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Safety and Feasibility of an Exercise Prescription Approach to Rehabilitation Acrossthe Continuum of Care for Survivors of Critical Illness.
MedLine Citation:
PMID:  22879441     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BackgroundSurvivors of critical illness can experience long standing functional limitation that negatively impacts 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.ObjectivesThe aims of this study are to describe a model of rehabilitation for survivors of critical illness; compare the model to local and national standard care and report the safety and feasibility of the program.DesignCohort study METHODS:/b>As part of a larger randomized controlled trial, 74 participants were randomized on day five following admission to intensive care (ICU) to a protocolized rehabilitation program that commenced in ICU, continued on the acute care ward and for a further eight weeks following hospital discharge as an outpatient program. Exercise training was prescribed based on objective outcome measures to achieve a physiological training response. RESULTS: /b>During acute hospitalization 60% of exercise sessions were able to be delivered. The most frequent barrier to exercise was patient safety and patient refusal due to fatigue. Point prevalence data showed patients were mobilized more often and for longer periods compared to standard care. Outpatient classes were poorly attended with only 41% of patients completing more than 70% of outpatient classes. No adverse events occurred.LimitationsLimitations include patient heterogeneity and delay to commencement in exercise in ICU due to issues of consent and recruitment. CONCLUSIONS:/b>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 require further investigation.
Authors:
Sue Berney; Kimberley Haines; Elizabeth Skinner; Linda Denehy
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-9
Journal Detail:
Title:  Physical therapy     Volume:  -     ISSN:  1538-6724     ISO Abbreviation:  Phys Ther     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0022623     Medline TA:  Phys Ther     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
S. Berney, PT, PhD, Intensive Care Unit, Austin Hospital, Melbourne, Victoria, Australia. Mailing address: Department of Physiotherapy, Austin Hospital, Level 3 HSB, PO Box 5555, Heidelberg 3084, Victoria, Australia.
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