Early Mobilization in the Neuro-ICU: How Far Can We Go?

Immobility that is frequently encountered in the intensive care unit (ICU) can lead to patient complications. Early mobilization of patients in the ICU has been shown to reduce the complications associated with critical illness; however, early mobilization in the neurological intensive care unit (NICU) presents a unique challenge for the multidisciplinary team. The early mobilization of patients with acute neurologic injuries such as acute ischemic stroke, aneurysmal subarachnoid hemorrhage, intracerebral hemorrhage, and neurotrauma varies because of differing disease processes and management. When developing an early mobility program in the NICU, the following should be considered: the effect of positional changes and exercise, the time from symptom onset to the initiation of early mobilization, and the type and intensity of the exercise prescribed.