Extended Physiotherapy After Intensive Care Unit (ICU) Stay

Study Overview
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Brief Summary
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Patients in an Intensive Care Unit (ICU) are at great risk of muscle atrophy and neuromuscular complications, that could lead to respiratory complications, decreased physical functioning and deteriorated health related quality of life. The objective is to investigate if extended physical therapy in a general ward could lead to increased physical functioning for post-ICU patients.The study hypothesis is that extended physical therapy would lead to increased physical function at hospital discharge compared to standard amount of physical therapy.

Detailed Description
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The study design is a before and after study. A control group was included for three months and received standard amount of physical therapy at surgical wards, corresponding to 1.75 employment. An intervention group was then included for six months and received extended amount of physical therapy corresponding to an extra 0.5 employment for study participants (2-4 patients/day). The primary outcome was physical function measured with the Chelsea Critical Care Physical Assessment Tool (CPAx), in the ICU and the surgical ward.

Official Title
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Extended Physiotherapy After Intensive Care Unit (ICU) Stay: A Prospective Before and After Study

Conditions
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Critical Illness, Physical Disability

Intervention / Treatment
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* Other: Extended physiotherapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age over 18 years ICU stay >48 hours Understand the Swedish language Exclusion Criteria: • Patients palliative care with no intention of rehabilitation

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: The study design was a before and after study. A control group was included for three months and received standard care. An intervention group was then included for six months and received extended amount of physical therapy.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control<br>Standard amount of physical therapy at surgical wards in an urban hospital, corresponding to 1.75 physiotherapy employment on weekdays divided on four wards with a total of approx. 40-48 patients. | |
| Experimental: Intervention<br>Extended physiotherapy with an extra 0.5 employment on weekdays, leading to 1-2 physiotherapy session per day for the study participants in the intervention group. | Other: Extended physiotherapy<br>* At admission to the surgical ward after ICU care, participants received an individual rehabilitation plan developed in collaboration with the participants and the ward-based physiotherapist. The rehabilitation plan included specified exercises for 1- 2 sessions of approximately 30 minutes a day. For example breathing exercises, practicing transfer in and out of bed and from sitting to standing, stairclimbing, and walking with or without walking aids.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in physical function according to Chelsea Critical Care Physical Assessment tool (CPAx) | Measures physical function in critically ill patients | Through study completion, an average of 2 weeks per participant | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility of intervention | Number of planned interventions not delivered, and number of safety events. | Through study completion, an average of 2 weeks per participant | 
| Length of stay at the ward | Number of days at the hospital ward after ICU discharge | Through study completion, an average of 2 weeks per participant | 
| Readmission to ICU | Number of readmissions to ICU from ward, within each study group | Through study completion, an average of 2 weeks per participant | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Physical therapy, Physical function