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exercise after critical illness

Tiphaine Bourseau, Flavie Fremondière, Valérie Dubus, Bénédicte Gohier, Dewi Le Gal, Fabien Cave, Isabelle Richard, Nicolas Lerolle
OBJECTIVE: After critical illness, some survivors experience long-term physical, functional, neurocognitive and/or mental health impairments, which has been termed "Post-Intensive Care syndrome" (PICS) [1]. A specific follow-up is required and many specialized follow-up clinics have been created both abroad and in France. The aim of this study is to evaluate long-term outcomes after critical illness, through the International Classification of Functioning, Disability and Health, and to analyse rehabilitation needs after intensive care unit (ICU) discharge...
September 2016: Annals of Physical and Rehabilitation Medicine
Kevin J Solverson, Christopher Grant, Christopher J Doig
BACKGROUND: Prior studies of physical functioning after critical illness have been mostly limited to survivors of acute respiratory distress syndrome. The purpose of this study was to objectively assess muscle strength and physical functioning in survivors of critical illness from a general ICU and the associations of these measures to health-related quality of life (HRQL), mental health and critical illness variables. METHODS: This was a prospective cohort study of 56 patients admitted to a medical ICU (length of stay ≥4 days) from April 1, 2009, and March 31, 2010...
December 2016: Annals of Intensive Care
Sabrina Eggmann, Martin L Verra, Gere Luder, Jukka Takala, Stephan M Jakob
BACKGROUND: Prolonged need for intensive care is associated with neuromuscular weakness, termed Intensive Care Unit Acquired Weakness. Those affected suffer from severe functional impairment that can persist for years. First studies suggest a positive effect of physiotherapy and early mobilisation. However, the ideal intervention for a preferential functional outcome is not known. So far no randomised controlled trial has been conducted to specifically evaluate an early endurance and resistance training in the mechanically ventilated, critically ill patient...
2016: Trials
Anneli Thelandersson, Bengt Nellgård, Sven-Erik Ricksten, Åsa Cider
BACKGROUND: Physiotherapy is an important part of treatment after severe brain injuries and stroke, but its effect on intracranial and systemic hemodynamics is minimally investigated. Therefore, the aim of this study was to assess the effects of an early bedside cycle exercise on intracranial and systemic hemodynamics in critically ill patients when admitted to a neurointensive care unit (NICU). METHODS: Twenty critically ill patients suffering from brain injuries or stroke were included in this study performed in the NICU at Sahlgrenska University Hospital...
May 23, 2016: Neurocritical Care
Michelle E Kho, Alexander J Molloy, France Clarke, Margaret S Herridge, Karen K Y Koo, Jill Rudkowski, Andrew J E Seely, Joseph R Pellizzari, Jean-Eric Tarride, Marina Mourtzakis, Timothy Karachi, Deborah J Cook
INTRODUCTION: Early exercise with in-bed cycling as part of an intensive care unit (ICU) rehabilitation programme has the potential to improve physical and functional outcomes following critical illness. The objective of this study is to determine the feasibility of enrolling adults in a multicentre pilot randomised clinical trial (RCT) of early in-bed cycling versus routine physiotherapy to inform a larger RCT. METHODS AND ANALYSIS: 60-patient parallel group pilot RCT in 7 Canadian medical-surgical ICUs...
2016: BMJ Open
Stefano Cobianchi, Ariadna Arbat-Plana, Víctor M López-Álvarez, Xavier Navarro
BACKGROUND: Shared connections between physical activity and neuroprotection has been studied for decades, but the mechanisms underlying this effect of specific exercise were only recently brought to light. Several evidences suggest that physical activity may be a reasonable and beneficial method to improve functional recovery in both peripheral and central nerve injuries and to delay functional decay in neurodegenerative diseases. In addition to improving cardiac and immune functions, Physical activity may represent a multifunctional approach not only to improve cardiocirculatory and immune functions, but potentially modulating trophic factors signaling and, in turn, neuronal function and structure at times that may be critical for neurodegeneration and regeneration...
March 29, 2016: Current Neuropharmacology
Gareth L Ackland, John Whittle, Andrew Toner, Asif Machhada, Ana Gutierrez Del Arroyo, Alberto Sciuso, Nicholas Jenkins, Alex Dyson, Richard Struthers, J Robert Sneyd, Gary Minto, Mervyn Singer, Ajay M Shah, Alexander V Gourine
OBJECTIVES: Molecular mechanisms linking autonomic dysfunction with poorer clinical outcomes in critical illness remain unclear. We hypothesized that baroreflex dysfunction alone is sufficient to cause cardiac impairment through neurohormonal activation of (nicotinamide adenine dinucleotide phosphate oxidase dependent) oxidative stress resulting in increased expression of G-protein-coupled receptor kinase 2, a key negative regulator of cardiac function. DESIGN: Laboratory/clinical investigations...
