Once they're stable, ICU patients can move around, which means they can go home sooner.

RODALE NEWS, EMMAUS, PA—If you think of a typical hospital recovery scene, particularly for a critically ill patient, you probably picture someone on bed rest in the intensive care unit (ICU). But emerging research suggests exercise in the ICU—even for patients still hooked up to ventilators—can actually speed up recovery time.

"Our work challenges physicians to rethink how they treat critically ill patients and shows the downstream benefits of early mobilization exercises," says lead study author Dale M. Needham, MD, PhD, medical director of the Critical Care Physical Medicine & Rehabilitation Program at Johns Hopkins University in Baltimore. In fact, doctors may be late to the game on this one. "Our patients keep telling us that they do not want to be confined to their beds, they want to be awake, alert, and moving, and engaged participants in their recovery," says Dr. Needham. "Patients are not afraid of exercising while they are in the ICU, and they are embracing this new approach to their care in the ICU," he adds. "It actually motivates them to get well and reminds them that they have a life outside the four walls surrounding their hospital beds."

THE DETAILS: The small study, published this month in the Archives of Physical Medicine and Rehabilitation, looked at 57 patients in the ICU who had been hooked up to mechanical ventilators for at least four days. They found that by cutting back on the drowsiness-inducing medications, patients could exercise. This, in turn, reduced muscle weakness and also lowered the risk of experiencing delirium and hallucinations associated with the heavy sedation medications. Introducing exercise early on after a patient's vital signs stabilized also cut down hospital recovery time by two to three days, the study authors found.

Dr. Needham says there are three major takeaways from the study:

1. Doctors were able to dramatically reduce, in a safe and comfortable manner, the amount of sedation medications received by these patients on life-support therapy in the ICU. As a result, patients were much wider awake, with clear thinking, compared with traditional practice.

2. As a result of this change in sedation, the proportion of ICU days in which eligible patients did not receive rehabilitation therapy were markedly decreased, from 41 percent down to 7 percent; there was a fivefold increase in the average number of rehabilitation treatments per day in the ICU.

3. Through increased rehabilitation therapy in the ICU, patients had a higher level of functional ability, that is, the ability to sit, stand, and walk. Although these seem like basic activities, many patients who are given standard care leave the ICU unable to sit or stand because of their severe illness and lack of rehabilitation therapy. So these are important benefits over traditional practice, in which patients are deeply sedated and are given bed rest through most of their ICU stay.

WHAT IT MEANS: When we don't move, our muscle melts away—fast. In fact, patients can lose as much as 5 percent per week of leg muscle mass when confined to bed rest, making it difficult to perform daily functions once they are discharged from the hospital. On top of that, Dr. Needham's latest findings, building on three years of researching exercise as medicine in more than 500 critically ill patients, highlight that mild exercise—up to 30 to 45 minutes a day—can actually help sick patients recover faster.