Study of the intensive care unit activity scale in the early rehabilitation of patients after direct cardiac surgery

Table 1 Intensive care unit mobility scale rating scale

IMS	Activity content
Grade 0	Perform the first step, physical activity (goal; twice daily), including PROM at least 10 times daily, and train and encourage family members to perform PROM on the patient for 15–30 min, if the patient can tolerate it
Grade 1	Perform step 2 and step 3. If not tolerated, perform step 3 first and step 2 again. Step 2, elevate the head of the bed > 45° for > 1 h (goal: Twice daily). Step 3, adjust the bed to a chair position, elevate the head of the bed > 60° for > 1 h, and repeat every 2 h if tolerated by the patient
Grade 2	Perform step 4, adjusting the bed into a heart failure chair position for > 1 h, and if the patient tolerates it, repeat the above every 2 h for > 4 h at a time. Steps 2 to 4 require checking the patient’s tolerance level at least twice every 30 min
Grade 3	Perform step 5, sit at the edge of the bed (target; 20 min) or help the patient to sit at the edge of the bed with minimal assistance, this step requires at least one staff member to help the patient sit and assist the patient to move their lower limbs
Grade 4	Perform step 6, stand at the edge of the bed for > 2 min (goal; twice daily). If possible, try to walk at the edge of the bed for 10 s
Grades 5–6	Perform step 7, move the patient to sit on a chair for > 60 min (goal; 2–3 times daily) and adjust the patient’s sitting position every 1 h, if the patient is unstable during this process, support the patient to the chair with assistance and do not continue to step 8
Grades 7–10	Perform step 8, walking tolerance training (goal; 2-3 times daily), recording the distance the patient walks and assistive devices used

IMS: Intensive care unit mobility scale; PROM: Passive physical activity.