Effect of Neurophysiological Facilitation Techniques in Intensive Care Patients
Condition: Intensive Care (ICU) Myopathy; Intensive Care Unit Acquired Weakness
MeSH terms: Asthenia
Study type: Interventional

Summary: 
      The aim of this study was to investigate the effect of neurophysiological facilitation
      techniques on respiratory and functional levels in intensive care patients. Participants were
      divided into two groups as experimental (n=20) and control (n=20). Conventional
      physiotherapy, which includes chest physiotherapy, mobilization exercises and range of motion
      exercises were applied in control group. Neurophysiological facilitation techniques in
      addition to the conventional physiotherapy program ere applied in experimental group. The
      functional status, lower and upper extremity muscle strength, grip strength measurements of
      the patients and the rates of weaning from mechanical ventilation were evaluated before and
      after treatment. Vital signs, dyspnea and fatigue perception were assessed each day of
      treatment. Evaluations were analyzed statistically using Statistical Package for the Social
      Sciences-22 program.
    

Detailed description: 
      The intensive care unit is a multidisciplinary unit in which patients with acute,
      life-threatening organ dysfunction or under risk are monitored and treated comprehensively.
      Advanced technology is used for follow-up and treatment in intensive care. These supports
      decrease the mortality rate. However, the increase length of stay in the ICU leads to higher
      hospital costs in addition to serious secondary pathologies. Prolonged immobilisation in the
      intensive care unit(ICU); causes the loss of muscle mass and strength of the patients. When
      the course of illness, the medical devices used, various medications, malnutrition and other
      reasons such as sepsis are accompanied by this immobilization, the disorder called Intensive
      Care Acquired Muscle Weakness (ICU-AW) occurs. This neuromuscular disorder, also causes
      functional impairments after ICU discharge.

      Early physiotherapy intervention in ICU, has a positive effect on the symptoms frequently
      occur in patients. In addition to improve the functional status of the patient such as
      exercise capacity, muscle strength and mobilization, its increase weaning from mechanical
      ventilation, and decrease the length of stay in the ICU and hospital. It also provides airway
      clearance, reduction the work of breathing and improvement of respiratory function.

      Neurophysiological facilitation of respiration is the use of proprioceptive and tactile
      stimulation that produce reflexive movement responses. These responses provide to increase
      the depth of breathing, decrease respiratory rate in patients with decreased level of
      consciousness. It also increase inspiratory expansion of the ribs, epigastric excursion and
      abdominal muscles tone. In the study conducted Kumar et al. has indicated that
      neurophysiological facilitation (NPF) techniques improves levels of dyspnea and oxygen
      saturation (spO2) in Coronavirus patients. It is very important to increase the level of
      oxygen saturation to rate the mortality. In NPF techniques, respectively the proprioceptors
      and tactile receptors in the abdominal, intercostals and spinal muscles are affected, phrenic
      motor neurons are stimulated, thoracic and abdominal excursions are increased and thus
      provide improves vital parameters.
    

Intervention name(s): NPF Group; Control Group
Intervention type(s): Other; Other
Intervention description(s): Participants allocated to the experimental group completed until discharged, neurophysiological facilitation(NPF) techniques in addition to conventional physiotherapy.; Critical ill patients was applied their conventional physiotherapy which includes chest physiotherapy and mobilization until discharged
Other intervention name(s): Neurophysiological facilitation techniques in addition to conventional physiotherapy.; Conventional physiotherapy
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Intensive Care Unit; Critical Ill; Physiotherapy; Neurophysiologic Facilitation Techniques; Intensive Care Unit Acquired Weakness