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Experts Confirm

Very Early Mobilization
one key to faster recovery

Experts Confirm

Very Early Mobilization
one key to faster recovery

at a glance

Vem – clinical benefits

reduce ICU delirium risk
improve vigilance levels
preserve cardiovascular endurance
facilitate breathing
improve digestion
decrease risk for decubitus
preserve bone density
preserve muscle strength

Very Early Mobilization is part of the ABCDEF-bundle and is seen as one of the most important therapies in the prevention of negativeeffects of immobility.

Very Early Mobilization improves the recovery process and reduces secondary complications associated with immobility.

VEM was shown to be an effective treatment:

  • Reduce risk of decubitus
  • Preserve muscle strength and bone density
  • Facilitate breathing and support lung function
  • Facilitate digestion
  • Improve vigilance
  • Preserve cardiovascular endurance
  • Reduce risk of delirium

→ Prevention of secondary complications and higher vigilance may reduce the need of therapist attention

For ventilated patients, up to three therapists are required to perform early mobilization. Given the strained staff situation of critical care nurses, severely affected patients might not receive optimal therapy.

conventional approach

Manual Mobilization –helpful but challenging

© Schön Kliniken Bad Aibling, used with permission

Manually mobilizing patients that are severely affected or have limited ability to interact is challenging. Besides the physical strain on therapists, several nurses are required to perform therapy, and patients safety may be compromised. If the patient is mobilized to the bed-side, tubes, catheters and cables might come under tension

Why are other technologies for therapy not sufficient?

Conventional tilt tables offer therapy without leg movement and the cardiovascular and musculoskeletal system is almost not addressed. Without leg movement, the duration of verticalization is severely limited because leg movement provides cardiovascular stability. 

  • Robotic mobilization with separate „stand-alone“ devices requires the patient to be transferred onto a separate device. 
  • More than one person is needed for the transfer, it takes time and is physically demanding.

ROBOT-ASSISTED VEM FOR CRITICALLY ILL PATIENTS

70% of the ICU patients in Germany receive manual VEM. 
30% of the patients are so critically ill that manual therapy is suboptimal or too dangerous due to severity of their symptoms.

Reasons for not mobilizing are amongst others paralysis / sedation, unconsciousness, lack of staff or weekends.

VEM assisted by a VEMO® system would enable the clinic personnel to treat even the most critically ill patients:

  • as the patient can stay in their bed which transforms into a therapy device transfers out of the bed are avoided
  • a mobilization with one person is feasible instead of two or more therapists

EXPERTS CONFIRM

PD&MER I Dr. Karin Diserens Neurologist, Head of the Acute Neurorééducation Unit Neurology Department of Clinical Neuroscience – Lausanne University Hospital – Lausanne, Switzerland

Our experience has proven that Very Early Mobilization is instrumental for faster recovery of patients. With the VEMO® system coming up, we will be able to treat our ventilated patients more often, in a very secure environment, with lower physical strain on our nurses and therapists. The idea of transforming the patient bed into a therapy device will allow us to implement early mobilization even more efficiently in our ICU.

References

Needham, D. M., R. Korupolu, et al. (2010). "Early physical medicine and rehabilitation for patients with acute respiratory failure: a quality improvement project." Arch Phys Med Rehabil 91(4): 536-542.

M. Morreale, P. Marchione,, A. Pili, A. Lauta, S. Castiglia, A. Spalleone, F. Pierelli, P. Giacomini, “Early versus delayed rehabilitation treatment in hemiplegic patients with ischemic stroke: proprioceptive or cognitive approach?”, in Eur. J. Phys. Rehabil. Med., 2015 July 28

Schweickert, W.D., et al., Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet, 2009. 373(9678): p. 1874-82.

Morris, P.E., et al., Early critical care unit mobility therapy in the treatment of acute respiratory failure. Crit Care Med, 2008. 36(8): p. 2238-43.

Chiang, L.L., et al., Effects of physical training on functional status in patients with prolonged mechanical ventilation. Phys Ther, 2006. 86(9): p. 1271-81.

Goemaere, S., et al., Bone mineral status in paraplegic patients who do or do not perform standing. Osteoporos Int, 1994. 4(3): p. 138-43.

Hoenig, H., et al., Case study to evaluate a standing table for managing constipation. SCI Nurs, 2001. 18(2): p. 74-7.

Walter, J.S., et al., Indications for a home standing program for individuals with spinal cord injury. J Spinal Cord Med, 1999. 22(3): p. 152-8.

Chang, A.T., et al., Standing with assistance of a tilt table in critical care: a survey of Australian physiotherapy practice. Aust J Physiother, 2004. 50(1): p. 51-4.

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