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Table 2 Intervention Strategies for early targeted rehabilitation for the critically ill.

From: Early rehabilitation in sepsis: a prospective randomised controlled trial investigating functional and physiological outcomes The i-PERFORM Trial(Protocol Article)

Ramsay Sedation Scale

Stages of exercise

progression

Conditions

Type of Intervention

Recommended Exercise Prescription

6-4

Stage 1

Sedated

Passive Range of Motion with stretch reflex to upper and lower limbs

30 Mins/day

   

Electrical Muscle Stimulation to major muscle groups

30 Mins/day

3-2

Stage 2

Inotropic Dependence

Active Range of Motion/Lightly resisted with upper and lower limb

10 Mins × 2/day

   

Electrical Muscle Stimulation to major muscle groups

30 Mins/day

   

Sitting up in Bed with assistance as tolerated

30 Mins × 2/day

   

Sitting on Edge of Bed

10 Mins × 2/day

2

Stage 3

Weight

Active Range of Motion/Lightly resisted with upper and lower limb

10 Mins × 2/day

  

Bearing

Electrical Muscle Stimulation to major muscle groups

30 Mins/day

  

Muscle Strength

Sitting On Edge of Bed

10 Mins × 2/day

  

Grade < 3

Sitting Out of Bed with assistance

60 Mins × 2/day

   

Lower Limb Ergometry

15 Mins × 2/day

   

Tilt Table Therapy

30 Mins/day

2

Stage 4

Weight

Active Range of Motion/Lightly resisted with upper and lower limb

10 Mins × 2/day

  

Bearing

Electrical muscle stimulation to major muscle groups

30 Mins/day

  

Muscle Strength

Sitting On Edge of Bed

10 Mins/day

  

Grade > 3

Sitting Out of Bed

30 Mins/day

   

Upper Limb Ergometry (low level resistance)

15 Mins/day

   

Lower Limb Ergometry

15 Mins × 2/day

   

Ambulation with assistive device and therapist

30 Mins × 2/day

  1. The Intervention strategies act as a guide for the execution of early exercises for the patients with sepsis syndromes based on the level of alertness according to the Ramsay Sedation Scale