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Intensive Care AND Physiotherapy

I Meisingset, A K Stensdotter, A Woodhouse, O Vasseljen
OBJECTIVE: To investigate the prognostic importance of a number of sensorimotor and psychological factors for global perceived effect (GPE) after physiotherapy in patients with neck pain. In addition to baseline values, change scores were used as independent variables to identify treatment-modifiable factors. DESIGN: Clinical cohort study. SETTING: Primary and secondary healthcare physiotherapy clinics. PARTICIPANTS: Patients (n=70) with non-specific neck pain...
December 2018: Physiotherapy
Marzena Kobylańska, Joanna Kowalska, Jolanta Neustein, Justyna Mazurek, Bartosz Wójcik, Małgorzata Bełza, Michał Cichosz, Joanna Szczepańska-Gieracha
BACKGROUND: A large proportion of individuals with a stroke are unable to return to work, although figures vary greatly. Due to the very high cost of post-stroke care, both tangible and intangible, in the form of long-term social consequences, it seems extremely important to search for factors responsible for the low efficiency of the rehabilitation and recovery process, because this fact has direct influence on future employment. Such knowledge would enable physiotherapists to quickly identify those patients who are at risk of rehabilitation breakdown, in order to provide them with special care and include them in intensive therapeutic treatments...
November 22, 2018: Work: a Journal of Prevention, Assessment, and Rehabilitation
Julien Mayaux, Jérôme Lambert, Capucine Morélot-Panzini, Jésus Gonzalez-Bermejo, Julie Delemazure, Claudia Llontop, Gaëlle Bruneteau, François Salachas, Martin Dres, Alexandre Demoule, Thomas Similowski
PURPOSE: Amyotrophic lateral sclerosis (ALS) entails a risk of acute respiratory failure (ARF). The decision to admit such patients to the intensive care unit (ICU) is difficult given the inexorable prognosis of ALS. To fuel this discussion, this study describes the ICU and post-ICU survival of ALS-related ARF. MATERIAL AND METHODS: Retrospective cohort analysis over 10 years (university hospital setting, ALS reference center). RESULTS: Of 90 patients (66 men, median age: 67 [IQR 59-71], median interval since ALS diagnosis: 26...
November 12, 2018: Journal of Critical Care
János Fazakas, Anikó Smudla
One of the most prominent results of our age is organ transplantation, the single treatment option for patients with end-stage organ failure. The success of transplants depends on the donor care, the patient preoperative preassessment, the perioperative care of organ transplantation and aftercare. Successful transplantation therefore requires a prominent level of continuous collaboration between the surgeon, anaesthesiologist, radiologist, internal medicine and hepatologist, laboratory physician and almost all their associates...
November 2018: Orvosi Hetilap
Sabrina Eggmann, Martin L Verra, Gere Luder, Jukka Takala, Stephan M Jakob
INTRODUCTION: Neuromuscular weakness resulting in severe functional impairment is common in critical care survivors. This study aimed to evaluate effects of an early progressive rehabilitation intervention in mechanically ventilated adults at risk. METHODS: This was a parallel, two-arm, assessor-blinded, randomised controlled trial with 6-months follow-up that was conducted in a mixed ICU of an academic centre in Switzerland. Previously independent, mechanically ventilated, critically ill adults with expected critical care stay ≥72 hours (n = 115) were randomised to a control group receiving standard physiotherapy including early mobilisation or to an experimental group with early endurance and resistance training combined with mobilisation...
2018: PloS One
Adrian C Traeger, Hopin Lee, Markus Hübscher, Ian W Skinner, G Lorimer Moseley, Michael K Nicholas, Nicholas Henschke, Kathryn M Refshauge, Fiona M Blyth, Chris J Main, Julia M Hush, Serigne Lo, James H McAuley
Importance: Many patients with acute low back pain do not recover with basic first-line care (advice, reassurance, and simple analgesia, if necessary). It is unclear whether intensive patient education improves clinical outcomes for those patients already receiving first-line care. Objective: To determine the effectiveness of intensive patient education for patients with acute low back pain. Design, Setting, and Participants: This randomized, placebo-controlled clinical trial recruited patients from general practices, physiotherapy clinics, and a research center in Sydney, Australia, between September 10, 2013, and December 2, 2015...
