| 1. |
- Söderberg, Annika, et al.
(författare)
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From fear to fight : Patients experiences of early mobilization in intensive care. A qualitative interview study
- 2022
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Ingår i: Physiotherapy Theory and Practice. - : Taylor & Francis. - 0959-3985 .- 1532-5040. ; 38:6, s. 750-758
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Early mobilization (EM) in intensive care is frequently used to prevent physical and psychological complications, with promising results. However, the patient´s perception of EM has been sparsely investigated. Purpose : To investigate the experience of EM in patients treated in intensive care. Method : Nineteen former patients who had been treated in intensive care were interviewed. The interviews were analyzed using qualitative, inductive content analysis. Results : The analysis resulted in three categories; 1) Facing the impossible - a too demanding situation; 2) Struggling successfully on the way back; and 3) Need of having dedicated supporters. Conclusion : A considerable variety of experiences of EM were described in this study, both negative and positive. Prominent features were that pleasant emotions and great physical effort occurred simultaneously and that interaction and cooperation with the caregivers was paramount. To regain independence was another prominent feature, with EM considered to be of great importance in the recovery process. Moving to an upright position and ambulating appears to be beneficial to both body and mind. EM should therefore be among the first priorities in intensive care. EM should be practiced with respect and support, while encouraging and challenging the patient to strive for independence.
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| 2. |
- Thelandersson, Annelie, et al.
(författare)
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Blood flow velocity and vascular resistance during passive leg exercise in the critically ill patient
- 2012
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Ingår i: Clinical Physiology and Functional Imaging. - 1475-0961. ; 32:5, s. 338-342
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Tidskriftsartikel (refereegranskat)abstract
- Passive range of motion exercise is a very common physical therapy treatment for patients admitted to an intensive care unit. However is the knowledge scarce regarding its impact on blood circulation in the extremities. The objective of this study was therefore to investigate the effect of passive range of motion on arterial peripheral leg blood flow velocity (BFV) and vascular resistance. A cross-sectional consecutive study of twelve patients admitted to an intensive care unit and twelve healthy age- and gender-matched controls was conducted. Passive range of motion was performed in one leg by a physical therapist. Blood flow velocities and resistance index in the common femoral artery (CFA), blood pressure and heart rate were measured before, directly after and at rest after passive range of motion. No changes were seen in BFV or resistance index in the patient group or the control group. No changes were found in blood pressure or heart rate in the patient group. In the control group, changes were found in systolic and mean blood pressure, with a higher pressure before passive range of motion. The controls had lower BFV and higher resistance index than the patients when comparing the groups. The conclusion of this study including twelve patients is that passive range of motion does not alter BFV or resistance index in the CFA in comatose and/or sedated critically ill patients.
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| 3. |
- Thelandersson, Annelie
(författare)
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Early Physiotherapy in the Neurointensive Care Unit - Passive Physiotherapy Interventions
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: In critically ill patients, treated in the neurointensive care unit (NICU) because of severe brain injury or stroke, physical activities have been restricted to a minimum due to the potential risks of complications and adverse events. Nevertheless, passive physiotherapy treatments are widely used without conclusive evidence for their safety. Aim: The overall aim of this thesis was to investigate if three different passive physiotherapy interventions i.e. prone position (PP), passive range of motion (passive-ROM) and continuous passive motion (CPM), were safe to use in patients that are critically ill due to severe brain injury or stroke when admitted to a NICU and to investigate the respiratory and circulatory effects of these interventions. Methods: This thesis consists of four different quantitative research papers. Paper I investigated the effect of PP on lung oxygenation as well as the intracranial and systemic haemodynamic variables before, during and after PP. Paper II investigated the intracranial, cerebrovascular and systemic haemodynamics before, during and after a session of passive-ROM as performed in clinical practice. Paper III studied peripheral blood flow velocity (PBFV) and resistance index (RI) before, directly after and after a passive-ROM intervention. In paper II and III a healthy control group matched for age and sex was also included. Paper IV studied intracranial and systemic haemodynamics before, during and after a session of 20 minutes of CPM with a bedcycle ergometer. Main results: I. PP enhanced oxygenation without any significant changes in intracranial pressure (ICP), cerebral perfusion pressure (CPP) or blood pressure (BP) while heart rate (HR) increased. II. During passive-ROM CPP, BP and HR did not change significantly, while ICP decreased after passive-ROM. Furthermore, no significant changes in cerebral blood flow velocity (CBFV) or pulsatility index (PI) were noted. In the healthy control group a significantly higher BP was found before the intervention, but no other significant results were noted. III. Passive-ROM interventions did not significantly affect PBFV or RI. When comparing the patient group with the control group in paper II and III, a significantly higher PI and PBFV and a lower RI were noted in the patient group. IV. CPM did not affect ICP but significantly increased BP and stroke volume (SV) during the exercise. Furthermore, cardiac output, SV, BP and CPP were increased during versus after the intervention. Conclusion: Prone position, passive-ROM and CPM are safe to use in critically ill patients, suffering from brain injuries or stroke treated in the NICU, since the intracranial and systemic haemodynamic responses are small. PP increased the oxygenation in this patient group. Keywords: physiotherapy, brain injury, stroke, intensive care unit, prone position, range of motion, continuous passive motion, intracranial pressure, cerebral perfusion pressure, haemodynamics
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