Mobilisation of patients recovering from COVID

Patients that have been admitted to the ICU, due to serious COVID complications, require effective strategies for early mobilisation and rehabilitation as they recover. Mary Muir and Mark Pinder offer an insight into best practice and the technologies that can assist, to ensure the best possible patient outcomes.

During the initial phases of the COVID-19 pandemic, the focus was on managing hospital admissions, expanding intensive care and ensuring that there was capacity to manage high acuity patients. With thousands hospitalised because of the pandemic, the role of early mobilisation and rehabilitation to aid patient recovery and advance care had never been more important1 as patients exhibited signs of physical and psychological dysfunction,2 which included severe physical impairments, deconditioning and muscle weakness.3 For example, it is recognised that excessive immobility has profound effects on key body systems during hospitalisation – lasting for months or years after discharge.4 Loss of muscle mass (up to 20% per week), and nerve dysfunction or damage leading to ICU acquired weakness appears to start within the first few days of critical illness.5-6 Muscle loss in the large lower extremity muscle groups will affect standing and walking ability

Early mobilisation and rehabilitation requires a multidisciplinary team approach that considers the prevention of hospitalacquired conditions, increasing patient comfort, well-being and recovery from illness. Evidence shows that physical and occupational therapy approaches are a fundamental component of the care pathway.7 The World Health Organization has called for a coordinated approach and investment to raise the profile of rehabilitation as a health strategy relevant to all people across their life and care continuum.8