Observational studyCritical care (London, England)2016
The association of sleep quality, delirium, and sedation status with daily participation in physical therapy in the ICU.
Observational study in Critical care (London, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Efficacy of the "Start to Move" Protocol on Functionality, Delirium and Acquired Weakness in ICU. Randomized Clinical Trial.
Optimising Analgosedation in Extracorporeal Membrane Oxygenation (ECMO) Using a Co-designed Analgosedation Protocol
Feasibility of a Cluster Randomised Control Trial Evaluating a Co-designed Analgosedation Protocol in Extracorporeal Membrane Oxygenation (ECMO) Patients
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Non-pharmacological interventions for sleep promotion in hospitalized children.The Cochrane database of systematic reviews · 2022Pooled it
- Sleepless in the hospital: A systematic review of non-pharmacological sleep interventions.General hospital psychiatryPooled it
- Development and Validation of a Prediction Model for Intensive Care Unit-Acquired Weakness in Adult Patients with Sepsis: A Prospective, Observational, Single-Center Study.International journal of general medicine · 2026Article
- Optimizing Sleep Hygiene in the Hospital Environment.Sleep medicine clinics · 2025Review
- Decreasing the incidence of delirium via multi-sensory stimulation in patients receiving mechanical ventilation in the intensive care unit: A protocol for a randomized feasibility study.Contemporary clinical trials communications · 2024Article
- Causes, Consequences, and Treatments of Sleep and Circadian Disruption in the ICU: An Official American Thoracic Society Research Statement.American journal of respiratory and critical care medicine · 2023Article
- A Global Survey on Diagnostic, Therapeutic and Preventive Strategies in Intensive Care Unit-Acquired Weakness.Medicina (Kaunas, Lithuania) · 2022Article
- The future of intensive care: delirium should no longer be an issue.Critical care (London, England) · 2022Review
- Delirium prediction in the ICU: designing a screening tool for preventive interventions.JAMIA open · 2022Article
- Speech-language pathology approaches to neurorehabilitation in acute care during COVID-19: Capitalizing on neuroplasticity.PM & R : the journal of injury, function, and rehabilitation · 2022Article
- Article
- Physical Rehabilitation in Critically Ill Children: A Multicenter Point Prevalence Study in the United States.Critical care medicine · 2020Article
- Sleep and Delirium in Older Adults.Current sleep medicine reports · 2020Review
- Implementing early physical rehabilitation and mobilisation in the ICU: institutional, clinician, and patient considerations.Intensive care medicine · 2018Article
- Physical rehabilitation interventions in the intensive care unit: a scoping review of 117 studies.Journal of intensive care · 2018Article
- Early Mobilization in the Neuro-ICU: How Far Can We Go?Neurocritical care · 2017Review
- Understanding early goal-directed mobilization in the surgical intensive care unit.Annals of translational medicine · 2017Article
- The ABCDEF Bundle: Science and Philosophy of How ICU Liberation Serves Patients and Families.Critical care medicine · 2017Article
- Delirium in a Latin American intensive care unit. A prospective cohort study of mechanically ventilated patients.Revista Brasileira de terapia intensivaArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundPoor sleep is common in the ICU setting and may represent a modifiable risk factor for patient participation in ICU-based physical therapy (PT) interventions. This study evaluates the association of perceived sleep quality, delirium, sedation, and other clinically important patient and ICU factors with participation in physical therapy (PT) interventions.
methodThis was a secondary analysis of a prospective observational study of sleep in a single academic medical ICU (MICU). Perceived sleep quality was assessed using the Richards-Campbell Sleep Questionnaire (RCSQ) and delirium was assessed using the Confusion Assessment Method for the ICU (CAM-ICU). Other covariates included demographics, pre-hospitalization ambulation status, ICU admission diagnosis, daily mechanical ventilation status, and daily administration of benzodiazepines and opioids via bolus and continuous infusion. Associations with participation in PT interventions were assessed among patients eligible for PT using a multinomial Markov model with robust variance estimates.
resultsOverall, 327 consecutive MICU patients completed ≥1 assessment of perceived sleep quality. After adjusting for all covariates, daily assessment of perceived sleep quality was not associated with transitioning to participate in PT the following day (relative risk ratio [RRR] 1.02, 95 % CI 0.96-1.07, p = 0.55). However, the following factors had significant negative associations with participating in subsequent PT interventions: delirium (RRR 0.58, 95 % CI 0.41-0.76, p <0.001), opioid boluses (RRR 0.68, 95 % CI 0.47-0.99, p = 0.04), and continuous sedation infusions (RRR 0.58, 95 % CI 0.40-0.85, p = 0.01). Additionally, in patients with delirium, benzodiazepine boluses further reduced participation in subsequent PT interventions (RRR 0.25, 95 % CI 0.13-0.50, p <0.001).
conclusionsPerceived sleep quality was not associated with participation in PT interventions the following day. However, continuous sedation infusions, opioid boluses, and delirium, particularly when occurring with administration of benzodiazepine boluses, were negatively associated with subsequent PT interventions and represent important modifiable factors for increasing participation in ICU-based PT interventions.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.