Importantly, despite experiences
with early and intensive physical
therapy in surgical and medical
NICUs, the present study demonstrated
that earlier and potentially
more intensive physical therapy is
not being performed for patients in
the NICU. We found that physical
therapy started at a median of hospital
day 3 and significantly later in
patients requiring mechanical ventilation
or ICP monitoring. In comparison,
in the Very Early Rehabilitation
Trial (AVERT) for stroke study,
patients with stroke were randomized
to receive mobilization within
24 hours of admission rather than
the standard of care.6 7 Similarly, in
studies of early physical therapy in
the medical NICU with positive outcomes,
physical therapy was started
as early as 24 to 48 hours after intubation
and focused on respiratory
muscle strength, ROM, functional
mobility training, and exercise
training