THERAPY-Magazin
Patients in intensive care should be mobilised as soon as possible
Ticino hospital staff report how the THERA-Trainer bemo supports early mobilisation in ICU patients, improving recovery, reducing PICS symptoms, and shortening rehab stays.
Rebecca Birchler
Movement Scientist, Dividat AG
Early mobilisation can reduce medical complications and is associated with improvements in respiratory function, reductions in delirium, increased functional independence, cardiovascular fitness and psychological well-being. In practice, however, early mobilisation is often a major challenge.
Mobilisation in the intensive care unit: Interview with Ticino professionals by Eva van het Reve and Damiano Zemp, Dividat AG
The Swiss company Dividat AG already presented the new bed trainer THERA-Trainer bemo to specialists from the intensive care units of the Ticino hospitals at the end of 2020. It quickly became clear that this kind of product would make their work in the intensive care unit much easier. In the following interview they tell us about their experiences.
The Swiss company Dividat AG already presented the new bed trainer THERA-Trainer bemo to specialists from the intensive care units of the Ticino hospitals at the end of 2020. It quickly became clear that this kind of product would make their work in the intensive care unit much easier. In the following interview they tell us about their experiences.
Dividat: Hello Giuseppe and Christian. Thank you very much for taking the time to be interviewed! What advantages do you see in the THERA-Trainer bemo for early mobilisation?
Giuseppe de Pasquale:We had been looking for a device that met our needs in terms of quality, comfort and manageability for some time. It was not an easy search. The few products in this area were not convincing. When the bemo was introduced to us, we were immediately enthusiastic and this only increased when we started to use it in our everyday life. The exerciser is easy to disinfect, offers a wide range of functions as both a leg ergometer and an arm ergometer, in passive, assistive and active modes. In addition, a feedback system enables active participation of the patient. Many studies show the effectiveness of early mobilisation in the ICU. Patients leave the unit in a better condition and show better motor recovery. As well as this, it has a positive effect on the mental state and results in a faster reduction of the administered medication.
Giuseppe de Pasquale:We had been looking for a device that met our needs in terms of quality, comfort and manageability for some time. It was not an easy search. The few products in this area were not convincing. When the bemo was introduced to us, we were immediately enthusiastic and this only increased when we started to use it in our everyday life. The exerciser is easy to disinfect, offers a wide range of functions as both a leg ergometer and an arm ergometer, in passive, assistive and active modes. In addition, a feedback system enables active participation of the patient. Many studies show the effectiveness of early mobilisation in the ICU. Patients leave the unit in a better condition and show better motor recovery. As well as this, it has a positive effect on the mental state and results in a faster reduction of the administered medication.
“Many studies show the effectiveness of early mobilisation in the ICU.”
Dividat: Why is early mobilisation so important from a medical point of view?
Christian Nicole:Many patients suffer from Post Intensive Care Syndrome (PICS) after their stay in the ICU. These are health problems (physical, psychological, cognitive) that remain after a critical illness. PICS appears as general muscle weakness (better known as ICU-Aquired Weakness). Efforts should be directed towards preventing PICS. This involves trying to minimise sedation and maximise early mobilisation during the stay in the ICU. The benefits of early mobilisation are undisputed: it affects the severity of PICS, ventilation time, risk of delirium and rehabilitation time.
Christian Nicole:Many patients suffer from Post Intensive Care Syndrome (PICS) after their stay in the ICU. These are health problems (physical, psychological, cognitive) that remain after a critical illness. PICS appears as general muscle weakness (better known as ICU-Aquired Weakness). Efforts should be directed towards preventing PICS. This involves trying to minimise sedation and maximise early mobilisation during the stay in the ICU. The benefits of early mobilisation are undisputed: it affects the severity of PICS, ventilation time, risk of delirium and rehabilitation time.
Dividat: Which kinds of patients used the bemo? Which patients benefit most and what are the results?
Christian Nicole:In Mendrisio, the THERA-Trainer bemo was used in both ventilated and non-ventilated, sedated and non-sedated patients – with very good results. In the awake patients, it was found that in the next training session, the exertion force and the training time could be increased. As we weren’t used to it yet, we only used the movement exerciser on stable patients for safety reasons. When working according to the early mobilisation protocol, which includes restrictions and safety criteria, all patients could benefit from the bemo. I think the only limitation is respiratory instability in patients who need continuous pronation – those we are treating during this pandemic period.
