Patient Overview
A 64-year-old patient was hospitalized following hernia repair complicated by repeated surgical procedures and an open abdomen lasting more than nine days.
The patient was mechanically ventilated, sedated, and receiving vasopressor support. During the early phase of recovery, the patient demonstrated minimal responsiveness and no active movement, creating significant barriers to traditional mobility.
Given the patient’s medical complexity and open abdomen status, mobility would typically have been deferred due to perceived risk.
Mobility Intervention
Verticalization Therapy® was initiated using The Catalyst® to provide an earlier pathway to mobility while the patient remained medically complex.
The care team incorporated progressive verticalization into the patient’s plan of care with a focus on:
- Supporting arousal and engagement
- Optimizing pulmonary function and ventilation mechanics
- Monitoring hemodynamic tolerance with positional changes
- Supporting pressure offloading
- Introducing early weight-bearing to help preserve musculoskeletal function
The intervention allowed mobility activities to begin while the patient remained in a controlled bedside environment.
Outcomes
Following the initiation of Verticalization Therapy®, the patient demonstrated rapid improvement in alertness and return of limb movement.
As recovery progressed, the patient achieved significant functional milestones. By hospital day 33, the patient was able to sit unsupported at the edge of the bed despite ongoing open abdomen status.
The patient progressed to standing shortly afterward and continued advancing through the mobility program.
Ultimately, the patient was discharged home without requiring a skilled nursing facility or inpatient rehabilitation.
The progression from minimal responsiveness and no active movement to unsupported sitting, standing, and discharge home illustrates the patient’s significant functional recovery during a highly complex surgical hospitalization.
Clinical Considerations
High-acuity surgical patients may face prolonged periods of immobility due to repeated procedures, mechanical ventilation, hemodynamic support, sedation, and concerns related to complex wounds or an open abdomen.
These clinical challenges can make traditional out-of-bed mobility difficult to initiate, potentially delaying functional recovery.
This case demonstrates how Verticalization Therapy® using The Catalyst® may be incorporated into a comprehensive mobility strategy for medically complex surgical patients when conventional mobility approaches are limited.
By providing a controlled method for introducing upright positioning and progressive weight-bearing, Verticalization Therapy® can help clinical teams identify opportunities to begin mobility earlier while continuing to monitor patient tolerance and clinical response.
From Critical Illness to Functional Recovery
For medically complex patients, mobility does not have to begin with walking. Creating opportunities for earlier upright positioning, engagement, and progressive weight-bearing may help establish a pathway toward more advanced rehabilitation.
In this case, the patient progressed from minimal responsiveness and no active movement to unsupported sitting, standing, and ultimately returning home.
Learn how The Catalyst® helps healthcare teams address mobility barriers and advance early mobility for medically complex patients.