The early use of prone positioning, longer duration in prone lying (i.e., sufficient dosage), and use of prone positioning over a sufficient number of days are important components of the prone-positioning protocol for ventilated patients with ARDS/ALI.47–49,70,72,73 Kinetic therapy or lateral positioning with head of bed >30° and sitting with head of the bed >30° may be used for routine positioning of patients with ventilated ARDS/ALI.28,42,43 Step-wise early mobilization of ICU patients is safe and is associated with favourable outcomes in terms of both hospital length of stay and functional ability of the patient.29,30,32 Early intervention of sufficient frequency and duration and over an adequate period are the key to success for many physiotherapy interventions for ventilated ARDS/ALI patients. This review provides a starting point for physiotherapy guidelines in the management of patients with ARDS/ALI, but more clinical research is needed, and, of course, the patient's best interest is paramount when research findings are incorporated into clinical practice.88,89 Even given the complexity involved in clinical research on ICU care of severely ill patients, there may be some simple but important treatment interventions for physical therapists to use that may save lives when properly administered.90
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Chung et al. (2010) studied this question.