Einstein Montgomery Offers ICU MOVE Program in the Critical Care Unit

Einstein Medical Center Montgomery offers the ICU (Intensive Care Unit) MOVE (Mobilization Optimization Via Exercise) Program in the Critical Care Unit. Patients in the ICU are treated for various life-threatening conditions and physical activity and exercise in this unit has shown to help improve physical and cognitive functioning. This intervention supports decreased time in the ICU and in the hospital, and can mean fewer days on a mechanical ventilator. Overall, the sooner a patient can start an exercise regimen, the better, leading to an improved quality of life. Einstein Montgomery is one of only a handful of hospitals in the Philadelphia region that offers this type of program.

Patients are evaluated for the ICU MOVE Program using a protocol developed by a multi-disciplinary group of clinicians including intensivists (an intensive care physician that specializes in caring for critically ill patients), nurses, respiratory therapists, physical therapists and occupational therapists. Patients that are deemed appropriate, have an exercise plan tailored to their needs to help them in their recovery.

'The goal of the ICU MOVE Program is to help patients maintain as much of their muscle strength as possible while in the ICU which helps decrease the number of days needed in the hospital as well as decreasing the number of days needed in rehabilitation,' says Kimberly Mikula, MSN, RN, Clinical Director Critical Care for Einstein Montgomery. 'The bottom line is the ICU MOVE Program helps get patients home sooner and in better physical and mental condition and that's why a team of clinical staff and senior leaders from Einstein Montgomery were so committed to bringing the program here.'

A bicycle machine called the MOTOmed letto2®, is part of the ICU MOVE Program and is used to strengthen leg and arm muscles. It can also help improve circulation, muscle atrophy, joint stiffness, edema in the legs and arms, digestion, bowel and bladder issues, high blood pressure, among other conditions. The equipment is placed at the end of the bed and is adjusted to accommodate different heights among patients so their legs can reach the machine. The same MOTOmed letto2® machine, with an adjustment added so patients' hands can be strapped onto the handles, is used to strengthen arms. The machine can automatically rotate patients' arms or legs and the patient has the choice to take over if they're able to do so. The equipment provides a daily report on how active each patient is and how long they're able to do the exercises on their own so staff can measure their activity and see if there's improvement.

'There's a definite cognitive benefit to having patients in the ICU do exercises because it gives patients an activity to focus on and something to challenge themselves with,' says Mikula. Exercise has also shown to reduce delirium in the ICU. Delirium is a sudden change in the brain that causes mental confusion and emotional disruption making it difficult to think, remember, sleep and focus. Older adults are at higher risk of developing delirium while in the hospital. 'When patients are engaged in an activity, they may focus less on their pain and discomfort which means they require less sedatives and that can help facilitate recovery,' adds Mikula.

The Program started during the COVID-19 pandemic, and initially, patients with coronavirus did not participate because the slightest movement could cause their oxygen level to drop which would be very dangerous. Clinical staff had to be extremely careful when and how these patients were moved. In addition, a lot of patients with COVID-19 are positioned prone on their belly which makes it difficult to move their extremities. Since the start of the pandemic, clinicians have learned a lot about how to care for patients with COVID-19 and now they are enrolled in the ICU MOVE Program if deemed good candidates.

For now, the ICU MOVE initiative is strictly used in the ICU on the Critical Care Unit but the goal is to see the program grow and be utilized for patients in other units at the hospital.

About Einstein Medical Center Montgomery

A technologically-advanced, 195-bed tertiary care medical center located in East Norriton, Pa. Einstein Medical Center Montgomery is part of Einstein Healthcare Network and offers a full range of medical and surgical care. Services include: a full service maternity unit with a Level III Neonatal Intensive Care Unit; 24-hour emergency medicine; advanced heart care, including cardiac catheterization, open heart surgery, and electrophysiology intervention; cutting-edge cancer care; orthopedics and bariatric surgery. Primary care services are provided by Einstein Physicians, a network of physicians, nurses and healthcare specialists dedicated to serving patients throughout every stage of life. For more information, visit Einstein.edu/Montgomery or call 1-800-EINSTEIN.

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