Passive mobilization could cut post-stroke pneumonia risk
MedWire News: Turning and passively mobilizing hospitalized stroke patients may reduce their risk for contracting pneumonia, research suggests.
The intervention, which the researchers call the “turn-mob” program, involves changing the patient’s position (eg, from lateral recumbent to supine) and mobilizing all four limbs for 10 seconds, 10 times. The program is implemented every 2 hours.
For the current study, Pilar Lavielle (Hospital de Especialidades, Mexico City, Mexico) and colleagues recruited relatives of 111 stroke patients to perform the turn-mob program. A further 112 patients were randomly assigned to standard care, which included having their position changed three times a day.
Between 48 hours after admission and 14 days after discharge, 12.6% of the turn-mob group versus 26.8% of the control group developed pneumonia, representing a 61% risk reduction associated with the turn-mob intervention.
Lavielle et al stress that baseline variables including age, obesity, chronic obstructive pulmonary disease, and current smoking did not significantly differ between the two groups.
Clinical symptoms and severity were also similar between groups, and supportive therapy, such as endotracheal intubation and enteral feeding, which are recognized pneumonia risk factors, was used in similar proportions of both groups.
The researchers explain that physiotherapeutic interventions such as the turn-mob program boost patients’ respiratory and cardiovascular function and increase mucociliary clearance, thus reducing their pneumonia risk.
Relatives administered the turn-mob program in the current study, providing “a benefit that in experienced hands could be even greater,” Lavielle et al note in the Journal of Stroke and Cerebrovascular Diseases.
The team concludes: “This program, just as it was developed in this project, represents a feasible strategy anywhere in the world, at minimum cost and with a clear benefit in reducing the incidence of pneumonia in patients with ischemic stroke.
“Its usefulness should be tested in patients with other chronic diseases, both during hospital stay and home.”
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By Eleanor McDermid