THERAPY-Magazin
Impact of early rehabilitation on the rehabilitation process
An Italian study shows that early interdisciplinary rehabilitation in the ICU reduces hospital stay, ventilation time, and accelerates recovery. Timely, structured care improves the entire rehab process.
Redaktion
THERAPY Magazin
A timely start to early rehabilitation has a positive effect on the entire rehabilitation process.
Optimal early rehabilitation in the intensive care unit (ICU) has a big impact on the entire rehabilitation process. An Italian study retrospectively compared the prospective data of a new interdisciplinary care pathway (152 patients) in accordance with the guidelines of the National Institute for Health and Care Excellence (NICE) with those of the conventional care pathway (133 patients). The patients had lung failure, brain injuries or operations.
What was special about the new care pathway was closer cooperation between the professions involved and goal-oriented rehabilitation with daily functional testing, continuous care and coordinated discharge management. A specialist in physical medicine and rehabilitation (PM&R) examined the patients promptly and, with the help of the interdisciplinary team and defined criteria, planned and coordinated early, tailor-made rehabilitation, which was regularly adjusted so that exercise complexity and duration increased, from passive mobilisation and breathing therapy to stabilisation exercises in sitting and standing positions and strengthening exercises.
Both care pathways were analysed in terms of the following points:
■ Number of patients who received an interdisciplinary rehabilitation evaluation and physiotherapy in ICU
■ Duration until start of rehabilitation diagnosis/therapy after transfer to ICU
■ ICU/hospital length of stay
■ Ventilator-free days (VFDs) after ICU
The newly introduced early interdisciplinary rehabilitation performed significantly better in all points: More patients received rehabilitation examinations/rehabilitation in ICU, with shorter time to examinations and earlier start of rehabilitation. ICU/hospital stays and period of ventilation were shorter. The entire subsequent rehabilitation process was positively impacted; furthermore, there were no serious complications or deaths. The results show how important it is to start early structured rehabilitation in the intensive care unit.
What was special about the new care pathway was closer cooperation between the professions involved and goal-oriented rehabilitation with daily functional testing, continuous care and coordinated discharge management. A specialist in physical medicine and rehabilitation (PM&R) examined the patients promptly and, with the help of the interdisciplinary team and defined criteria, planned and coordinated early, tailor-made rehabilitation, which was regularly adjusted so that exercise complexity and duration increased, from passive mobilisation and breathing therapy to stabilisation exercises in sitting and standing positions and strengthening exercises.
Both care pathways were analysed in terms of the following points:
■ Number of patients who received an interdisciplinary rehabilitation evaluation and physiotherapy in ICU
■ Duration until start of rehabilitation diagnosis/therapy after transfer to ICU
■ ICU/hospital length of stay
■ Ventilator-free days (VFDs) after ICU
The newly introduced early interdisciplinary rehabilitation performed significantly better in all points: More patients received rehabilitation examinations/rehabilitation in ICU, with shorter time to examinations and earlier start of rehabilitation. ICU/hospital stays and period of ventilation were shorter. The entire subsequent rehabilitation process was positively impacted; furthermore, there were no serious complications or deaths. The results show how important it is to start early structured rehabilitation in the intensive care unit.
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THERAPY 2020-I
THERAPY Magazine
Redaktion
THERAPY Magazin
References:
- Originalartikel [1] Chiarici A et al. (2019). An early tailored approach is the key to effective rehabilitation in the intensive care unit. Arch. Phys. Med. Rehabil. Feb 20
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