Early exercise in critically ill patients enhances short-term functional recovery*

Burtin, Chris; Clerckx, Béatrix; Robbeets, Christophe; Ferdinande, Patrick; Langer, Daniël; Troosters, Thierry; Hermans, Greet; Decramer, Marc; Gosselink, Rik

doi:10.1097/ccm.0b013e3181a38937

Cited by 876 publications

(912 citation statements)

References 40 publications

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“…Finalmente, apesar da amostra não probabilística e das limitações expostas anteriormente, sugere-se, a partir dos resultados deste estudo, bem como dos de outros estudos 2,22,23 , que os exercícios funcionais e neuromusculares são opção factível, segura…”

Section: Discussionunclassified

Efeitos dos exercícios funcionais e neuromusculares no tempo de internação e controle pressórico de pacientes hospitalizados

Costa¹,

Petto²,

Gomes

et al. 2015

ABCS Health Sci.

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Exercícios funcionais e neuromusculares são importantes ferramentas em centros de reabilitação, porém são pouco explorados em protocolos hospitalares. objetivo: Verificar se exercícios funcionais e neuromusculares são mais eficazes na redução do tempo de internamento e controle da pressão arterial (PA) dos indivíduos hospitalizados do que a fisioterapia hospitalar de rotina. Métodos: Foram incluídos pacientes hospitalizados por enfermidades não cardiológicas e sem hipertensão arterial sistêmica, sendo estes randomizados para grupo controle (GC), que realizou exercícios respiratórios, exercícios ativo-livres para membros superiores/ inferiores e caminhada no corredor, ou grupo de reabilitação funcional (GRF), submetido a exercícios neuromusculares para membros superiores/inferiores, cicloergômetro e treino de subir/descer degraus. Ambos os grupos receberam intervenção 2x/dia. A PA foi aferida na admissão, durante o internamento e na alta hospitalar. O tratamento estatístico foi realizado adotando-se intervalo de confiança de 95% e nível de significância de 5%. resultados: Avaliados 42 voluntários, dos quais 26 atenderam aos critérios de elegibilidade. Porém, seis foram excluídos, quatro por permanência hospitalar inferior a três dias e dois por não completarem o protocolo de tratamento. A média de idade no GC foi de 72±11 versus 73±8 no GRF. Não houve diferenças estatísticas da PA na admissão. Evidenciou-se redução da PA apenas no GRF durante o internamento (p<0,01), assim como na alta hospitalar (p<0,01). O GC apresentou maior tempo (dias) de internação 7,2±1,8 versus 5,5±1,3 do GRF (p<0,05). Conclusão: Exercícios funcionais e neuromusculares parecem mais eficazes na redução do tempo de internamento e controle da PA dos indivíduos hospitalizados do que a fisioterapia hospitalar de rotina.Palavras-chave: serviço hospitalar de fisioterapia; pressão arterial; terapia por exercício; medicina física e reabilitação; tempo de internação. ABStrACt introduction:Functional and neuromuscular exercises are important tools in rehabilitation centers, however they are little explored in hospital protocols. objective: To determine whether functional and neuromuscular exercises are more effective in reducing hospital stay and controlling blood pressure (BP) of hospitalized individuals than routine hospital physiotherapy. Methods: Hospitalized patients for non-cardiac illnesses and without hypertension were included, which were randomized to the control group (CG), who performed breathing exercises, active-free exercises for upper/lower limbs and walk in the hallway, or to functional rehabilitation group (FRG), which underwent neuromuscular exercises for upper/lower limbs, cycle ergometer and up/down stairs training. Both groups received intervention 2x/day. BP was measured at admission, during hospitalization and at discharge. Statistical analysis was performed by adopting a confidence interval of 95% and a 5% significance level. results: Forty-two volunteers were evaluated, of which 26 met the eligibility criteria. However, six...

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Section: Discussionunclassified

Efeitos dos exercícios funcionais e neuromusculares no tempo de internação e controle pressórico de pacientes hospitalizados

Costa¹,

Petto²,

Gomes

et al. 2015

ABCS Health Sci.

