According to a new systematic review of the evidence base for exercise in critically ill patients, physical therapy in the ICU appears to confer significant benefit in improving quality of life, physical function, and peripheral and respiratory muscle strength; increasing ventilator-free days; and decreasing hospital and ICU stay.
"It is apparent that survivors of critical illness experience poor physical, functional, and cognitive outcomes often lasting for years," said the authors of a paper published in Critical Care Medicine, noting that this condition, "post intensive care syndrome," and the related "intensive care unit acquired weakness" can result in major impacts on the health and productivity of survivors and caregivers, availability of hospital beds, and health care costs.
"Early physical therapy in intensive care in increasingly recommended, and this review has found preliminary evidence that there are beneficial effects," the study said.
The researchers analyzed 10 randomized control trials and 5 systematic reviews after identifying 3,126 abstracts (1980 through January 2012) from a keyword search using "critical care" and "physical therapy" and related synonyms. Overall there was a significant positive effect favoring physical therapy to improve quality of life (g = 0.40, 95% confidence interval 0.08, 0.71), physical function (g = 0.46, 95% confidence interval 0.13, 0.78), peripheral muscle strength (g = 0.27, 95% confidence interval 0.02, 0.52), and respiratory muscle strength (g = 0.51, 95% confidence interval 0.12, 0.89). Length of hospital stay (g = -0.34, 95% confidence interval -0.53, -0.15) and ICU stay (g = -0.34, 95% confidence interval -0.51, -0.18) significantly decreased, and ventilator-free days increased (g = 0.38, 95% confidence interval 0.16, 0.59) following physical therapy in the ICU, the study says.
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