Article

Survivors of critical illness can experience long-standing functional
limitations that negatively affect their health-related quality of life. To date,
no model of rehabilitation has demonstrated sustained improvements in physical
function for survivors of critical illness beyond hospital discharge. OBJECTIVE:
The aims of this study were: (1) to describe a model of rehabilitation for
survivors of critical illness, (2) to compare the model to local standard care,
and (3) to report the safety and feasibility of the program. DESIGN: This was a
cohort study. METHODS: As part of a larger randomized controlled trial, 74
participants were randomly assigned, 5 days following admission to the intensive
care unit (ICU), to a protocolized rehabilitation program that commenced in the
ICU and continued on the acute care ward and for a further 8 weeks following
hospital discharge as an outpatient program. Exercise training was prescribed
based on quantitative outcome measures to achieve a physiological training
response. RESULTS: During acute hospitalization, 60% of exercise sessions were
able to be delivered. The most frequently occurring barriers to exercise were
patient safety and patient refusal due to fatigue. Point prevalence data showed
patients were mobilized more often and for longer periods compared with standard
care. Outpatient classes were poorly attended, with only 41% of the patients
completing more than 70% of outpatient classes. No adverse events occurred.
LIMITATIONS: Limitations included patient heterogeneity and delayed commencement
of exercise in the ICU due to issues of consent and recruitment. CONCLUSIONS:
Exercise training that commences in the ICU and continues through to an
outpatient program is safe and feasible for survivors of critical illness. Models
of care that maximize patient participation across the continuum of care warrant
further investigation.

Langue : ANGLAIS