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A multimodal rehabilitation program for patients with ICU acquired weakness improves ventilator weaning and discharge home.

ABSTRACT: PURPOSE:To compare the effects of adding a progressive multimodal rehabilitation program to usual care (MRP?+?UC) versus UC alone on 1) functional mobility, strength, endurance and 2) ventilator weaning and discharge status of patients with ICU-acquired weakness (ICUAW) receiving prolonged mechanical ventilation (PMV). METHODS:Randomized pilot trial of an individualized MRP?+?UC versus UC in middle-aged and older ICU survivors with ICUAW receiving PMV. Outcomes compare changes in strength, mobility, weaning success and discharge home from a long-term acute care hospital (LTACH) between the groups. RESULTS:Eighteen males and 14 females (age 60.3?±?11.9?years) who received PMV for ?14?days were enrolled. Despite no significant differences between groups in the changes in handgrip, gait speed, short physical performance battery or 6-min walk distance after treatment, the MRP?+?UC group had greater weaning success (87% vs. 41%, p?

SUBMITTER: Verceles AC

PROVIDER: S-EPMC6143437 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

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A multimodal rehabilitation program for patients with ICU acquired weakness improves ventilator weaning and discharge home.

Verceles Avelino C AC Wells Chris L CL Sorkin John D JD Terrin Michael L ML Beans Jeffrey J Jenkins Toye T Goldberg Andrew P AP

Journal of critical care 20180711

<h4>Purpose</h4>To compare the effects of adding a progressive multimodal rehabilitation program to usual care (MRP + UC) versus UC alone on 1) functional mobility, strength, endurance and 2) ventilator weaning and discharge status of patients with ICU-acquired weakness (ICUAW) receiving prolonged mechanical ventilation (PMV).<h4>Methods</h4>Randomized pilot trial of an individualized MRP + UC versus UC in middle-aged and older ICU survivors with ICUAW receiving PMV. Outcomes compare changes in ...[more]

PMID: 30025227

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Project description:BackgroundGeriatric rehabilitation aims to maintain the functional reserves of older adults in order to optimize social participation and prevent disability. After discharge from inpatient geriatric rehabilitation, patients are at high risk for decreased physical capacity, increased vulnerability, and limitations in mobility. As a result, ageing in place becomes uncertain for a plethora of patients after discharge from geriatric rehabilitation and effective strategies to prevent physical decline are required. Collaboration between different health-care providers is essential to improve continuity of care after discharge from inpatient geriatric rehabilitation. The aim of this study is to evaluate the effectiveness of a multi-professional home-based intervention program (GeRas) to improve functional capacity and social participation in older persons after discharge from inpatient geriatric rehabilitation.MethodsThe study is a multicenter, three-arm, randomized controlled trial with a three-month intervention period. Two hundred and seventy community-dwelling older people receiving inpatient geriatric rehabilitation will be randomized with a 1:1:1 ratio to one of the parallel intervention groups (conventional IG or tablet IG) or the control group (CG). The participants of both IGs will receive a home-based physical exercise program supervised by physical therapists, a nutritional recommendation by a physician, and social counseling by social workers of the health insurance company. The collaboration between the health-care providers and management of participants will be realized within a cloud environment based on a telemedicine platform and supported by multi-professional case conferences. The CG will receive usual care, two short handouts on general health-related topics, and facultative lifestyle counseling with general recommendations for a healthy diet and active ageing. The primary outcomes will be the physical capacity measured by the Short Physical Performance Battery and social participation assessed by the modified Reintegration to Normal Living Index, three months after discharge.DiscussionThe GeRas program is designed to improve the collaboration between health-care providers in the transition from inpatient geriatric rehabilitation to outpatient settings. Compared to usual care, it is expected to improve physical capacity and participation in geriatric patients after discharge from inpatient geriatric rehabilitation.Trial registrationGerman Clinical Trials Register (DRKS00029559). Registered on October 05, 2022.

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A multimodal rehabilitation program for patients with ICU acquired weakness improves ventilator weaning and discharge home.

Publications

A multimodal rehabilitation program for patients with ICU acquired weakness improves ventilator weaning and discharge home.

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