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A Randomized Trial of an Intensive Physical Therapy Program for Patients with Acute Respiratory Failure
Open accessAbstract
RATIONALE: Early physical therapy (PT) interventions may benefit patients with acute respiratory failure by preventing or attenuating neuromuscular weakness. However, the optimal dosage of these interventions is currently unknown. OBJECTIVES: To determine whether an intensive PT program significantly improves long-term physical functional performance compared with a standard-of-care PT program. METHODS: Patients who required mechanical ventilation for at least 4 days were eligible. Enrolled patients were randomized to receive PT for up to 4 weeks delivered in an intensive or standard-of-care manner. Physical functional performance was assessed at 1, 3, and 6 months in survivors who were not currently in an acute or long-term care facility. The primary outcome was the Continuous Scale Physical Functional Performance Test short form (CS-PFP-10) score at 1 month. MEASUREMENTS AND MAIN RESULTS: A total of 120 patients were enrolled from five hospitals. Patients in the intensive PT group received 12.4 ± 6.5 sessions for a total of 408 ± 261 minutes compared with only 6.1 ± 3.8 sessions for 86 ± 63 minutes in the standard-of-care group (P < 0.001 for both analyses). Physical function assessments were available for 86% of patients at 1 month, for 76% at 3 months, and for 60% at 6 months. In both groups, physical function was reduced yet significantly improved over time between 1, 3, and 6 months. When we compared the two interventions, we found no differences in the total CS-PFP-10 scores at all three time points (P = 0.73, 0.29, and 0.43, respectively) or in the total CS-PFP-10 score trajectory (P = 0.71). CONCLUSIONS: An intensive PT program did not improve long-term physical functional performance compared with a standard-of-care program. Clinical trial registered with www.clinicaltrials.gov (NCT01058421).
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(2000) · New England Journal of Medicine · doi:10.1056/nejm200005043421801 · Cited by 12,941
Intensive insulin therapy in the medical ICU
Van den Berghe, G., Wilmer, A., Hermans, G., Meersseman, W., Wouters, P. J., Milants, I., Van Wijngaerden, E., Bobbaers, H., & Bouillon, R. (2006) · New England Journal of Medicine · doi:10.1056/nejmoa052521 · Cited by 3,639
One-Year Outcomes in Survivors of the Acute Respiratory Distress Syndrome
Herridge, M. S., Cheung, A. M., Tansey, C. M., Matte-Martyn, A., Diaz-Granados, N., Al-Saidi, F., Cooper, A. B., Guest, C. B., Mazer, C. D., Mehta, S., et al. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa022450 · Cited by 2,334 · cited 1×
“49 28 day ICU-free days 13 [3-18] 11 [4-18] 0.”
Early exercise in critically ill patients enhances short-term functional recovery*
Burtin, C., Clerckx, B., Robbeets, C., Ferdinande, P., Langer, D., Troosters, T., Hermans, G., Decramer, M., & Gosselink, R. (2009) · Critical Care Medicine · doi:10.1097/ccm.0b013e3181a38937 · Cited by 1,032
Mikkelsen, M. E., Christie, J. D., Lanken, P. N., Biester, R. C., Thompson, B. T., Bellamy, S. L., Localio, A. R., Demissie, E., Hopkins, R. O., & Angus, D. C. (2012) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201111-2025oc · Cited by 615
Walsh, T. S., Salisbury, L. G., Merriweather, J. L., Boyd, J. A., Griffith, D. M., Huby, G., Kean, S., Mackenzie, S. J., Krishan, A., Lewis, S. C., et al. (2015) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2015.0822 · Cited by 301
Cited by
Early, goal-directed mobilisation in the surgical intensive care unit: a randomised controlled trial
Schaller, S. J., Anstey, M., Blobner, M., Edrich, T., Grabitz, S. D., Gradwohl-Matis, I., Heim, M., Houle, T., Kurth, T., Latronico, N., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(16)31637-3 · Cited by 759
The ABCDEF Bundle: Science and Philosophy of How ICU Liberation Serves Patients and Families
Ely, E. W. (2017) · Critical Care Medicine · doi:10.1097/ccm.0000000000002175 · Cited by 514
Herridge, M. S., Moss, M., Hough, C. L., Hopkins, R. O., Rice, T. W., Bienvenu, O. J., & Azoulay, E. (2016) · Intensive Care Medicine · doi:10.1007/s00134-016-4321-8 · Cited by 442
Self-citationGirard, T. D., Alhazzani, W., Kress, J. P., Ouellette, D. R., Schmidt, G. A., Truwit, J. D., Burns, S. M., Epstein, S. K., Esteban, A., Fan, E., et al. (2017) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201610-2075st · Cited by 387
Devlin, J. W., Skrobik, Y., Gélinas, C., Needham, D. M., Slooter, A. J. C., Pandharipande, P. P., Watson, P. L., Weinhouse, G. L., Nunnally, M. E., Rochwerg, B., et al. (2018) · Critical Care Medicine · doi:10.1097/ccm.0000000000003259 · Cited by 372
Metadata
- Authors
- Moss, M., Nordon-Craft, A., Malone, D., Van Pelt, D., Frankel, S. K., Warner, M. L., Kriekels, W., McNulty, M., Fairclough, D. L., & Schenkman, M.
- Venue
- American Journal of Respiratory and Critical Care Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2016-05-15
- Volume
- 193
- Issue
- 10
- Pages
- 1101-1110
- ISSN
- 1073-449X (ISSN-L)
- 1535-4970
- OpenAlex
- W2193015193
- Cited by
- 349
- References
- 6
- FWCI
- 25.91
- Type
- journal article
- Language
- en
- Open access
- green
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- Moss, M., Nordon-Craft, A., Malone, D., Van Pelt, D., Frankel, S. K., Warner, M. L., Kriekels, W., McNulty, M., Fairclough, D. L., & Schenkman, M. (2016). A Randomized Trial of an Intensive Physical Therapy Program for Patients with Acute Respiratory Failure. American Journal of Respiratory and Critical Care Medicine. https://doi.org/10.1164/rccm.201505-1039oc
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