Technology-Assisted Early Mobilization Program Among Patients in the Intensive Care Units

The occurrence of ICUAW will primarily be assessed using the Medical Research Council (MRC) scale. An MRC sum score of less than 48 indicates the presence of ICUAW.

Muscle power will be evaluated using the MRC scale, which assesses the strength of six bilateral muscle groups rated from 0 (complete paralysis) to 5 (normal strength) for each group. The total score ranges from 0 to 60.

Hand-grip strength will be measured using a hydraulic hand dynamometer. A strength of less than 11 kg for males and less than 7 kg for females indicates the presence of ICUAW. This outcome will be used to assess the occurrence of ICUAW, as determined by the MRC sum score, concurrently.

Delirium is assessed by the Intensive Care Delirium Screening Checklist (ICDSC), which includes eight items. Each item is scored as absent (0) or present (1), with total score ranging from 0 to 8. A score of ≥ 4 indicates the presence of delirium. The scoring is based on observations during every nursing shift.

Richards-Campbell Sleep Questionnaire (RCSQ) will be used to assess subjective sleep quality on a visual analog scale among patients in the ICU. The total score is calculated with a formula and categorized into four levels: < 26 is very poor, 26-50 is poor, 51-75 is good, and > 76 is excellent.

Objective sleep status will be evaluated by SOMNOwatch™, which can extract not only sleep related parameters but also calculate sleep stages using additional electroencephalography (EEG) sensors.

Functional Status Score for the Intensive Care Unit (FSS-ICU) is used to assess the functional status of patients in the ICU. Patient's performance of five functional movements will be rated from 0 to 7. The total score ranges from 0 to 35, with higher scores indicating better functional status.

The duration of ventilation use is specified the accumulated days of using mechanical ventilation with endotracheal tube in the ICU for this hospitalization. This outcome will be recorded from the hospital's electronic system.

The length of stay in the ICU will be recorded from the hospital's electronic system.

The total length of stay in the hospital will be recorded from the hospital's electronic system.

Any adverse events occur during the intervention session.

The ADL will be assessed by the Barthel Index. The total score ranges from 0 to 100. A score of ≥ 70 indicates independent daily living abilities.

The Pittsburgh Sleep Quality Index (PSQI) is used to assess sleep quality over the past month. Score ranges from 0 to 21, with a score > 5 indicating poor sleep quality; higher scores reflect worse sleep quality.

The EuroQol Five-Dimensional Five-Level Scale (EQ-5D-5L) is used to evaluate health-related QoL. The health status classification comprises five dimensions, each with five levels, calculated using specific values. The vertical analog scale assesses the patient's overall evaluation of their current health status, ranging from 0 to 100. Higher scores indicate greater QoL.

Depression, anxiety, and stress-21 items (DASS-21) will be used to assess patients' level of psychological distress. It contains 21 items, using the likert scale, where 0 indicates no effect, 1 indicates occasional effect, 2 indicates very effective, and 3 indicates extremely effective. There are seven items each for depression, anxiety, and stress. The total score for each item is calculated by adding them together and multiplying by two, ranging from 0 to 42. Higher scores indicate a more severe mood disorder. This scale has been proven to have good reliability and efficacy in medical institutions, community environments, various cultural groups, and healthy individuals, and is also commonly used for critically ill patients.