 5 (p=0.042), lower mean: 0 vs. 1 (p=0.043) and highest IMS: 2 vs. 3 (p=0.039) during ICU stay. Circulatory factor were most frequently described as barriers to early mobilization on days 1 (51%), 2 (47%), and 3 (26%). On days 4 to 7, the most frequently described barrier was consciousness factors (21%, 16%, 19%, and 21%, respectively)
Conclusion The results of this study comparing the ECMO/blood purification group and the untreated group in the ICU showed that the ECMO/blood purification group had significantly longer days to mobilization and significantly lower mean and highest IMS.
Citations
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Impact of ICU-Based Extracorporeal Membrane Oxygenation and Blood Purification Therapy on the Time Required for Early Rehabilitation Shinichi Watanabe, Tomohiro Yoshikawa, Yoshie Hirota, Yuji Naito, Daisetsu Yasumura, Kota Yamauchi, Keisuke Suzuki, Takayasu Koike, Yasunari Morita Cureus.2025;[Epub] CrossRef
Survival outcomes and mobilization during venovenous extracorporeal membrane oxygenation: a retrospective cohort study Felix A. Rottmann, Christian Noe, Xavier Bemtgen, Sven Maier, Alexander Supady, Tobias Wengenmayer, Dawid L. Staudacher Frontiers in Medicine.2023;[Epub] CrossRef
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