View full text Add to dashboard Cite

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“…We evaluated effect of early‐stage rehabilitation on PICS‐related outcomes used our meta‐analysis (8 studies; Brunmmel et al .,441 Burtin et al .,442 Dantas et al .,443 Denehy et al .,444 Jones et al .,445 Kayamabu et al .,446 Pattanshetty et al .,447 and Schweickert et al 231436, 448.…”

Section: Cq18: Icu‐acquired Weakness (Icu‐aw) and Post‐intensive Carementioning

confidence: 99%

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

Nishida

Ogura

Egi

et al. 2018

Acute Medicine & Surgery

157

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Background and PurposeThe Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG 2016), a Japanese‐specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 in Japanese. An English‐language version of these guidelines was created based on the contents of the original Japanese‐language version.MethodsMembers of the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine were selected and organized into 19 committee members and 52 working group members. The guidelines were prepared in accordance with the Medical Information Network Distribution Service (Minds) creation procedures. The Academic Guidelines Promotion Team was organized to oversee and provide academic support to the respective activities allocated to each Guideline Creation Team. To improve quality assurance and workflow transparency, a mutual peer review system was established, and discussions within each team were open to the public. Public comments were collected once after the initial formulation of a clinical question (CQ), and twice during the review of the final draft. Recommendations were determined to have been adopted after obtaining support from a two‐thirds (>66.6%) majority vote of each of the 19 committee members.ResultsA total of 87 CQs were selected among 19 clinical areas, including pediatric topics and several other important areas not covered in the first edition of the Japanese guidelines (J‐SSCG 2012). The approval rate obtained through committee voting, in addition to ratings of the strengths of the recommendation and its supporting evidence were also added to each recommendation statement. We conducted meta‐analyses for 29 CQs. Thirty seven CQs contained recommendations in the form of an expert consensus due to insufficient evidence. No recommendations were provided for 5 CQs.ConclusionsBased on the evidence gathered, we were able to formulate Japanese‐specific clinical practice guidelines that are tailored to the Japanese context in a highly transparent manner. These guidelines can easily be used not only by specialists, but also by non‐specialists, general clinicians, nurses, pharmacists, clinical engineers, and other healthcare professionals.

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“…Currently, a tremendous amount of research is being done around the world to understand the risk factors for long-term consequences of critical illness developing. Risk factors that have been identified include [2][3][4][5][6][7][8][9][10][11][12][13] • age more than 65 years • sepsis • mechanical ventilation • heavy sedation, delirium • hypoglycemia • hypoxia Reducing the risk factors may mitigate the long-term consequences that ICU patients and their families suffer. Early physical and occupational therapy started while patients are in the ICU and are hemodynamically stable can improve physical function.…”

Section: Risk Factorsmentioning

confidence: 99%

Section: What Critical Care Nurses Can Domentioning

confidence: 99%

“…[2][3][4][5][6][7][8][9][10][11][12][13] • Encourage patients to do cycling exercises and range-of-motion activities within the first few days of admission, even those patients we once thought were appropriately left in a pharmacologically comatose state. 2,4 • Reduce the use of benzodiazepines and, instead, use other sedating agents and nonpharmacological measures to combat anxiety and discomfort imposed by critical illness. [2][3][4][5][6][7][8][9][10][11][12][13] • Work hand-in-hand with therapists to move patients who are receiving mechanical ventilation, patients who had once stayed in bed and at most achieved a head-of-bed-elevated position, out of bed and onto tilt-tables or chairs.…”

Section: What Critical Care Nurses Can Domentioning

confidence: 99%

See 1 more Smart Citation

Long-Term Consequences of Critical Illness: A New Opportunity For High-Impact Critical Care Nurses

Harvey

Davidson

2011

Critical Care Nurse

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Early exercise in critically ill patients enhances short-term functional recovery*

Abstract: : Early exercise training in critically ill intensive care unit survivors enhanced recovery of functional exercise capacity, self-perceived functional status, and muscle force at hospital discharge.

Cited by 876 publications

References 40 publications

Efeitos dos exercícios funcionais e neuromusculares no tempo de internação e controle pressórico de pacientes hospitalizados

Efeitos dos exercícios funcionais e neuromusculares no tempo de internação e controle pressórico de pacientes hospitalizados

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

Long-Term Consequences of Critical Illness: A New Opportunity For High-Impact Critical Care Nurses

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