Rehabilitation Center, Bach Mai Hospital, Hanoi, Vietnam.
University of Medicine and Pharmacy, Vietnam National University in Hanoi, Hanoi, Vietnam.
Disabil Rehabil. 2024 Jul;46(14):3077-3085. doi: 10.1080/09638288.2023.2243595. Epub 2023 Aug 9.
To evaluate the impact of early rehabilitation in intensive care unit (ICU) on the survival and functional outcomes of COVID-19 patients admitted to ICU at acute phase.
We conducted a prospective quasi-experimental study including 346 eligible COVID-19 patients from all admitted cases in an ICU in Vietnam, divided into three groups: no rehabilitation ( = 32), late rehabilitation ( = 109), and early rehabilitation ( = 205). Baseline characteristics and survival information of patient were collected with BORG-CR10 scale and PFIT; the data were collected at different time points: before intervention, when switching to oxygen-therapy, and at discharge.
The control group (patients not using rehabilitation therapy) has worse survival than both early rehabilitation group (hazard ratio [HR] 0.553; 95% confidence interval [CI] 0.380-0.806; value < 0.001) and late rehabilitation group (HR 0.374; CI 0.235-0.594; value < 0.001). Regarding functional improvement, during the first five days, rehabilitation did not make a significant impact on the patients ( value > 0.05), however if continued from day 5 to day 20, the early-rehabilitation patients obtained a statistically significant improvement for BORG-CR10 ( value < 0.01). No clear association was found for PFIT ( value > 0.05).
The research emphasises the benefits of the early rehabilitation in ICU for COVID-19 patients.
评估 ICU 早期康复对 COVID-19 患者在 ICU 急性期入住后的生存和功能结局的影响。
我们进行了一项前瞻性准实验研究，纳入了越南一家 ICU 所有符合条件的 346 例 COVID-19 患者，分为三组：无康复（ = 32）、晚期康复（ = 109）和早期康复（ = 205）。使用 BORG-CR10 量表和 PFIT 收集患者的基线特征和生存信息；数据在不同时间点收集：干预前、开始氧疗时和出院时。
对照组（未使用康复治疗的患者）的生存率明显低于早期康复组（风险比 [HR] 0.553；95%置信区间 [CI] 0.380-0.806； 值 < 0.001）和晚期康复组（HR 0.374；CI 0.235-0.594； 值 < 0.001）。在功能改善方面，前五天康复对患者没有显著影响（ 值 > 0.05），但是如果从第 5 天持续到第 20 天，早期康复患者的 BORG-CR10 评分有显著改善（ 值 < 0.01）。对于 PFIT，没有发现明显的关联（ 值 > 0.05）。
该研究强调了 ICU 中 COVID-19 患者早期康复的益处。
