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exercise after critical illness

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https://www.readbyqxmd.com/read/27891297/exercise-rehabilitation-following-intensive-care-unit-discharge-for-recovery-from-critical-illness-executive-summary-of-a-cochrane-collaboration-systematic-review
#1
REVIEW
Bronwen Connolly, Lisa Salisbury, Brenda O'Neill, Louise Geneen, Abdel Douiri, Michael P W Grocott, Nicholas Hart, Timothy S Walsh, Bronagh Blackwood
Skeletal muscle wasting and weakness are major complications of critical illness and underlie the profound physical and functional impairments experienced by survivors after discharge from the intensive care unit (ICU). Exercise-based rehabilitation has been shown to be beneficial when delivered during ICU admission. This review aimed to determine the effectiveness of exercise rehabilitation initiated after ICU discharge on primary outcomes of functional exercise capacity and health-related quality of life...
December 2016: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/27881152/fitness-and-mobility-training-in-patients-with-intensive-care-unit-acquired-muscle-weakness-fitonicu-study-protocol-for-a-randomised-controlled-trial
#2
Jan Mehrholz, Simone Thomas, Jane H Burridge, André Schmidt, Bettina Scheffler, Ralph Schellin, Stefan Rückriem, Daniel Meißner, Katja Mehrholz, Wolfgang Sauter, Ulf Bodechtel, Bernhard Elsner
BACKGROUND: Critical illness myopathy (CIM) and polyneuropathy (CIP) are a common complication of critical illness. Both cause intensive-care-unit-acquired (ICU-acquired) muscle weakness (ICUAW) which increases morbidity and delays rehabilitation and recovery of activities of daily living such as walking ability. Focused physical rehabilitation of people with ICUAW is, therefore, of great importance at both an individual and a societal level. A recent systematic Cochrane review found no randomised controlled trials (RCT), and thus no supporting evidence, for physical rehabilitation interventions for people with defined CIP and CIM to improve activities of daily living...
November 24, 2016: Trials
https://www.readbyqxmd.com/read/27852953/effectiveness-of-an-exercise-programme-on-physical-function-in-patients-discharged-from-hospital-following-critical-illness-a-randomised-controlled-trial-the-revive-trial
#3
Kathryn McDowell, Brenda O'Neill, Bronagh Blackwood, Chris Clarke, Evie Gardner, Paul Johnston, Michaeline Kelly, John McCaffrey, Brian Mullan, Sally Murphy, T John Trinder, Gavin Lavery, Daniel F McAuley, Judy M Bradley
OBJECTIVE: To investigate the effectiveness of a 6-week exercise programme in patients discharged home following critical illness compared with standard care. DESIGN: Multicentre prospective phase II randomised controlled trial, with blinded outcome assessment after hospital discharge, following the 6-week intervention and at 6 months. PARTICIPANTS: 60 patients (30 per group) aged ≥18 years, mechanically ventilated >96 hours, and not in other rehabilitation, that is, cardiac or pulmonary rehabilitation programmes...
November 15, 2016: Thorax
https://www.readbyqxmd.com/read/27793165/surviving-critical-illness-what-is-next-an-expert-consensus-statement-on-physical-rehabilitation-after-hospital-discharge
#4
M E Major, R Kwakman, M E Kho, B Connolly, D McWilliams, L Denehy, S Hanekom, S Patman, R Gosselink, C Jones, F Nollet, D M Needham, R H H Engelbert, M van der Schaaf
BACKGROUND: The study objective was to obtain consensus on physical therapy (PT) in the rehabilitation of critical illness survivors after hospital discharge. Research questions were: what are PT goals, what are recommended measurement tools, and what constitutes an optimal PT intervention for survivors of critical illness? METHODS: A Delphi consensus study was conducted. Panelists were included based on relevant fields of expertise, years of clinical experience, and publication record...
October 29, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27676820/evaluation-of-disabilities-and-rehabilitation-needs-after-critical-illness-impact-of-an-intensive-care-unit-follow-up-clinic-in-the-university-hospital-of-angers
#5
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
https://www.readbyqxmd.com/read/27646108/assessment-and-predictors-of-physical-functioning-post-hospital-discharge-in-survivors-of-critical-illness
#6
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
https://www.readbyqxmd.com/read/27527501/effects-of-early-combined-endurance-and-resistance-training-in-mechanically-ventilated-critically-ill-patients-a-study-protocol-for-a-randomised-controlled-trial
#7
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
https://www.readbyqxmd.com/read/27216931/effects-of-early-bedside-cycle-exercise-on-intracranial-pressure-and-systemic-hemodynamics-in-critically-ill-patients-in-a-neurointensive-care-unit
#8
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...
December 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27059469/cycle-pilot-a-protocol-for-a-pilot-randomised-study-of-early-cycle-ergometry-versus-routine-physiotherapy-in-mechanically-ventilated-patients
#9
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...
April 8, 2016: BMJ Open
https://www.readbyqxmd.com/read/27026050/neuroprotective-effects-of-exercise-treatments-after-injury-the-dual-role-of-neurotrophic-factors
#10
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
https://www.readbyqxmd.com/read/26950003/molecular-mechanisms-linking-autonomic-dysfunction-and-impaired-cardiac-contractility-in-critical-illness
#11
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
https://www.readbyqxmd.com/read/26252301/bilateral-diaphragmatic-paralysis-in-a-patient-with-critical-illness-polyneuropathy-a-case-report
#12
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)
https://www.readbyqxmd.com/read/26212171/combining-nutrition-and-exercise-to-optimize-survival-and-recovery-from-critical-illness-conceptual-and-methodological-issues
#13
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
https://www.readbyqxmd.com/read/26160731/unraveling-the-myriad-contributors-to-persistent-diminished-exercise-capacity-after-critical-illness
#14
EDITORIAL
Nicola Latronico, Margaret S Herridge
No abstract text is available yet for this article.
October 2015: Intensive Care Medicine
https://www.readbyqxmd.com/read/26104324/effects-of-exercise-on-soleus-in-severe-burn-and-muscle-disuse-atrophy
#15
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
https://www.readbyqxmd.com/read/26101907/women-and-exertional-heat-illness-identification-of-gender-specific-risk-factors
#16
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
https://www.readbyqxmd.com/read/26098746/exercise-rehabilitation-following-intensive-care-unit-discharge-for-recovery-from-critical-illness
#17
REVIEW
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
https://www.readbyqxmd.com/read/26004031/improving-rehabilitation-after-critical-illness-through-outpatient-physiotherapy-classes-and-essential-amino-acid-supplement-a-randomized-controlled-trial
#18
RANDOMIZED CONTROLLED TRIAL
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
https://www.readbyqxmd.com/read/25867659/increased-hospital-based-physical-rehabilitation-and-information-provision-after-intensive-care-unit-discharge-the-recover-randomized-clinical-trial
#19
RANDOMIZED CONTROLLED TRIAL
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
https://www.readbyqxmd.com/read/25845082/modeling-potential-reduction-of-child-mortality-after-national-scale-up-of-community-based-treatment-of-childhood-illnesses-in-ethiopia
#20
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
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