Occupational therapy for delirium management in elderly patients without mechanical ventilation in an intensive care unit: A pilot randomized clinical trial

Álvarez, Evelyn; Garrido, Maricel; Tobar, Eduardo; Prieto, Stephanie; Vergara, Sebastian O.; Briceño, Constanza; González, Francisco

doi:10.1016/j.jcrc.2016.09.002

Cited by 117 publications

(161 citation statements)

References 37 publications

Supporting

Mentioning

142

Contrasting

Unclassified

Order By: Relevance

“…A randomized control study showed that occupational therapy in nonintubated ICU patients reduced delirium incidence (3% versus 20%, P<0.001). 45 Finally, a quality improvement study implementing early physical and occupational interventions along with reduced benzodiazepine use for mechanically ventilated patients in the medical ICU resulted in a reduced incidence of delirium (21% versus 53%, P=0.003) and a reduction in hospital length of stay by 3.1 days (95% CI; 0.3-5.9 days), compared with historical rates before the interventions were implemented. 46 As described above, early mobilization is an important tool in preventing delirium, however, this can prove challenging in certain CICU patients, particularly patients with mechanical support devices and temporary pacemakers.…”

Section: Preventionmentioning

confidence: 99%

Delirium in the Cardiac Intensive Care Unit

Khalil

McCarthy

et al. 2018

JAHA

View full text Add to dashboard Cite

Section: Preventionmentioning

confidence: 99%

Delirium in the Cardiac Intensive Care Unit

Khalil

McCarthy

et al. 2018

JAHA

View full text Add to dashboard Cite

“…The preliminary and final results of this study have been recently published. (38,39) The primary objective of this study was to evaluate the efficacy of an experimental non-pharmacological intervention (standard intervention plus early and intensive OT) in reducing the delirium incidence. A standard intervention was applied in both groups, which consisted of reorientation, mobility exercises, sensory deficit correction, environmental management, sleep protocols, and minimization of the use of drugs with the potential to trigger delirium.…”

Section: Introductionmentioning

confidence: 99%

Cognitive stimulation and occupational therapy for delirium prevention

Tobar¹,

Álvarez²,

Garrido³

2017

Revista Brasileira De Terapia Intensiva

View full text Add to dashboard Cite

Delirium is a relevant condition in critically ill patients with long-term impacts on mortality, cognitive and functional status and quality of life. Despite the progress in its diagnosis, prevention and management during the last years, its impact persists being relevant, so new preventive and therapeutic strategies need to be explored. Among non-pharmacologic preventive strategies, recent reports suggest a role for occupational therapy through a series of interventions that may impact the development of delirium. The aim of this review is to evaluate the studies evaluating the role of occupational therapy in the prevention of delirium in critically ill patient populations, and suggests perspectives to future research in this area.

show abstract

“…Early rehabilitation within critical care units has been shown to be effective in limited studies [11,15], however the occupational therapy approaches to enhance long term recovery require further investigation especially in mechanically ventilated patients. This trial aims to explore the feasibility of providing occupational therapy to mechanically ventilated patients in a critical care setting.…”

Section: Discussionmentioning

confidence: 99%

“…A recent study by Alvarez et al (2017) [15] demonstrated the effectiveness of occupational therapy for managing delirium in non-mechanically ventilated patients and provided a basis for the introduction of occupational therapists as core multidisciplinary team members to address intensive care unit-related disorders during recovery. However, there is an ongoing need for research into the feasibility and effectiveness of graded occupation-based activities within the intensive care unit for patients who are mechanically ventilated.…”

Section: Introductionmentioning

confidence: 99%

A comparison of standard occupational therapy versus early enhanced occupation-based therapy in a medical / surgical intensive care unit: study protocol for a single site feasibility trial (EFFORT-ICU).

Rapolthy-Beck

Fleming

Turpin

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Admissions to intensive care units (ICUs) are increasing due to an aging population, and rising incidence of cardiac and respiratory disease. With advances in medical care, more patients are surviving an initial stay in critical care; however, they can experience ongoing health and cognitive limitations, that may influence return to baseline function up to a year post-admission. Recent research has focused on the introduction of early rehabilitation within the ICU to reduce long-term physical and cognitive complications. The aim of this study is to explore the feasibility and impact of providing early occupational therapy intervention, including cognitive stimulation and activities of daily living, to patients in intensive care.Methods: This study involves a single site randomised-controlled feasibility trial comparing standard occupational therapy care to an enhanced occupation-based therapy. Thirty mechanically ventilated ICU patients will be recruited and randomly allocated to the intervention or control group. The primary outcome measure is the Functional Independence Measure (FIM), and secondary measures include the Modified Barthel Index (MBI), Montreal Cognitive Assessment (MoCA), grip strength, Hospital Anxiety and Depression Scale (HADS) and Short-Form 36 Health survey (SF-36). Measures will be collected by a blind assessor at discharge from intensive care, hospital discharge and a 90-day follow-up. Daily outcome measures including the Glasgow Coma Scale (GCS), Richmond Agitation and Sedation Scale (RASS) and Confusion Assessment Measure for intensive care units (CAM-ICU) will be taken prior to treatment. Participants in the intervention group will receive daily 60 minute sessions with an occupational therapist involving cognitive and functional activities such as self-care and grooming. At the follow-up, intervention group participants will be interviewed to gain user perspectives of the intervention. Feasibility data including recruitment and retention rates will be summarised descriptively. Parametric tests will compare outcomes between groups. Interview data will be thematically analysed.Discussion: This trial will provide information about the feasibility of investigating how occupational therapy interventions in ICU influence longer term outcomes. It aims to inform the design of a phase III multicentre trial of occupational therapy in critical care general medical intensive care units.Trial registration: Australia New Zealand Clinical Trials Registry (ANZCTR): ACTRN12618000374268; prospectively registered on 13th March 2018 / https://www.anzctr.org.au

show abstract

Occupational therapy for delirium management in elderly patients without mechanical ventilation in an intensive care unit: A pilot randomized clinical trial

Cited by 117 publications

References 37 publications

Delirium in the Cardiac Intensive Care Unit

Delirium in the Cardiac Intensive Care Unit

Cognitive stimulation and occupational therapy for delirium prevention

A comparison of standard occupational therapy versus early enhanced occupation-based therapy in a medical / surgical intensive care unit: study protocol for a single site feasibility trial (EFFORT-ICU).

Contact Info

Product

Resources

About