Trial reportIntensive care medicine2019
Influence of the initial level of consciousness on early, goal-directed mobilization: a post hoc analysis.
Trial report in Intensive care medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.
- Guideline on positioning and early mobilisation in the critically ill by an expert panel.Intensive care medicine · 2024Guideline
- Standard of care for rehabilitation in critical illness.Intensive care medicine · 2026Review
- Timing of ceiling lift-assisted out-of-bed sitting training and outcomes in critically ill patients: a prospective cohort study.Critical care (London, England) · 2025Observational
- A Culture of Early Mobilization in Adult Intensive Care Units: Perspective and Competency of Physicians.Healthcare (Basel, Switzerland) · 2024Article
- Risk factors for early death in severe non-brain-injured trauma patients.World journal of emergency medicine · 2024Article
- The optimal dose of mobilisation therapy in the ICU: a prospective cohort study.Journal of intensive care · 2023Article
- [Interprofessional curriculum for early mobilization : Developed by the nursing section of the DGIIN in close cooperation with the German early mobilization network].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2023Review
- Early Mobilization for Critically Ill Patients.Respiratory care · 2023Review
- Clustering of critically ill patients using an individualized learning approach enables dose optimization of mobilization in the ICU.Critical care (London, England) · 2023Observational
- Barriers and facilitators to implementation of early mobilisation of critically ill patients in Zimbabwean and South African public sector hospitals: a qualitative study.Disability and rehabilitation · 2022Article
- Timing of early mobilization to optimize outcomes in mechanically ventilated ICU patients.Intensive care medicine · 2022Article
- Attenuating Muscle Mass Loss in Critical Illness: the Role of Nutrition and Exercise.Current osteoporosis reports · 2022Review
- A Global Survey on Diagnostic, Therapeutic and Preventive Strategies in Intensive Care Unit-Acquired Weakness.Medicina (Kaunas, Lithuania) · 2022Article
- The validity, reliability and feasibility of four instruments for assessing the consciousness of stroke patients in a neurological intensive care unit compared.BMC medical research methodology · 2022Article
- Goal-Directed Mobility of Medical Inpatients-A Mini Review of the Literature.Frontiers in medicine · 2022Review
- What Factors Predict Adverse Discharge Disposition in Patients Older Than 60 Years Undergoing Lower-extremity Surgery? The Adverse Discharge in Older Patients after Lower-extremity Surgery (ADELES) Risk Score.Clinical orthopaedics and related research · 2021Article
- Focus on neuro-critical care: combined interventions to improve relevant outcomes.Intensive care medicine · 2020Article
- Functional mobility recovery predicts readmission to the surgical intensive care unit.Intensive care medicine · 2020Article
- Assessment of mobilization capacity in 10 different ICU scenarios by different professions.PloS one · 2020Article
- [Early mobilisation on the intensive care unit : What we know].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 8 institutions in 3 countries.
Funding
Abstract
purposeEarly mobilization within 72 h of intensive care unit (ICU) admission improves functional status at hospital discharge. We aimed to assess the effectiveness of early, goal-directed mobilization in critically ill patients across a broad spectrum of initial consciousness levels.
methodsPost hoc analysis of the international, randomized, controlled, outcome-assessor blinded SOMS trial conducted 2011-2015. Randomization was stratified according to the immediate post-injury Glasgow Coma Scale (GCS) (≤ 8 or > 8). Patients received either SOMS-guided mobility treatment with a facilitator or standard care. We used general linear models to test the hypothesis that immediate post-randomization GCS modulates the intervention effects on functional independence at hospital discharge.
resultsTwo hundred patients were included in the intention-to-treat analysis. The significant effect of early, goal-directed mobilization was consistent across levels of GCS without evidence of effect modification, for the primary outcome functional independence at hospital discharge (p = 0.53 for interaction), as well as average achieved mobility level during ICU stay (mean achieved SOMS level) and functional status at hospital discharge measured with the functional independence measure. In patients with low GCS, delay to first mobilization therapy was longer (0.7 ± 0.2 days vs. 0.2 ± 0.1 days, p = 0.008), but early, goal-directed mobilization compared with standard care significantly increased functional independence at hospital discharge in this subgroup of patients with immediate post-randomization GCS ≤ 8 (OR 3.67; 95% CI 1.02-13.14; p = 0.046).
conclusionThis post hoc analysis of a randomized controlled trial suggests that early, goal-directed mobilization in patients with an impaired initial conscious state (GCS ≤ 8) is not harmful but effective.
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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.