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Post Hospital Discharge Functional Recovery of Critical Illness Survivors. Systematic Review

Irini Patsaki
Irini Patsaki
, 
Georgia Bachou
Georgia Bachou
, 
Georgios Sidiras
Georgios Sidiras
, 
Serafim Nanas
Serafim Nanas
, 
Christina Routsi
Christina Routsi
 oraz 
Eleftherios Karatzanos
Eleftherios Karatzanos
   | 08 maj 2023
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Article Category: Review
Data publikacji: 08 maj 2023
Zakres stron: 87 - 96
Otrzymano: 04 gru 2022
Przyjęty: 02 mar 2023
DOI: https://doi.org/10.2478/jccm-2023-0011
Słowa kluczowe
© 2023 Irini Patsaki et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Fig. 1.

Prisma Flow diagram
Prisma Flow diagram

Description of the studies included in the systematic-review.

Study Group (N) APACHE-II Intervention Configuration Duration Outcomes
Batterham et al. (2014) CG:30APACHE-II:16.4(7.8)IG:29APACHE-II:15.9(7.9) CG: Standard care(medical follow-up, no rehabilitation)IG : Program with cycle ergometer 30′ of moderate intensity, 2 supervised sessions/1 unsupervised SF-36 (PF) 9 weeksFollow up: 26 weeks SF-36 (PF): IG : 43.5 (18)vs CG: 40.1(23),95% confidence interval [-1.4-8.2])
Battle et al. (2018) CG :30APACHE-II:15 (12-19)IG :30APACHE-II:13 (9-19) CG : Standard care (no rehabilitation prescription)IG : Personalized supervised exercise program in an outpatient gym 6MWT, Berg balance, HG 6 weeks afterhospital Followup:7 weeks, 6months, 12 months At 6 weeks6MWT: IG:379.3(207.9) vs CG:283.6(229.3), p=0.491Berg :IG :53.4(6.2) vs CG:50.5 (7.0), p=0.99HG(L): IG:20.7(11.4) vs19.5(12.5),p=0.287
Connolly et al. (2015) CG :10APACHE-II:23.5 (21-30.3)IG :10APACHE-II:24.5(18.8-29.5) CG: Weekly telephone follow-upIG: 16 sessions in an outpatient gym ISWT, 6MWT, SF-36 (PCS), 3 months afterhospital Change in outcomesISWT(m): CG: 170(40-315)vs IG: 115(-2.5-237.5)6MWT(m):CG:185(40-285)vs IG:140(35.8-210.3)PCS: CG: 11(4.3-28.3) vs IG:1.8 (-6.8-15.9)
Elliot et al. (2011) CG: 91APACHE-II:19.5(7.2)IG: 92APACHE-II:19.4(12.6) CG : Standard care (medical follow-up)IG : Home rehabilitation program with an emphasis on increasing muscle strength & walking SF-36 (PF), 6MWT 8 weeksFollow up:26 weeks SF-36 (PF) :IG :39.9 vs CG :41.0, p<0.05,while the effect time was notable for PF (p=0,034) and for 6MWT(p=0,0003).
McDowell et al. (2016) CG : 30APACHE-II:15.2(5.6)IG : 30APACHE-II:17.3 (7.7) CG : Standard care(no support)IG : personalized exercise program in the hospital gym (supervised-2 sessions) or at home (unsupervised-1 session) SF-36(PF),ISWT HG 6 weeksFollow up: 6 months SF-36(PF) :IG :6.8(10.9) vs CG:3.9(8.2),p=0,26ISWT : IG :135.5(119.8) vs CG:52.4(126.7),p=0.03HG(dominant): IG:6.1(28.1)vs CG:12.5(22.8), p=0.39
McWilliams et al. (2016) CG :36APACHE-II:15.9(5.3)IG :37APACHE-II:16.6(5.7) CG : Standard care (no exercise prescription or consultation)IG : supervised session with a 10-station program-cardiovascular exercises SF-36 (PCS), 7 weeks Degree of improvement SF-36 (PF) IG :3.5(95% CI;1.6-6.7 vs CG :8.6(95%;5.4-10.6), p=0,048)
Vitacca et al. (2016) CG :24IG :24 OE: Standard care (medical support, free to conduct physical activity without monitoring or support)IG : pulmonary rehabilitation program at home under supervision MIP/MEP, BADL, MRC-SS, 6 months MIP: IG : +33cm H2O vs CG : +26cm H2O,p<0.03MEP :IG : +42cm H2O vs CG : +28cm H2O, p<0.03BADL: p=0.63Biceps MRC-SS: p=0.07Quadriceps MRC-ss:p=0.53
Veldema et al. (2019) CG : 14IG : a)13b)12 OE: Standard careIG : a) cycle ergometer program, b) resistance program(inpatients in a neurological rehabilitation clinic) 5times/week, 4 sets of 15 repititions FAC, TUG test, 10MWT, MMS test SF-36(PF) 2 weeks4 weeks 6MWT (4 weeks): p<0.05 within groupsTUG(4weeks):p<0.05 within groupsFAC(2weeks):p<0.05 between groupsMRC knee flexion (2weeks): p<0.05 between groups
Shelly et al (2017) CG:18, IG:17 IG: 4 weeks unsupervised home rehabilitation programCG: no exercise prescrition SF-36 (PF) 4weeks SF-36 (PF ): IG: 10.32(8.51-14.92) vs CG: 7.36(3.68-8.48), p=0.003

