You have full access to this open access article. A scientific panel was created consisting of 23 interdisciplinary and interprofessional experts in intensive care medicine, physiotherapy, nursing care, surgery, rehabilitative medicine, and pneumology delegated from scientific societies together with a patient representative and a delegate from the Association of the Scientific Medical Societies who advised methodological implementation.
The topics of early mobilisation, neuromuscular electrical stimulation, assist devices for mobilisation, and positioning, including prone positioning, were identified as areas to be addressed and assigned to specialist expert groups, taking conflicts of interest into account. The panel formulated PICO questions addressing the population, intervention, comparison or control group as well as the resulting outcomes , conducted a systematic literature review with abstract screening and full-text analysis and created summary tables.
This was followed by grading the evidence according to the Oxford Centre for Evidence-Based Medicine Levels of Evidence and a risk of bias assessment. The recommendations were finalized according to GRADE and voted using an online Delphi process followed by a final hybrid consensus conference. The German long version of the guideline was approved by the professional associations.
For this English version an update of the systematic review was conducted until April and recommendation adapted based on new evidence in systematic reviews and randomized controlled trials. In total, 46 recommendations were developed and research gaps addressed.
In adult critically ill patients in intensive care units ICU , prolonged immobility is associated with several short- and long-term sequelae such as intensive care unit-acquired weakness ICUAW [ 1 ], loss of muscle mass [ 2 , 3 ] and functionality [ 4 ], delirium [ 5 , 6 , 7 , 8 ], cognitive decline [ 9 , 10 ], and reduced quality of life [ 10 ] which may be minimised by early mobilisation.
