Physical rehabilitation and early mobilization for critically ill adults

Added April 19, 2020

Citation: Arias-Fernandez, P, Romero-Martin M, Gomez-Salgado J, et al. Rehabilitation and early mobilization in the critical patient: systematic review. Journal of Physical Therapy Science 2018; 30(9): 1193-201

What is this? Some patients with COVID-19 will become critically ill and need treatment in an intensive care unit. They may develop physical complications, such as muscle weakness, which is commonly referred to as Intensive Care Unit-Acquired Weakness (ICU-AW). Physical rehabilitation and early mobilization might be used to manage this ICU-AW.

In this systematic review, the authors searched for randomized trials, crossover trials and case-control studies that evaluated rehabilitation or early mobilization interventions for adults who had been in an ICU for at least 48 hours. They restricted their search to studies published in English or Spanish between 2006 and 2016, and did the search in May 2016. They identified 8 randomized trials, 1 cross-over trial and 2 case-control studies (total: 850 participants).

What works: Early rehabilitation of critically ill patients has some benefits in functional status, muscle strength, duration of mechanical ventilation, walking capacity at discharge and health-related quality of life; but had no significant effect on the length of stay or number of cases of Intensive Care Unit-Acquired Weaknesses.

Early mobilization of critically ill patients is associated with an increased probability of walking more distance at discharge.

What’s uncertain: The overall effect of rehabilitation of critically ill adults is uncertain, in particular its optimum dose, intensity, frequency and duration.

 

Disclaimer: This summary has been written by staff and volunteers of Evidence Aid in order to make the content of the original document accessible to decision makers who are searching for the available evidence on the coronavirus (COVID-19) but may not have the time, initially, to read the original report in full. This summary is not intended as a substitute for the medical advice of physicians, other health workers, professional associations, guideline developers, or national governments and international agencies. If readers of this summary think that the evidence that is presented within it is relevant to their decision-making they should refer to the content and details of the original article, and the advice and guidelines offered by other sources of expertise, before making decisions. Evidence Aid cannot be held responsible for any decisions made about the coronavirus (COVID-19) on the basis of this summary alone.

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