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Outpatient-based physical rehabilitation for survivors of prolonged critical illness: A randomized controlled trial

机译：危重病幸存者的门诊物理康复：一项随机对照试验

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Introduction: The physical and psychological impact of critical illness is well documented. Recovery may take many months and is often incomplete. The optimal way of addressing these important sequelae following hospital discharge remains unclear. Methods: Single center, randomized controlled trial in patients invasively ventilated for >= 5 days. The treatment group (TG) underwent a 7-week, outpatient-based exercise and education program, with the control group (CG) receiving no intervention during the study period. Primary outcome measures were changes in functional capacity assessed using the cardiopulmonary exercise testing parameters, peak VO2, and anaerobic threshold (AT). Secondary outcome measures were changes in and health-related quality of life assessed using the Short Form 36 version 2 questionnaire. Assessors remained blinded to group allocation. Results: Sixty-three patients completed the study (target n = 90). Improvements in both peak VO2 and AT were seen in both TG and CG but no significant difference between groups was evident. AT improved by 11.7% in CG (baseline 10.3 ml O-2 kg(-1) min(-1), follow-up 11.5 ml O-2 kg(-1) min(-1)), and by 14.6% in TG (baseline 10.3 ml O-2 kg(-1) min(-1), follow-up 11.8 ml O-2 kg(-1) min(-1); ANCOVA p = 0.74). Peak VO2 improved by 14.0% in CG (baseline 13.6 ml O-2 kg(-1) min(-1), follow-up 15.5 ml O-2 kg(-1) min(-1)), and by 18.8% in TG (baseline 13.8 ml O-2 kg(-1) min(-1), follow-up 16.4 ml O-2 kg(-1) min(-1); ANCOVA p = 0.68). Significant improvements were seen in both groups for physical component summary scores (PCS) (TG 39.6 versus 31.0; CG 36.1 versus 32.6) and mental component summary scores (MCS) (TG 48.6 versus 38.4; CG 41.3 versus 37.0). The degree of improvement was significantly higher in the treatment group in comparison to control subjects (PCS p = 0.048; MCS p = 0.017). This improvement was most marked in the subgroup ventilated for >14 days. Conclusions: A 7-week, outpatient-based exercise and education program resulted in improved health-related quality of life scores but not improved exercise capacity.
机译：简介：重大疾病对身体和心理的影响已有详细记录。恢复可能需要几个月的时间，并且通常是不完整的。出院后解决这些重要后遗症的最佳方法仍不清楚。方法：单中心随机对照试验用于有创呼吸≥5天的患者。治疗组（TG）进行了为期7周，基于门诊的运动和教育计划，而对照组（CG）在研究期间未接受干预。主要的结局指标是使用心肺运动测试参数，VO2峰值和无氧阈值（AT）评估的功能改变。次要结果指标是使用简短表格36第2版问卷调查的变化以及与健康相关的生活质量。评估者对小组分配不了解。结果：63位患者完成了研究（目标n = 90）。 TG和CG的VO2和AT峰值均得到改善，但两组之间无明显差异。 CG的AT改善了11.7％（基线10.3 ml O-2 kg（-1）min（-1），随访11.5 ml O-2 kg（-1）min（-1）），而CG改善了14.6％ TG（基线10.3 ml O-2 kg（-1）min（-1），随访11.8 ml O-2 kg（-1）min（-1）; ANCOVA p = 0.74）。 CG的最高VO2改善了14.0％（基线13.6 ml O-2 kg（-1）min（-1），15.5 ml O-2 kg（-1）min（-1））和18.8％ TG（基线13.8 ml O-2 kg（-1）min（-1），随访16.4 ml O-2 kg（-1）min（-1）; ANCOVA p = 0.68）。两组的身体成分总分（PCS）（TG 39.6比31.0; CG 36.1比32.6）和精神成分总分（MCS）（TG 48.6比38.4; CG 41.3比37.0）均有显着改善。与对照组相比，治疗组的改善程度明显更高（PCS p = 0.048; MCS p = 0.017）。在通气时间超过14天的亚组中，这种改善最为明显。结论：一项为期7周，基于门诊的运动和教育计划可以改善与健康相关的生活质量得分，但不能提高运动能力。

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