November 5, 2018: JAMA Neurology
J M Hussey, T Yang, J Dowds, L O'Connor, J V Reynolds, E M Guinan
OBJECTIVE: Early mobilisation is in integral component of postoperative recovery following complex surgical procedures such as oesophageal cancer resections, however evidence to guide early mobilisation protocols in critical care settings is limited. Furthermore, little is known about actual mobilisation levels postoperatively. This study quantified postoperative mobilisation post- oesophagectomy and investigated barriers to mobility. DESIGN: Prospective observational study...
August 16, 2018: Physiotherapy
Anastasia N L Newman, Janelle Gravesande, Stephanie Rotella, Stephen S Wu, Nam Topp-Nguyen, Michelle E Kho, Jocelyn E Harris, Alison Fox-Robichaud, Patricia Solomon
PURPOSE: This scoping review summarizes the literature on the safety and effectiveness of physiotherapy interventions in patients with neurological and/or traumatic injuries in the intensive care unit (ICU), identifies literature gaps and provides recommendations for future research. MATERIALS AND METHODS: We searched five databases from inception to June 2, 2018. We included published retrospective studies, case studies, observation and randomized controlled trials describing physiotherapy interventions in ICU patients with neurotrauma injuries...
October 3, 2018: Journal of Critical Care
Paula Soukkio, Sara Suikkanen, Sanna Kääriä, Hannu Kautiainen, Sarianna Sipilä, Katriina Kukkonen-Harjula, Markku Hupli
BACKGROUND: Health concerns, such as frailty and osteoporotic fractures decrease functional capacity and increase use of health and social care services in the aging population. The ability to continue living at home is dependent on functional capacity, which can be enhanced by rehabilitation. We study the effects of a 12-month home-based physiotherapy program with 12-month follow-up on duration of living at home, functional capacity, and the use of social and health care services among older persons with signs of frailty, or with a recently operated hip fracture...
October 1, 2018: BMC Geriatrics
Qi Zhang, Shujun Jiang, Lufei Young, Feng Li
Group-based physiotherapy-led behavioral psychological interventions (GPBPIs) are an emerging treatment for chronic low back pain (CLBP), but the efficacy of these interventions is uncertain. A review of relevant randomized controlled trials and a meta-analysis was conducted to evaluate the effectiveness of GPBPIs on pain relief in adults with CLBP. Literature databases, Google Scholar, bibliographies, and other relevant sources were searched. Thirteen (13) intervention studies published from 1998 to 2013 were included...
October 2, 2018: American Journal of Physical Medicine & Rehabilitation
Pamela Borges Nery, Laurie Snider, José Simon Camelo, Boychuck Zachary, Khodary Fatima, Goldschleger Jessica, Majnemer Annette
Rehabilitation specialists are an integral part of the team in the neonatal intensive care unit (NICU). New approaches to rehabilitation practice in the NICU have evolved over the past decade that aim to promote child health and development. AIMS: The aim of this study was to describe the current roles of the occupational therapist (OT), physical therapist (PT) and speech-language pathologist (SLP) in Canadian NICUs as compared to the roles documented in an earlier national survey conducted 15 years ago...
September 28, 2018: Physical & Occupational Therapy in Pediatrics
Tsung-Hsien Wang, Chin-Pyng Wu, Li-Ying Wang
BACKGROUND: Extubation failure can lead to a longer intensive care unit (ICU) stay, higher mortality rate, and higher risk of requiring tracheostomy. Chest physiotherapy (CPT) can help patients in reducing the accumulation of airway secretion, preventing collapsed lung, improving lung compliance, and reducing comorbidities. Much research has investigated the correlation between CPT and respiratory system clearance. However, few studies have investigated the correlation between CPT and failed ventilator extubation...
September 28, 2018: Clinical Respiratory Journal
Diana P Pozuelo-Carrascosa, Ana Torres-Costoso, Celia Alvarez-Bueno, Iván Cavero-Redondo, Purificación López Muñoz, Vicente Martínez-Vizcaíno
QUESTION: In intubated adult patients receiving mechanical ventilation, does multimodality respiratory physiotherapy prevent ventilator-associated pneumonia, shorten length of intensive care unit (ICU) stay, and reduce mortality? DESIGN: A systematic review with meta-analysis of randomised controlled trials. PARTICIPANTS: Intubated adult patients undergoing mechanical ventilation who were admitted to an intensive care unit. INTERVENTION: More than two respiratory physiotherapy techniques such as positioning or postural drainage, manual hyperinflation, vibration, rib springing, and suctioning...
