Effect of vibration therapy on physical function in critically ill adults (VTICIA trial): protocol for a single-blinded randomised controlled trial

Effects of Vibration Therapy on the Physical Function of Critically Ill Adults Trial: A Randomized Controlled Trial

OBJECTIVES

Vibration therapy uses vibration to rehabilitate physical functions. Recently, it has been demonstrated to be safe for critically ill patients. However, its effects on physical functions are unclear.

DESIGN

Randomized controlled trial.

SETTING

A single-center, ICU.

PATIENTS

Patients were randomly assigned to either vibration therapy coupled with protocolized mobilization or protocolized mobilization alone. We included patients who could sit at the edge of the bed or in a wheelchair during their ICU stay. The exclusion criteria were based on the early mobilization inhibition criteria.

INTERVENTIONS

The primary outcome was the Functional Status Score for the ICU (FSS-ICU) at ICU discharge. Secondary outcomes were the Medical Research Council score, ICU-acquired weakness, delirium, ICU Mobility Scale (IMS), and ventilator- and ICU-free days. For safety assessment, vital signs were monitored during the intervention.

MEASUREMENTS AND MAIN RESULTS

Among 180 patients, 86 and 90 patients remained in the vibration therapy and control groups, respectively. The mean age was 69 ± 13 vs. 67 ± 16 years in the vibration therapy and control groups, and the Acute Physiology and Chronic Health Evaluation (APACHE) II score was 19 (14-25) vs. 18 (13-23). The total FSS-ICU at ICU discharge was 24 (18-27) and 21 (17-26) in the intervention and control groups, respectively ( p = 0.09), and the supine-to-sit ability significantly improved in the intervention group ( p < 0.01). The secondary outcomes were not significantly different. Vital signs remained stable during vibration therapy. In the predefined subgroup analysis, FSS-ICU improved in the population with a higher body mass index (≥ 23 kg/m 2 ), lower APACHE II scores (< 19), and higher IMS scores (≥ 6).

CONCLUSIONS

Vibration therapy did not improve the total FSS-ICU. However, the supine-to-sit ability in the FSS-ICU improved without any adverse event.

Early Mobilization Using a Mobile Patient Lift in the ICU: A Randomized Controlled Trial

OBJECTIVES

To ascertain whether a mobile patient lift facilitates early mobilization in ventilated ICU patients.

DESIGN

A single-center, open-label, randomized controlled trial.

SETTING

An academic ICU in Tokyo.

PATIENTS

Eighty patients were admitted to ICU and expected ventilation for at least 48 hours.

INTERVENTIONS

In the intervention group, in addition to the rehabilitation protocol received by the control group, patients were assisted in sitting, standing, transfers, and walking using the mobile patient lift.

MEASUREMENTS AND MAIN RESULTS

The intervention group predominantly stood faster than the control group (1.0 vs. 3.0 d, p < 0.01). The Intervention group also had significantly higher Functional Status Score-ICU scores at ICU discharge. However, the Medical Research Council score and Barthel index at discharge, length of ICU stay, and number of ventilator-free days did not differ between the two groups.

CONCLUSIONS

The use of mobile patient lifts facilitates the earlier standing of patients on ventilators. This may contribute to patients improved physical function in the ICU.

TRIAL REGISTRATION

The study protocol was registered with the University Hospital Medical Information Network (UMIN) under the registration number UMIN000044965. Registered July 30, 2021.