Physical training is beneficial to functional status and survival in patients with prolonged mechanical ventilation

Journal of the Formosan Medical Association

卷:110

Huey-Dong Wu¹  Chin-Pyng Wu²  Shiauyee Chen³  Li-Ying Wang⁴  Ying-Tai Wu⁴  Chien-Ling Su⁵  Ling-Ling Chiang⁵ 

[1] Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan;

[2] Department of Thoracic Internal Medicine, Landseed Hospital, Tao-Yuan, Taiwan;

[3] Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University–Wan Fang Hospital, Taipei, Taiwan;

[4] School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan;

[5] School of Respiratory Therapy, Taipei Medical University, Taipei, Taiwan;

关键词: functional status;    physical therapy training;    prolonged mechanical ventilation;    survival;   

DOI  :  10.1016/j.jfma.2011.07.008

来源: DOAJ

【 摘 要 】

Early physical training is necessary for severely deconditioned patients undergoing prolonged mechanical ventilation (PMV), because survivors often experience prolonged recovery. Long-term outcomes after physical training have not been measured; therefore, we investigated outcome during a 1-year period after physical training for the PMV patients.Methods: We conducted a prospective randomized control trial in a respiratory care center. Thirty-four patients were randomly assigned to the rehabilitation group (n = 18) and the control group (n = 16). The rehabilitation group participated in supervised physical therapy training for 6 weeks, and continued in an unsupervised maintenance program for 6 more weeks. The functional independence measurement (FIM) was used to assess functional status. Survival status during the year after enrollment, the number of survivors discharged, and the number free from ventilator support were collected. These outcome parameters were assessed at entry, immediately after the 6 weeks physical therapy training period, after 6 weeks unsupervised maintenance exercise program, and 6 months and 12 months after study entry.Results: The scores of total FIM, motor domain, cognitive domain, and some sub-items, except for the walking/wheelchair sub-item, increased significantly in the rehabilitation group at 6 months postenrollment, but remained unchanged for the control group. The eating, comprehension, expression, and social interaction subscales reached the 7-point complete independence level at 6 months in the rehabilitation group, but not in the control group. The 1-year survival rate for the rehabilitation group was 70%, which was significantly higher than that for the control group (25%), although the proportion of patients discharged and who were ventilator-free in the rehabilitation and control groups did not differ significantly.Conclusion: Six weeks physical therapy training plus 6 weeks unsupervised maintenance exercise enhanced functional levels and increased survival for the PMV patients compared with those with no such intervention. Early physical therapy interventions are needed for the PMV patients in respiratory care centers. [J Formos Med Assoc 2011; 110(X):XX–XX]

【 授权许可】

Unknown