October 2018: Journal of Physiotherapy
Megan Whelan, Heleen van Aswegen, Evelyn Corner
Background: Critically ill patients following traumatic injury or major surgery are at risk of loss of skeletal muscle mass, which leads to decreased physical function. Early rehabilitation in an intensive care unit (ICU) is thought to preserve or restore physical functioning. The Chelsea critical care physical assessment (CPAx) is a measurement tool used to assess physical function in the ICU. Objectives: To determine whether the use of the CPAx tool as part of physiotherapy patient assessment, in two adult trauma and surgical ICU settings where early patient mobilisation forms part of standard physiotherapy practice, had an impact on ICU and hospital length of stay (LOS) through delivery of problem-oriented treatment plans...
2018: South African Journal of Physiotherapy
Rebekah Haylett, Owen Gustafson
PURPOSE: To report the feasibility of assessing pre-admission functional status of ICU trauma patients, with repeat assessment at six months post ICU discharge using a standardised measure. MATERIALS AND METHODS: A prospective longitudinal observational cohort design recruited consecutive adult major trauma admissions to a UK general ICU, between 1st November 2016 and 1st November 2017. The 12-item World Health Organisation Disability Schedule 2.0 was completed to assess pre-admission functional status as soon as possible after ICU admission...
August 26, 2018: Journal of Critical Care
Sue C Berney, Joleen W Rose, Linda Denehy, Catherine L Granger, George Ntoumenopoulos, Elise Crothers, Bronwyn Steel, Sandy Clarke, Elizabeth H Skinner
OBJECTIVES: To develop a decision tree that objectively identifies the most discriminative variables in the decision to provide out-of-bed rehabilitation, measure the effect of this decision and to identify the factors that intensive care unit (ICU) practitioners think most influential in that clinical decision. DESIGN: A prospective 3-part study: (1) consensus identification of influential factors in mobilization via survey; (2) development of an early rehabilitation decision tree; (3) measurement of practitioner mobilization decision-making...
August 30, 2018: Archives of Physical Medicine and Rehabilitation
Carlos A Cuello-Garcia, Safiah Hwai Chuen Mai, Racquel Simpson, Samah Al-Harbi, Karen Choong
OBJECTIVE: To characterize how early mobilization is defined in the published literature and describe the evidence on safety and efficacy on early mobilization in critically ill children. STUDY DESIGN: Systematic search of randomized and nonrandomized studies assessing early mobilization-based physical therapy in critically ill children under 18 years of age in MEDLINE, Embase, CINAHL, CENTRAL, the National Institutes of Health, Evidence in Pediatric Intensive Care Collaborative, Physiotherapy Evidence Database, and the Mobilization-Network...
August 29, 2018: Journal of Pediatrics
Claire J Tipping, Anne E Holland, Meg Harrold, Tom Crawford, Nick Halliburton, Carol L Hodgson
BACKGROUND: The intensive care unit mobility scale (IMS) is reliable, valid and responsive. Establishing the minimal important difference (MID) of the IMS is important in order to detect clinically significant changes in mobilization. OBJECTIVE: To calculate the MID of the IMS in intensive care unit patients. METHODS: Prospective multi center observational study. The IMS was collected from admission and discharge physiotherapy assessments...
September 2018: Heart & Lung: the Journal of Critical Care
Chunyan Zhu, Bao Liu, Tianjun Yang, Qing Mei, Aijun Pan, Dongsheng Zhao
OBJECTIVE: To investigate the effect of early rehabilitation physiotherapy on muscle quality and function in critical patients. METHODS: A prospective randomized controlled study was performed. Adult critically ill patients admitted to intensive care unit (ICU) of Anhui Provincial Hospital from October 1st, 2016 to August 31st, 2017 who had been hospitalized for more than 7 days and had acute physiology and chronic health evaluation II (APACHE II) > 8 were enrolled, and they were divided into treatment group and control group according to random number table method...
June 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Elizabeth L Capell, Claire J Tipping, Carol L Hodgson
BACKGROUND: Early mobilisation in the intensive care unit (ICU) has been consistently reported as feasible and safe with minimal adverse events; however, invasive mechanical ventilation patients are rarely actively mobilised. An expert consensus group developed and published recommendations using a traffic light system on safety criteria to promote active mobilisation of invasive mechanical ventilation patients. OBJECTIVES: The aim of this study was to determine whether, in clinical practice, the safety consensus recommendations resulted in (1) increased early mobilisation in patients assessed as appropriate to mobilise based on the risk classification and (2) early mobilisation without adverse events...
July 10, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
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