Matsuki Ryosuke, Kojima Noriaki, Watanabe Koki, Hotta Akira, Kubori Yohei, Oura Keisuke, Morisawa Tomoyuki, Koyama Hidehiko, Ebisu Toshihiko, Hashino Takuya
Department of Rehabilitation Medicine, Kansai Electric Power Hospital, Osaka, Japan.
Division of Rehabilitation Medicine, Kansai Electric Power Medical Research Institute, Osaka, Japan.
Prog Rehabil Med. 2020 Nov 6;5:20200027. doi: 10.2490/prm.20200027. eCollection 2020.
The goal of this study was to determine the effects of an intensive care unit (ICU) rehabilitation protocol with dedicated therapists on the physical function and activities of daily living (ADL) of patients on discharge from the ICU.
This retrospective study included patients who started rehabilitation during their ICU stay. Patients were divided into three groups: the Usual Care group (before the introduction of the rehabilitation protocol), the Protocol group (after the introduction of the rehabilitation protocol), and the PT + Protocol group (with a dedicated therapist in addition to the rehabilitation protocol). The standard interventions in the Protocol group and the PT + Protocol group were set according to the protocol based on the level of consciousness and strength of each individual patient. Patients' age, APACHE II score, length of ICU stay, length of hospital stay, and the Functional Status Score for the ICU (FSS-ICU) and Medical Research Council score (MRC score) on discharge from the ICU were compared among the three groups.
There were no significant differences among the three groups in age and APACHE II score. The MRC and FSS-ICU scores were significantly higher in the PT + Protocol and Protocol groups than in the Usual Care group. Furthermore, the lengths of ICU stay and hospital stay were lower in the PT + Protocol group than in the Usual Care group.
Introduction of the rehabilitation protocol improved the limb strength and ADL of patients. Moreover, the presence of dedicated therapists in addition to the protocol reduced the lengths of ICU and hospital stays.
本研究的目的是确定由专门治疗师实施的重症监护病房（ICU）康复方案对ICU出院患者身体功能和日常生活活动（ADL）的影响。
这项回顾性研究纳入了在ICU住院期间开始康复治疗的患者。患者分为三组：常规护理组（康复方案引入前）、方案组（康复方案引入后）和物理治疗师+方案组（除康复方案外还有专门的治疗师）。方案组和物理治疗师+方案组的标准干预措施根据方案并依据每位患者的意识水平和肌力来设定。比较三组患者的年龄、急性生理与慢性健康状况评分系统（APACHE II）得分、ICU住院时长、住院总时长，以及ICU出院时的ICU功能状态评分（FSS-ICU）和医学研究委员会评分（MRC评分）。
三组患者在年龄和APACHE II评分方面无显著差异。物理治疗师+方案组和方案组的MRC评分和FSS-ICU评分显著高于常规护理组。此外，物理治疗师+方案组的ICU住院时长和住院总时长低于常规护理组。
康复方案的引入改善了患者的肢体力量和ADL。此外，除方案外有专门治疗师可缩短ICU住院时长和住院总时长。
