Physical rehabilitation and early mobilization for critically ill adults
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.
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