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Castro-Avila AC, Serón P, Fan E, et al. Effect of Early Rehabilitation during Intensive Care Unit Stay on Functional Status: Systematic Review and Meta-Analysis. PLoS One. 2015;10(7):e0130722doi: 10.1371/journal.pone.0130722.
Castro-Avila, A. C., Serón, P., Fan, E., Gaete, M., & Mickan, S. (2015). Effect of Early Rehabilitation during Intensive Care Unit Stay on Functional Status: Systematic Review and Meta-Analysis. PloS one, 10(7), e0130722. https://doi.org/10.1371/journal.pone.0130722
Castro-Avila, Ana Cristina, et al. "Effect of Early Rehabilitation during Intensive Care Unit Stay on Functional Status: Systematic Review and Meta-Analysis." PloS one vol. 10,7 (2015): e0130722. doi: https://doi.org/10.1371/journal.pone.0130722
Castro-Avila AC, Serón P, Fan E, Gaete M, Mickan S. Effect of Early Rehabilitation during Intensive Care Unit Stay on Functional Status: Systematic Review and Meta-Analysis. PLoS One. 2015 Jul 01;10(7):e0130722. doi: 10.1371/journal.pone.0130722. eCollection 2015. PMID: 26132803; PMCID: PMC4488896.
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PLoS One. 2015 Jul 01;10(7):e0130722. doi: 10.1371/journal.pone.0130722. eCollection 2015.

Effect of Early Rehabilitation during Intensive Care Unit Stay on Functional Status: Systematic Review and Meta-Analysis.

PloS one

Ana Cristina Castro-Avila, Pamela Serón, Eddy Fan, Mónica Gaete, Sharon Mickan

Affiliations

  1. Carrera de Kinesiología, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile.
  2. Internal Medicine Department, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile.
  3. Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada.
  4. Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.

PMID: 26132803 PMCID: PMC4488896 DOI: 10.1371/journal.pone.0130722

Abstract

BACKGROUND AND AIM: Critically ill survivors may have functional impairments even five years after hospital discharge. To date there are four systematic reviews suggesting a beneficial impact for mobilisation in mechanically ventilated and intensive care unit (ICU) patients, however there is limited information about the influence of timing, frequency and duration of sessions. Earlier mobilisation during ICU stay may lead to greater benefits. This study aims to determine the effect of early rehabilitation for functional status in ICU/high-dependency unit (HDU) patients.

DESIGN: Systematic review and meta-analysis. MEDLINE, EMBASE, CINALH, PEDro, Cochrane Library, AMED, ISI web of science, Scielo, LILACS and several clinical trial registries were searched for randomised and non-randomised clinical trials of rehabilitation compared to usual care in adult patients admitted to an ICU/HDU. Results were screened by two independent reviewers. Primary outcome was functional status. Secondary outcomes were walking ability, muscle strength, quality of life, and healthcare utilisation. Data extraction and methodological quality assessment using the PEDro scale was performed by primary reviewer and checked by two other reviewers. The authors of relevant studies were contacted to obtain missing data.

RESULTS: 5733 records were screened. Seven articles were included in the narrative synthesis and six in the meta-analysis. Early rehabilitation had no significant effect on functional status, muscle strength, quality of life, or healthcare utilisation. However, early rehabilitation led to significantly more patients walking without assistance at hospital discharge (risk ratio 1.42; 95% CI 1.17-1.72). There was a non-significant effect favouring intervention for walking distance and incidence of ICU-acquired weakness.

CONCLUSIONS: Early rehabilitation during ICU stay was not associated with improvements in functional status, muscle strength, quality of life or healthcare utilisation outcomes, although it seems to improve walking ability compared to usual care. Results from ongoing studies may provide more data on the potential benefits of early rehabilitation in critically ill patients.

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