Mobilidade de pacientes críticos submetidos à cicloergometria ativa de membros inferiores usando o Perme Escore: ensaio clínico randomizado e duplo-cego

Abstract

Introduction: The proportion of patients who survive critical illness is increasing, but the mobility at hospital discharge is low and it is related to immobility on the bed, muscle weakness and worse functional outcomes. Mobilization of critically ill patients is feasible and safe; however, the benefits of active cycle ergometry on the bed, as well as the use of the Perme Intensive Care Unit Perme (Perme Score) as a measure of patient mobility, are not yet known to cycle ergometry. Objective: To analyze and compare the mobility and muscle strength of critically ill patients undergoing active cycle ergometry on the lower limb and conventional physical therapy using the Perme Score. Methodology: A randomized, doubleblind clinical trial with 24 patients, conducted at the Intensive Care Unit (ICU) of the Federal University of Uberlândia (HC-UFU). Patients with '3' grade of the lower limb strength according to the Medical Research Council (MRC) o and under mechanical ventilation for at least 48 hours were randomized by an independent researcher and subjected to the Perme Score. The experimental group (EG) performed active cycle ergometry on the lower limb in the bed associated with conventional physiotherapy and the control group (CG) conventional physiotherapy for eight consecutive days. Both groups were reevaluated on a ninth day. Results: There was no statistical difference for mobility pré-intervention (p = 0.343), but there was for mobility post-intervention (p = 0.017). There was an improvement for mobility score (18.5 ± 2.50 vs 13.7 ± 5.84) for in the EG, but no significant difference was in the postintervention on muscle strength between groups (p> 0.05). Conclusion: Active cycle ergometry on the lower limb improved the mobility level when compared to the group submitted just to conventional physical therapy, and muscle strength remained unchanged. The Perme Score represented a viable tool to measure the evolution of mobility of critically ill patients.