Christian Nicole:In Mendrisio, the THERA-Trainer bemo was used in both ventilated and non-ventilated, sedated and non-sedated patients – with very good results. In the awake patients, it was found that in the next training session, the exertion force and the training time could be increased. As we weren’t used to it yet, we only used the movement exerciser on stable patients for safety reasons. When working according to the early mobilisation protocol, which includes restrictions and safety criteria, all patients could benefit from the bemo. I think the only limitation is respiratory instability in patients who need continuous pronation – those we are treating during this pandemic period.
Dividat: How are patients mobilised without the THERA-Trainer bemo?
Christian Nicole:It was well received by the patients who used it and they felt the benefit – this especially in terms of their strength. As carers, we noticed how from one training session to the next, both the intensity and the duration of the exercise increased. This applied to the arms as well as the legs. Thanks to bemo, transfers from bed to chair, as well as vice versa, were possible earlier without a lifting device, and patients regained functional and muscular abilities more quickly.
Christian Nicole:It was well received by the patients who used it and they felt the benefit – this especially in terms of their strength. As carers, we noticed how from one training session to the next, both the intensity and the duration of the exercise increased. This applied to the arms as well as the legs. Thanks to bemo, transfers from bed to chair, as well as vice versa, were possible earlier without a lifting device, and patients regained functional and muscular abilities more quickly.
Dividat: Have you also been able to mobilise Covid patients? Can you envisage this device also having positive effects on Covid patients?
Christian Nicole:Early mobilisation is also carried out at the Covid Hospital in Locarno. However, logistics and resources only allow for respiratory physiotherapy and active-passive mobilisation such as transfer from bed to chair. However, Covid patients, just like all other patients, could also benefit from the new THERA-Trainer bemo, because it’s a device that, if used daily, can certainly lead to better outcomes and a reduction in the length of stay in the intensive care unit. For this reason, we have shared the experience we gained on the wards of the other three cantonal hospitals with the Covid Hospital in Locarno.
Christian Nicole:Early mobilisation is also carried out at the Covid Hospital in Locarno. However, logistics and resources only allow for respiratory physiotherapy and active-passive mobilisation such as transfer from bed to chair. However, Covid patients, just like all other patients, could also benefit from the new THERA-Trainer bemo, because it’s a device that, if used daily, can certainly lead to better outcomes and a reduction in the length of stay in the intensive care unit. For this reason, we have shared the experience we gained on the wards of the other three cantonal hospitals with the Covid Hospital in Locarno.
Dividat: Do you think that the bemo should also be used for patients from other departments? Which ones?
Giuseppe de Pasquale: The only disadvantage of the bemo is its size. It’s adapted for an ICU room, so it would be difficult in a standard ward room. If there are no logistical restrictions, the range of applications is very broad: Geriatrics, oncology, rehabilitation – all could benefit. After 15 years as a physiotherapist in intensive care, I can safely say that it is really worth trying out the bemo to be convinced of its efficiency. When the exerciser was introduced to us, we were immediately enthusiastic and this only increased when we started to use it in our everyday life.
Dividat: Thank you very much, Christian and Giuseppe, for making yourselves available for the interview!
Giuseppe de Pasquale: The only disadvantage of the bemo is its size. It’s adapted for an ICU room, so it would be difficult in a standard ward room. If there are no logistical restrictions, the range of applications is very broad: Geriatrics, oncology, rehabilitation – all could benefit. After 15 years as a physiotherapist in intensive care, I can safely say that it is really worth trying out the bemo to be convinced of its efficiency. When the exerciser was introduced to us, we were immediately enthusiastic and this only increased when we started to use it in our everyday life.
Dividat: Thank you very much, Christian and Giuseppe, for making yourselves available for the interview!
bemo
Cycling
Fachkreise
Intensiv- & Akutpflege
Therapy & Practice
THERAPY 2022-I
THERAPY Magazine
Rebecca Birchler
Movement Scientist, Dividat AG
Rebecca Birchler completed her studies at ETH Zurich with a focus on Movement Sciences and Sports. During her master’s thesis, she evaluated home-based cognitive-motor training solutions in collaboration with Dividat. In her current role at Dividat, she supports clients in the practical implementation of cognitive-motor movement concepts.
Manuela Adcock
Head of Research, Dividat AD
Manuela Adcock is Head of Research at Dividat AG and holds a doctorate from ETH Zurich.
from the ETH Zurich. Manuela Adcock is a neuropsychologist with many years of clinical
years of clinical experience at the University Hospital Zurich.
References:
- Dividat AG, Neuhofstrasse 14, Schindellegi 8834, Switzerland www.dividat.com
Related contents
Find related exciting contents in our media library.
This is not what you are searching for? Knowledge
Meet our specialists.
Are you interested in our solutions? Schedule a meeting with a Consultant to talk through your strategy and understand how TEHRA-Trainer can help you to advance rehabilitation.