Volitional rehabilitative assessments in patients admitted in a post-intensive care step down unit. A feasibility study

Abstract

A high variability in functional tests and activities used during the pulmonary rehabilitation has been observed in post-intensive care unit (ICU) patients, and the best battery of tests to adopt has not been described yet. We tested in patients admitted in a post-ICU Step Down Unit the ability to perform the more frequent functional volitional tests. The relations of each single volitional test with general disability and dyspnea at discharge were also evaluated. At admission, >70% of subjects performed muscle strength test, while <25% performed respiratory and effort tolerance tests. At discharge, feasibility of spirometry, respiratory muscle strength and effort tolerance tests improved (all, p<0.001); 6MWT was the least feasible. At discharge, cardiorespiratory patients were more capable to perform tests compared to neurological ones. All outcome measures, with exception of FEV 1 %, and FVC%, were significantly related to the disability score.Peripheral muscle exercises showed the highest feasibility, spirometry and leg effort tolerance the lowest. Motor disability was explained mainly by the peripheral muscle strength. The study of non-volitional outcome measures and tests linked to a protocol-driven intervention should be performed in this specific population.

ERS International Congress 2023: highlights from the Respiratory Intensive Care Assembly

“…M. Vitacca (Pavia, Italy) explored the multiple dimensions of post-ICU disability [ 80 – 83 ], post-intensive care syndrome, which leads to long-term impairments [ 84 ], and the high level of disability in weaning centre patients. The need to evaluate patients in these centres with a variety of tools was stressed [ 85 , 86 ] as well as the importance of multidimensional [ 65 ] and volitional assessments [ 87 ] (such as spirometry and muscle strength) and preventive actions [ 88 ].…”