Barriers, Perceptions and Knowledge of Early Mobilization Practice Post Cardiovascular Surgeries Across Indian Physiotherapists Working in Intensive Care Units: Observational Cross Sectional Survey Study

Abstract

 Introduction: Early mobilisation (EM) post cardiovascular surgeries is paramount to attaining positive effects, as EM is
shown to have physical, mental and emotional benefits in restoring a patient’s condition. Despite the benefits, safety,
and feasibility, clinicians, including Physiotherapists, do not commonly use early mobilisation in intensive care units.
Methods: An observational descriptive Cross-Sectional Survey to study barriers, knowledge and perceptions of early
mobilisation practised post-cardiovascular surgery patients among Indian Physiotherapists working in ICU/PCCU was
carried out from February 2024 to April 2024.
Results: The rate of responses was 84.2%. Most respondents (48.5%) checked early ambulation as crucial, as it should
be a top priority in the care of critically ill patients and should be initiated as soon as the patient’s cardiac-pulmonary
function stabilised. More than half of the respondents (52.5%) were familiar with clinical trials and/or literature that
evaluate early mobilisation to post-cardiovascular surgery in ICU/PCCU, while 47.5% were not. Regarding training, over
one-third of the respondents (37.6%) do not feel sufficiently trained or informed to mobilise non-invasive mechanical
ventilated post-cardiac surgery clients in the ICU/PCCU. The most important barriers identified were medical or surgical
instability (69 (68.3%), prior order required from consultants/surgeons or physicians (60 (59.4%)), absence of written
guidelines or protocols (45 (44.6%)), excessive sedation (44 (43.6)), inadequate equipment (42 (41.6%)) and limited
staffing (Physiotherapists).
Conclusion: Barriers to practice early ambulation or mobilisation in critical care units still exist.