The Feasibility and Acceptability of Virtual Therapy Environments for Early ICU Mobilization

PM R. 2020 Dec;12(12):1214-1221. doi: 10.1002/pmrj.12352. Epub 2020 Mar 26.

Abstract

Background: Early mobilization in critically ill patients has been documented to reduce neuromuscular complications, but access to rehabilitation services is often limited in the intensive care unit (ICU). Virtual platforms that deliver therapy may increase access to rehabilitation services and improve patient motivation to participate. Xbox Kinect Jintronix software delivers interventions using games and activities designed for therapy.

Objective: To determine the feasibility of the Jintronix virtual therapy system in an ICU setting by observing outcomes related to patient satisfaction, adverse events, and technical applicability.

Design: Prospective observational feasibility study.

Setting: Medical ICU at a Level 1 Trauma Center within an academic medical center.

Participants: Twenty adults admitted to ICU.

Intervention: Participants engaged in one therapy session with a maximum of 14 Jintronix modules targeting arm, leg, and/or trunk strength, range of motion, and endurance.

Outcome measures: A trained physician-observer recorded events related to adverse events and technical applicability. Participants completed a survey to determine patient satisfaction.

Results: A total of 188 modules were completed. Participants completed a median of nine modules each. Five participants completed the maximum of 14 modules. Fatigue was the most common reason for cessation. Mean intervention time was 29 minutes. There were no falls, lines dislodged, or medical events. Participants required physical assistance or verbal cues in 36% of modules. Technical errors affected 25% of modules and led to activity cessation in one case. Nearly all participants reported the activity was enjoyable, comfortable, safe, easy to understand, would improve range of motion and strength, and would motivate them to continue.

Conclusions: Use of a virtual therapy environment in an intensive care setting is feasible.