Exercise rehabilitation following hospital discharge in survivors of critical illness: an integrative review
Open accessAbstract
Although clinical trials have shown benefit from early rehabilitation within the ICU, rehabilitation of patients following critical illness is increasingly acknowledged as an area of clinical importance. However, despite recommendations from published guidelines for rehabilitation to continue following hospital discharge, there is limited evidence to underpin practice during this intermediate stage of recovery. Those patients with ICU-acquired weakness on discharge from the ICU are most likely to benefit from ongoing rehabilitation. Despite this, screening based on strength alone may fail to account for the associated level of physical functioning, which may not correlate with muscle strength, nor address non-physical complications of critical illness. The aim of this review was to consider which patients are likely to require rehabilitation following critical illness and to perform an integrative review of the available evidence of content and nature of exercise rehabilitation programmes for survivors of critical illness following hospital discharge. Literature databases and clinical trials registries were searched using appropriate terms and groups of terms. Inclusion criteria specified the reporting of rehabilitation programmes for patients following critical illness post-hospital discharge. Ten items, including data from published studies and protocols from trial registries, were included. Because of the variability in study methodology and inadequate level of detail of reported exercise prescription, at present there can be no clear recommendations for clinical practice from this review. As this area of clinical practice remains in its relative infancy, further evidence is required both to identify which patients are most likely to benefit and to determine the optimum content and format of exercise rehabilitation programmes for patients following critical illness post-hospital discharge.
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Exercise is recognized to provide a potent anabolic stimulus to muscle, even among patients who are mostly limited to bed rest.
“Exercise is recognized to provide a potent anabolic stimulus to muscle, even among patients who are mostly limited to bed rest.153,157,168”
From Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group (2013) · cites this paper as [168]
The Introduction (page unavailable) describes prolonged immobility as a risk factor for ICU-acquired weakness and presents rehabilitation as a way to improve muscular strength and endurance. It also reports benefits from early mobilisation in the ICU. The paper does not establish that exercise provides a potent anabolic stimulus to muscle in patients mostly limited to bed rest. (LLM, conf=0.78)
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- Authors
- Connolly, B., Denehy, L., Brett, S., Elliott, D., & Hart, N.
- Affiliations
- King's College London (GB)
- The University of Melbourne (AU)
- Imperial College Healthcare NHS Trust (GB)
- University of Technology Sydney (AU)
- St Thomas' Hospital (GB)
- Corresponding author
- Hart, Nicholas
- Venue
- Critical Care
- Published
- 2012
- Volume
- 16
- Issue
- 3
- Pages
- 226
- ISSN
- 1364-8535 (ISSN-L)
- PMC
- PMC3580599
- OpenAlex
- W2139423869
- Cited by
- 49
- References
- 87
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 3 · 2020: 3 · 2019: 3 · 2018: 3 · 2017: 5 · 2016: 7 · 2015: 7 · 2014: 6 · 2013: 5 · 2012: 2
- FWCI
- 1.11
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Critical Care (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion)
- UTS ePRESS (University of Technology Sydney) (submittedVersion)
- Funders
- King's College Hospital NHS Foundation Trust
- National Institute for Health and Care Research
- Imperial College London
- Imperial College Healthcare NHS Trust
- King's College London
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Keywords
- exercise rehabilitation, critical illness survivors, post-discharge rehabilitation, ICU-acquired weakness, exercise prescription, physical function
- MeSH terms
- Exercise Therapy, Humans, Patient Discharge, Quality of Life, Time Factors, Critical Illness, Survivors, Muscle Weakness, Muscle Strength
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