August 2016: Critical Care Medicine
Hsuan-Yu Chen, Hung-Chen Chen, Meng-Chih Lin, Mei-Yun Liaw
Bilateral diaphragmatic paralysis (BDP) manifests as respiratory muscle weakness, and its association with critical illness polyneuropathy (CIP) was rarely reported. Here, we present a patient with BDP related to CIP, who successfully avoided tracheostomy after diagnosis and management.A 71-year-old male presented with acute respiratory failure after sepsis adequately treated. Repeated intubation occurred because of carbon dioxide retention after each extubation. After eliminating possible factors, septic shock-induced respiratory muscle weakness was suspected...
August 2015: Medicine (Baltimore)
Daren K Heyland, Renee D Stapleton, Marina Mourtzakis, Catherine L Hough, Peter Morris, Nicolaas E Deutz, Elizabeth Colantuoni, Andrew Day, Carla M Prado, Dale M Needham
Survivors of critical illness commonly experience neuromuscular abnormalities, including muscle weakness known as ICU-acquired weakness (ICU-AW). ICU-AW is associated with delayed weaning from mechanical ventilation, extended ICU and hospital stays, more healthcare-related hospital costs, a higher risk of death, and impaired physical functioning and quality of life in the months after ICU admission. These observations speak to the importance of developing new strategies to aid in the physical recovery of acute respiratory failure patients...
October 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Nicola Latronico, Margaret S Herridge
No abstract text is available yet for this article.
October 2015: Intensive Care Medicine
Melody R Saeman, Kevin DeSpain, Ming-Mei Liu, Brett A Carlson, Juquan Song, Lisa A Baer, Charles E Wade, Steven E Wolf
BACKGROUND: Muscle loss is a sequela of severe burn and critical illness with bed rest contributing significantly to atrophy. We hypothesize that exercise will mitigate muscle loss after burn with bed rest. MATERIALS AND METHODS: Male rats were assigned to sham ambulatory (S/A), burn ambulatory (B/A), sham hindlimb unloading (S/H), or burn hindlimb unloading (B/H). Rats received a 40% scald burn or sham and were ambulatory or placed in hindlimb unloading, a model of bed rest...
September 2015: Journal of Surgical Research
Josh B Kazman, Dianna L Purvis, Yuval Heled, Peter Lisman, Danit Atias, Stephanie Van Arsdale, Patricia A Deuster
OBJECTIVE: With the expanding role of women into previously closed combat military occupational specialties, women will likely be exposed more to challenging and extreme conditions. Physical work or exercise in extreme environments could increase the risk for exertional heat illness (EHI) and exertional heat stroke (EHS), the most severe type of EHI. Although men have higher rates of EHS than women, women have slightly higher rates of other EHI. Women may respond differently to exertion in the heat than men, as they typically have higher percentage of body fat (BF%) and lower aerobic power...
April 2015: U.S. Army Medical Department Journal
Bronwen Connolly, Lisa Salisbury, Brenda O'Neill, Louise Geneen, Abdel Douiri, Michael P W Grocott, Nicholas Hart, Timothy S Walsh, Bronagh Blackwood
BACKGROUND: Skeletal muscle wasting and weakness are significant complications of critical illness, associated with degree of illness severity and periods of reduced mobility during mechanical ventilation. They contribute to the profound physical and functional deficits observed in survivors. These impairments may persist for many years following discharge from the intensive care unit (ICU) and can markedly influence health-related quality of life. Rehabilitation is a key strategy in the recovery of patients after critical illness...
2015: Cochrane Database of Systematic Reviews
C Jones, J Eddleston, A McCairn, S Dowling, D McWilliams, E Coughlan, R D Griffiths
PURPOSE: Patients recovering from critical illness may be left with significant muscle mass loss. This study aimed to evaluate whether a 6-week program of enhanced physiotherapy and structured exercise (PEPSE) and an essential amino acid supplement drink (glutamine and essential amino acid mixture [GEAA]) improves physical and psychological recovery. MATERIALS AND METHODS: Intensive care patients aged 45 years or older, with a combined intensive care unit stay/pre-intensive care unit stay of 5 days or more were recruited to a randomized controlled trial examining the effect of PEPSE and GEAA on recovery...
