Keywords

Mobility; Delirium; Early Mobility; ICU; Exercise

Abstract

Delirium is common among the critically ill population, affecting 50-70% of mechanically ventilated patients. Delirium is associated with prolonged mechanical ventilation and hospitalization, long-term cognitive dysfunction, and increased mortality. The effects of early mobilization on delirium are not well understood. The purpose of this integrative literature review is to explore the role of exercise and mobility in preventing delirium. Delirium incidence in critically ill mechanically ventilated patients undergoing mobility protocols was compared to delirium rates of patients receiving usual care. Databases searched included CINAHL, MEDLINE, and PsycINFO for articles published between 2013 and 2025. Inclusion criteria consisted of mobility or exercise protocols, reported delirium outcomes, mechanically ventilated ICU patients, and English language. Pediatrics or non-ICU populations were excluded. Twenty five studies were screened, and ten were included in the final synthesis following critical appraisal. Findings from ten articles (one meta-analysis, five RCTs, three quasi-experimental studies, and one non-experimental study) suggest a trend toward reduced delirium incidence when regular mobility protocols are incorporated into patient care. Higher intensity mobility exercise appears to be associated with reduced delirium. Mobility consistently improved recovery and patient outcomes, such as decreased hospital and ICU length of stay, decreased mechanical ventilation duration, improved Barthel index and Medical Research Council (MRC) Muscle Strength Scale. Some findings suggest that delirium and mobility may have an interrelated relationship. This review reinforces the assertion that early mobility is safe and feasible in the ICU setting. Early mobilization appears to be a promising intervention for not only reducing delirium but also improving clinical outcomes in critically ill adults. Moderate intensity exercise protocols show iii the most promise in regard to delirium reduction. However, higher-quality studies are needed to clarify this relationship to help develop standardized protocols to help prevent delirium in the critically ill population.

Thesis Completion Year

2026

Thesis Completion Semester

Spring

Thesis Chair

Bourgault, Annette

College

College of Nursing

Department

Nursing

Thesis Discipline

Nursing

Language

English

Access Status

Campus Access

Length of Campus Access

3 years

Campus Location

Orlando (Main) Campus

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Rights Statement

In Copyright