Department of Medicine, Pulmonary and Critical Care, Intermountain Medical Center, 5121 S Cottonwood St, Murray, UT 84107, USA.
Phys Ther. 2012 Dec;92(12):1518-23. doi: 10.2522/ptj.20110446. Epub 2012 Apr 5.
Weakness and debilitation are common following critical illness. Studies that assess whether early physical activity initiated in the intensive care unit (ICU) continues after a patient is transferred to a ward are lacking.
The purpose of this study was to assess whether physical activity and mobility initiated during ICU treatment were maintained after patients were discharged from a single ICU to a ward.
This was a cohort study.
Consecutive patients who were diagnosed with respiratory failure and admitted to the respiratory ICU (RICU) at LDS Hospital underwent early physical activity and mobility as part of usual care. Medical data, the number of requests for a physical therapy consultation or nursing assistance with ambulation at ICU discharge, and mobility data were collected during the first 2 full days on the ward.
Of the 72 patients who participated in the study, 65 had either a physical therapy consultation or a request for nursing assistance with ambulation at ward transfer. Activity level decreased in 40 participants (55%) on the first full ward day. Of the 61 participants who ambulated 100 ft (30.48 m) or more on the last full RICU day, 14 did not ambulate, 22 ambulated less than 100 ft, and 25 ambulated 100 ft or more on the first ward day.
Limitations include lack of data regarding why activity was not performed on the ward, lack of longitudinal follow-up to assess effects of activity, and lack of generalizability to patients not transferred to a ward or not treated in an ICU with an early mobility program.
Despite the majority of participants having a physical therapy consultation or a request for nursing assistance with ambulation at the time of transfer to the medical ward, physical activity levels decreased in over half of participants on the first full ward day. The data suggest a need for education of ward staff regarding ICU debilitation, enhanced communication among care providers, and focus on the importance of patient-centered outcomes during and following ICU treatment.
重症疾病后常出现虚弱和乏力。评估患者从 ICU 转入病房后是否继续进行 ICU 早期身体活动的研究较少。
本研究旨在评估患者从单一 ICU 转入病房后，ICU 期间开始的身体活动和移动是否得以维持。
这是一项队列研究。
作为常规护理的一部分，在 LDS 医院呼吸 ICU（RICU）被诊断为呼吸衰竭并入院的连续患者接受早期身体活动和移动。在转入病房的前 2 天，收集了医疗数据、物理治疗咨询请求的数量、ICU 出院时护理协助行走的请求数量以及移动数据。
在参与研究的 72 名患者中，有 65 名患者在转入病房时进行了物理治疗咨询或护理协助行走的请求。在第一个完整的病房日，40 名患者（55%）的活动水平下降。在最后一个完整的 RICU 日行走 100 英尺（30.48 米）或以上的 61 名参与者中，14 名未行走，22 名行走不足 100 英尺，25 名行走 100 英尺或以上在第一个病房日。
限制包括缺乏关于为什么在病房内不进行活动的原因的数据，缺乏纵向随访以评估活动的影响，以及缺乏对未转入病房的患者或未在 ICU 接受早期移动计划治疗的患者的普遍性。
尽管大多数参与者在转入普通病房时接受了物理治疗咨询或护理协助行走的请求，但在第一个完整的病房日，超过一半的参与者的身体活动水平下降。数据表明，需要对病房工作人员进行 ICU 衰弱的教育，加强护理提供者之间的沟通，并关注 ICU 治疗期间和之后以患者为中心的结果的重要性。