October 2015: Journal of Critical Care
Timothy S Walsh, Lisa G Salisbury, Judith L Merriweather, Julia A Boyd, David M Griffith, Guro Huby, Susanne Kean, Simon J Mackenzie, Ashma Krishan, Stephanie C Lewis, Gordon D Murray, John F Forbes, Joel Smith, Janice E Rattray, Alastair M Hull, Pamela Ramsay
IMPORTANCE: Critical illness results in disability and reduced health-related quality of life (HRQOL), but the optimum timing and components of rehabilitation are uncertain. OBJECTIVE: To evaluate the effect of increasing physical and nutritional rehabilitation plus information delivered during the post-intensive care unit (ICU) acute hospital stay by dedicated rehabilitation assistants on subsequent mobility, HRQOL, and prevalent disabilities. DESIGN, SETTING, AND PARTICIPANTS: A parallel group, randomized clinical trial with blinded outcome assessment at 2 hospitals in Edinburgh, Scotland, of 240 patients discharged from the ICU between December 1, 2010, and January 31, 2013, who required at least 48 hours of mechanical ventilation...
June 2015: JAMA Internal Medicine
Luwei Pearson, Elizabeth Hazel, Yvonne Tam
BACKGROUND: Since 2010, 28,000 female health extension workers (IEWs) received training and support to provide integrated community based case management (iCCM) of childhood pneumonia, diarrhea, malaria, and se- vere malnutrition in Ethiopia. OBJECTIVE: We conducted a modeling exercise using two scenarios to project the potential reduction of the under five mortality, riate due io the iCCM program in the four agrarian regions of Ethiopia. METHODS. We created three projections: (1) baseline projection without iCCM; (2) a "moderate" projection using 2012 coverage data scaled up to 30% by 2015 and (3) a "best case" scenario scaled up to 80% with 50% of newborns with sepsis receiving effective treatment by 2015...
October 2014: Ethiopian Medical Journal
D Clark Files, Chun Liu, Andrea Pereyra, Zhong-Min Wang, Neil R Aggarwal, Franco R D'Alessio, Brian T Garibaldi, Jason R Mock, Benjamin D Singer, Xin Feng, Raghunatha R Yammani, Tan Zhang, Amy L Lee, Sydney Philpott, Stephanie Lussier, Lina Purcell, Jeff Chou, Michael Seeds, Landon S King, Peter E Morris, Osvaldo Delbono
Early mobilization of critically ill patients with the acute respiratory distress syndrome (ARDS) has emerged as a therapeutic strategy that improves patient outcomes, such as the duration of mechanical ventilation and muscle strength. Despite the apparent efficacy of early mobility programs, their use in clinical practice is limited outside of specialized centers and clinical trials. To evaluate the mechanisms underlying mobility therapy, we exercised acute lung injury (ALI) mice for 2 days after the instillation of lipopolysaccharides into their lungs...
March 11, 2015: Science Translational Medicine
Bronwen Connolly, April Thompson, Abdel Douiri, John Moxham, Nicholas Hart
PURPOSE: The aim of this study was to investigate feasibility of exercise-based rehabilitation delivered after hospital discharge in patients with intensive care unit-acquired weakness (ICU-AW). MATERIALS AND METHODS: Twenty adult patients, mechanically ventilated for more than 48 hours, with ICU-AW diagnosis at ICU discharge were included in a pilot feasibility randomized controlled trial receiving a 16-session exercise-based rehabilitation program. Twenty-one patients without ICU-AW participated in a nested observational cohort study...
June 2015: Journal of Critical Care
Timo Hinrichs, Bettina Bücker, Stefan Wilm, Renate Klaaßen-Mielke, Michael Brach, Petra Platen, Anna Moschny
OBJECTIVES: To present detailed adverse event (AE) data from a randomized controlled trial (RCT) of a home-based exercise program delivered to an elderly high-risk population by an exercise therapist after medical clearance from a general practitioner (GP). DESIGN: Randomized controlled trial. SETTING: General practitioner practices and participant homes. PARTICIPANTS: Community-dwelling, chronically ill, mobility-limited individuals aged 70 and older (mean 80 ± 5) participating in a RCT of an exercise program (HOMEfit; ISRCTN17727272) (N = 209; n = 106 experimental, n = 103 control; 74% female)...
February 2015: Journal of the American Geriatrics Society
Chia-Yu Hsu, Yi-Ling Wu, Chun-Yu Cheng, Jiann-Der Lee, Ying-Chih Huang, Ming-Hsueh Lee, Chih-Ying Wu, Huan-Lin Hsu, Ya-Hui Lin, Yen-Chu Huang, Hsin-Ta Yang, Jen-Tsung Yang, Meng Lee, Bruce Ovbiagele
Urinary creatinine excretion rate (CER) is an established marker of muscle mass. Low CER has been linked to poor coronary artery disease outcomes, but a link between CER and acute stroke prognosis has not been previously explored. We prospectively collected data from patients with acute stroke (ischemic or hemorrhagic) within 24 hours from symptom onset in a Neurological and Neurosurgery Intensive Care Unit in Taiwan. Baseline CER (mg/d) was calculated by urine creatinine concentration in morning spot urine multiplies 24-hour urine volume on the second day of admission...
2015: Current Neurovascular Research
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