Description of the rehabilitation program that the intervention group followed.

Study Duration / Intensity / Frequency Intervention
Batterham et al. (2014) Duration: 30 minutes Cardiorespiratory exercises: cycle ergometer (12-14 Borg Scale)
Intensity: moderate and progressively increasing 3 minutes at 60rpm and 3 minutes break
Frequency: 2 times/week Pedal resistance increased by 10 and 20W/min (The program included warm-up and recovery)
Battle et al. (2018) Duration: 60 minutes Cardiorespiratory exercises: cycle ergometer, treadmill, rowing machines
Intensity: progressively increasing Muscle strength and balance exercises with strength balls and bands, weights
Frequency: 2 times/week Functional balance exercises in a sitting and standing position, balance board
Connolly et al. (2015) Duration: 40 minutes Cardiorespiratory exercises
Intensity: progressively increasing Exercises to strengthen upper and lower limb muscle strength
Frequency: 2 times/week Balance exercises
Functional exercises (The program included warm-up and recovery)
Elliot et al. (2011) Duration: 20-30 minutes Cardiorespiratory exercises-5 exercises (walking at 80% walking speed)
Intensity: moderate to heavy (progressively increasing) Core stabilization exercises (3 exercises)
Upper-lower limb strengthening exercises with weights (8 reps/3 sets with progressive weight increase from 0.25 to 1.5 kg)
Frequency: 5 times/week Flexibility exercises and stretching (3 exercises and 4 respectively) (Total 16 different exercises)
Mcdowell et al. (2016) Duration: 60 minutes Strengthening exercises (10 repetitions upper-lower limbs-trunk and stretching exercises)
Intensity: moderate-gradually increasing Cardiorespiratory exercises: walking, cycle ergometer, treadmill (from 10-30 minutes and 3-4 Borg)
Frequency: 3 times/week (The program included warm-up and recovery)
McWilliams et al. (2016) Duration: 20 minutes Circuit Training 10 stations [(1 minute exercise/statìon)*2] (3-4 Borg)
Intensity: moderate-progressively increasing
Frequency: 3 times/week
Vitacca et al. (2016) Duration: 60 minutes Program of passive-active and assisted exercises (increasing range of motion-passive transfers-standing-stand-up/sit down)
Intensity: progressively increasing Breathing exercises (2 sessions daily-breathing cycle-chest expansion-violent breathing-coughing)
Frequency: 6 times/week
Balance exercises
Application of electroneuromuscular stimulation to the lower limbs
Cardiorespiratory exercises: cycle ergometer, treadmill
Strengthening exercises
Veldema et al. (2019) Duration: 20 minutes Cardiorespiratory exercises: cycle ergometer (13 Borg Scale)
Intensity: moderate to heavy-progressively increasing Strength exercises with weights (4 sets/15 repetitions with a 30-40” rest)
Frequency: 5 times/week
Shelly et al. (2017) Duration: 30-40 minutes Ambulation
Frequency: 5 times/week Exercises on bed (each exercise 10times/per set)
Ambulation twice a day (11-13 on Borg scale) Respiratory exercises
Dynamic quadriceps

Quality of the RCT studies of stroke patients on Pedro Scale (item1 doesn’t contribute to total score)

Batterham et al (2014) Battle et al (2018) Connolly et al (2015) Elliott et al (2011) McDowell et al (2016) McWilliams et al (2016) Vitacca et al (2016) Veldema et al (2019) Shelly et al (2017)
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Total 6/10 7/10 4/10 8/10 8/10 7/10 5/10 6/10 5/10
eISSN:
2393-1817
Język:
Angielski
Częstotliwość wydawania:
4 razy w roku
Dziedziny czasopisma:
Medycyna, Medycyna kliniczna, Medycyna wewnętrzna, inne, Chirurgia, Anestezjologia, Medycyna ratunkowa i intensywna opieka medyczna
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