Clinician's Commentary on Baldwin et al.

Critically ill patients invariably spend most of their time lying in bed, and they potentially endure a whole host of conditions acquired in the hospital: ventilator-associated pneumonia, atelectasis, secretion retention, decubitus ulcers, deconditioning, total body weakness, pulmonary emboli, deep vein thrombosis, intolerance of vertical positions, balance and gait disturbances, delirium, and other deleterious complications of immobility. The introduction and practice of early mobility and physical activity in the intensive care unit (ICU) have been shown to significantly improve clinical outcomes,2 and information on activity levels may help clinicians assess and plan exercise activity programs without having to rely on patient self-reporting, nursing notes, or activity logs. A small device that can be useful for this is an accelerometer, which senses movement and can continuously measure patients' activity; however, the use of an accelerometer with critically ill patients has been limited, and its reliability in this population has not yet been fully substantiated.