Advances in the rehabilitation of intensive care unit acquired weakness

Abstract

Introduction: Traditional physiotherapy is currently the best approach to manage patients with intensive care unit acquired weakness (ICUAW). We report on a patient with ICUAW, who was provided with an intensive, in-patient regimen, that is, conventional plus robot-assisted physiotherapy. Aim of this case study was to assess the efficacy of a combined approach (conventional plus robot-assisted physiotherapy), on muscle strength, overall mobility, and disability burden in a patient with ICUAW in post-ICU intensive rehabilitation setting. Patient concerns: A 56-years-old male who was unable to stand and walk independently after hospitalization in an Intensive Care Unit. He initially was provided with daily sessions of conventional physiotherapy for 2 months, with mild results. Diagnosis: The patient was affected by ICUAW. Intervention: Given that the patient showed a relatively limited improvement after conventional physiotherapy, he was provided with daily sessions of robot-aided training for upper and lower limbs and virtual reality-aided rehabilitation for other 4 months, beyond conventional physiotherapy. Outcomes: At the discharge (6 months after the admission), the patient reached the standing station and was able to ambulate with double support. Conclusions: Our case suggests that patients with ICUAW should be intensively treated in in-patient regimen with robot-aided physiotherapy. Even though our approach deserves confirmation, the combined rehabilitation strategy may offer some advantage in maximizing functional recovery and containing disability.

Atuação fisioterapêutica na fraqueza muscular adquirida em unidade de terapia intensiva

“…Consoante Chillura et al, (2020), o tratamento que se utiliza da reabilitação precoce na UTI consiste, principalmente, em mobilização, em estimulação elétrica muscular e em fisioterapia convencional, a qual foi relatada como capaz de melhorar o resultado do paciente, além de ser o melhor tratamento para pacientes com FAUTI, pois ele é capaz conter o avanço da incapacidade.…”

Virtual and augmented reality in intensive care medicine: a systematic review

“…This can have a positive impact on sleep quality [ 31 ], development of delirium [ 42 ], and cognitive impairment [ 45 ]. Six studies have also shown that VR can help during rehabilitation [ 47 , 48 , 57 , 58 , 73 , 74 ]. The application led to an increase in activity and was well tolerated by the patient without the occurrence of adverse events such as falls.…”

From bedside to recovery: exercise therapy for prevention of post-intensive care syndrome

“…They have been proposed as a strategy to facilitate out-of-bed mobilisation for ICU patients [143]. However, proposed exoskeleton devices remain in their infancy for the critically ill population, with limited studies investigating back-support exoskeletons worn by staff to reduce physical burden during patient handling [144], body weight supported robotic gait retraining (Lokomat) [145], robotic mobilisation devices such as the VEMOTION ® that can be attached to a specific patient bed [146,147], and upper limb robotic devices such as the Armeo © Spring [145]. Whilst currently proposed as useful adjunctive therapies for traditional ET, future research is required to determine feasibility, safety, and benefits of these devices.…”