A. Nordon-Craft, PT, DSc, Department of Physical Therapy, School of Health Professions, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, MET 535, Fort Worth, TX 76107, USA.
Phys Ther. 2012 Dec;92(12):1494-506. doi: 10.2522/ptj.20110117. Epub 2012 Jan 26.
Patients admitted to the intensive care unit (ICU) can develop a condition referred to as "ICU-acquired weakness." This condition is characterized by profound weakness that is greater than might be expected to result from prolonged bed rest. Intensive care unit-acquired weakness often is accompanied by dysfunction of multiple organ systems. Individuals with ICU-acquired weakness typically have significant activity limitations, often requiring physical assistance for even the most basic activities associated with bed mobility. Many of these individuals have activity limitations months to years after hospitalization. The purpose of this article is to review evidence that guides physical rehabilitation of people with ICU-acquired weakness. Included are diagnostic criteria, medical management, and prognostic indicators, as well as criteria for beginning physical rehabilitation, with an emphasis on patient safety. Data are presented indicating that rehabilitation can be implemented with very few adverse effects. Evidence is provided for appropriate measurement approaches and for physical intervention strategies. Finally, some of the key issues are summarized that should be investigated to determine the best intervention guidelines for individuals with ICU-acquired weakness.
患者入住重症监护病房（ICU）后可能会出现一种称为“ICU 获得性肌无力”的病症。这种病症的特征是严重肌无力，其严重程度超出了长时间卧床休息可能导致的程度。ICU 获得性肌无力常伴有多个器官系统功能障碍。患有 ICU 获得性肌无力的个体通常活动受限，即使是与床旁活动最基本相关的活动也常常需要他人协助。这些个体中有许多在住院后数月甚至数年内仍存在活动受限。本文旨在回顾指导 ICU 获得性肌无力患者进行物理康复的证据。包括诊断标准、医学管理和预后指标，以及开始物理康复的标准，重点关注患者安全。本文提供了有关康复实施很少有不良影响的数据。还为适当的测量方法和物理干预策略提供了证据。最后，总结了一些关键问题，这些问题需要进一步研究，以确定 ICU 获得性肌无力患者的最佳干预指南。
