Overview of the verticalization of technology: history of the occurrence and relevance of application

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Verticalization is a mobilization technique that is aimed at preventing and treating impaired gravitational gradient in patients who are on bed rest for >24 h, regardless of their motor and cognitive status, and is conducted actively and passively. Passive verticalization as a rehabilitation technique is recommended for patients who cannot stand up independently and keep themselves in an upright position because of the severity of the general condition.

In the preparation of this review, mainly literature sources from highly rated publications were used. Preference was given to sources published in the last 10 years. Review articles and materials prepared by experts in the field of writing/editing scientific publications, including review articles, were selected for the review.

In the aggregate of the verticalization methods analyzed, the common recommendations for all are the early start of rehabilitation measures, continuity, and careful monitoring of hemodynamic characteristics. The technique itself today has more than 50 years of experience, and the combination of verticalization technologies with a mechanotherapeutic simulator with electric motor support is a modern solution for their application. This equipment can be used in both intensive care in addition to the equipment of continuous respiratory support and rehabilitation and other wards.

The verticalization procedure, if possible, should be applied at the earliest possible time after the traumatic event to improve the rehabilitation potential. The verticalization of patients with chronic impairment of consciousness has physiological features, and hemodynamic adaptation is recommended to reduce the risk of orthostatic cerebral ischemia. For patients with disorders of the central nervous system, preliminary adaptation should be conducted to subsequent verticalization by gradually lifting on a multifunctional bed under hemodynamic control, including the CNAP continuous blood pressure monitoring system (Dräger systems).

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Julia А. Podolskaya

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology

Author for correspondence.
Email: julia031181@yandex.ru
ORCID iD: 0000-0003-3158-8209
SPIN-code: 9607-9951

Research Associate
Russian Federation, Lytkino

Ilya V. Borisov

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology

Email: realzel@gmail.com
ORCID iD: 0000-0002-5707-118X
SPIN-code: 7800-6446

Junior Research Associate

Russian Federation, Lytkino

Otgontsetseg Sukhbaatar

Peoples’ Friendship University of Russia

Email: runa7693@mail.ru
ORCID iD: 0000-0003-3261-2944
Russian Federation, Moscow

Viktoriya S. Sorokina

Peoples’ Friendship University of Russia

Email: vvorontsova@fnkcrr.ru
ORCID iD: 0000-0002-1490-1331
SPIN-code: 3407-1625

Junior Research Associate

Russian Federation, Moscow


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Supplementary files

Supplementary Files
1. Fig. 1. Layout and modern view of the “Parapodium” device [10].

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2. Fig. 2. The first verticalizer model developed by LEMO (Switzerland) in 1975 and its modern version.

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3. Fig. 3. A verticalizer with a simulator for active-passive mechanotherapy of the lower extremities (Hocoma, Switzerland, 2005).

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4. Fig. 4. SNAP module: Unique unique design with two cylinders for quick and easy application for continuous measurement of blood pressure and provision of extended hemodynamic parameters.

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