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Adult nursing
Early mobilisation in the intensive care unit randomised controlled trial: a need to look beyond the surface
  1. David Anekwe1,
  2. Jadranka Spahija2,3,4
  1. 1 Department of Physical Therapy, The University of British Columbia, Vancouver, British Columbia, Canada
  2. 2 School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada
  3. 3 Hôpital du Sacré-Coeur de Montréal Research Center, CIUSSS du Nord-de-l'Île-de-Montréal, Montréal, Québec, Canada
  4. 4 Centre for Interdisciplinary Research in Rehabilitation (CRIR), Jewish Rehabilitation Hospital Research Centre, CISSS de Laval, Laval, Québec, Canada
  1. Correspondence to Dr Jadranka Spahija, School of Physical and Occupational Therapy, McGill University, Montreal, QC H3A 0G4, Canada; jadranka.spahija{at}

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Commentary on: TEAM Study Investigators and the ANZICS Clinical Trials Group; Hodgson CL, Bailey M, Bellomo R, Brickell K, Broadley T, Buhr H, Gabbe BJ, Gould DW, Harrold M, Higgins AM, Hurford S, Iwashyna TJ, Serpa Neto A, Nichol AD, Presneill JJ, Schaller SJ, Sivasuthan J, Tipping CJ, Webb S, Young PJ. Early active mobilization during mechanical ventilation in the ICU. N Engl J Med 2022;387(19):1747–58. doi:10.1056/NEJMoa2209083. Epub 26 Oct 2022.

Implications for practice and research

  • Early mobilisation may improve patient outcomes; however, starting with a higher dosage at the early stage of critical illness may not provide any added benefit.

  • Future research should explore the intensity, timing, duration and level of activity required to optimise physical rehabilitation of critically ill patients.


Early mobilisation (EM) refers to the practice of initiating physical activity that is of sufficient intensity to elicit acute physiological effects that enhance ventilation, central and peripheral perfusion, circulation and muscle metabolism early in the course of critical illness. …

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  • Twitter @david_anekwe

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.