Early Mobility of Patients Poststroke in the Neuroscience Intensive Care Unit

Abstract

Patients who are critically ill benefit from skilled interventions, including mobility, to prevent the effects of prolonged bed rest. The literature suggests that early mobility of patients poststroke leads to improved outcomes such as decreased length of stay, improved transfers, and improved tolerance to activity. However, few descriptive reports regarding physical therapy interventions for the critically ill patient admitted with stroke to the neuroscience intensive care unit have been published. Mobility and physical therapy in the intensive care unit can be intimidating and challenging for a bedside clinician and may be deferred when the critically ill patient is also neurologically compromised. This article describes an early mobility program within a 14-bed neuroscience intensive care unit at an eastern Pennsylvania community-based, university-affiliated hospital. The program's goal is to develop a comprehensive patient-centered program that begins with the patient's admission to our hospital. The interdisciplinary process used to manage medical care and early mobility in persons with hemorrhagic and ischemic strokes in the neuroscience intensive care unit is illustrated in an algorithm and described in 2 case reports.