Shimizu Yoshitaka, Someya Ryoko, Minamimoto Yugo, Nemoto Akinobu, Nakamura Takeshi
Department of Rehabilitation Medicine, Yokohama City University Medical Center: 4-57 Urafune-cho, Minami-ku, Yokohama-shi, Kanagawa 232-0024, Japan.
Department of Cardiovascular Internal Medicine, Yokosuka General Hospital Uwamachi, Japan.
J Phys Ther Sci. 2024 Nov;36(11):750-755. doi: 10.1589/jpts.36.750. Epub 2024 Nov 1.
[Purpose] To examine the effectiveness of acute and outpatient cardiac rehabilitation for severe intensive care unit (ICU)-acquired weakness. [Participant and Methods] A 79-year-old woman, diagnosed with takotsubo syndrome. A percutaneous catheter-based transvalvular left ventricular assist device was used from day 2 to day 8, extracorporeal membrane oxygenation from day 3 to day 9, and inotropic support from day 1 to day 15. The patient was weaned from the ventilator on day 59, transferred to another hospital on day 67, and discharged home on day 152. From days 16 to 65 and 177 to 262, she underwent inpatient rehabilitation and outpatient cardiac rehabilitation, respectively, at our hospital. [Results] After inpatient rehabilitation at our hospital, her Medical Research Council score improved from 16 to 46. In outpatient cardiac rehabilitation, her 6-minute walk distance improved from 385 to 473 m, and her Kansas City Cardiomyopathy Questionnaire score improved from 88.6 to 100. [Conclusion] The results suggest that acute rehabilitation can effectively improve muscle strength, whereas outpatient cardiac rehabilitation can effectively improve exercise tolerance and quality of life in patients with severe ICU-acquired weakness.
[目的] 探讨急性和门诊心脏康复对重症监护病房(ICU)获得性严重肌无力的有效性。[参与者和方法] 一名79岁女性,诊断为应激性心肌病。从第2天到第8天使用经皮导管瓣膜置换左心室辅助装置,从第3天到第9天使用体外膜肺氧合,从第1天到第15天使用血管活性药物支持。患者于第59天脱机,第67天转至另一家医院,第152天出院回家。在第16天至65天以及第177天至262天,她分别在我院接受了住院康复和门诊心脏康复。[结果] 在我院住院康复后,她的医学研究委员会评分从16分提高到46分。在门诊心脏康复中,她的6分钟步行距离从385米提高到473米,堪萨斯城心肌病问卷评分从88.6分提高到100分。[结论] 结果表明,急性康复可有效改善肌肉力量,而门诊心脏康复可有效提高重症ICU获得性肌无力患者的运动耐力和生活质量。