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Abstract

Objective

This systematic review and meta-analysis aimed to analyze the published randomized controlled trials (RCTs) that investigated the effects of exercise interventions on functioning and health-related quality of life following hospital discharge for recovery from critical illness.

Design

Systematic review and meta-analysis of RCTs.

Data sources

We searched PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, PEDro data base, and SciELO (from the earliest date available to January 2023) for RCTs that evaluated the effects of physical rehabilitation interventions following hospital discharge for recovery from critical illness.

Review methods

Study quality was evaluated using the PEDro Scale. Mean differences (MDs), standard MDs (SMD), and 95% confidence intervals (CIs) were calculated.

Results

Fourteen studies met the study criteria, including 1259 patients. Exercise interventions improved aerobic capacity SMD 0.2 (95% CI: 0.03–0.3, I² = 0% N = 880, nine studies, high-quality evidence), and physical component score of health-related quality of life MD 3.3 (95% CI: 1.0–5.6, I² = 57%, six studies N = 669, moderate-quality evidence). In addition, a significant reduction in depression was observed MD −1.4 (95% CI: −2.7 to −0.1, I² = 0% N = 148, three studies, moderate-quality evidence). No serious adverse events were reported.

Conclusion

Exercise intervention was associated with improvement of aerobic capacity, depression, and physical component score of health-related quality of life after hospital discharge for survivors of critical illness.

Keywords

Critical illness exercise rehabilitation systematic review

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References

Iwashyna

Ely

Smith

, et al. Long-term cognitive impairment and functional disability among survivors of severe sepsis. JAMA 2010; 304: 1787–1794.

Parry

Knight

Connolly

, et al. Factors influencing physical activity and rehabilitation in survivors of critical illness: a systematic review of quantitative and qualitative studies. Intensive Care Med 2017; 43: 531–542.

Connolly

Salisbury

O'Neill

, et al. Exercise rehabilitation following intensive care unit discharge for recovery from critical illness: executive summary of a Cochrane Collaboration Systematic Review. J Cachexia Sarcopenia Muscle 2016; 7: 520–526.

Gosselink

Bott

Johnson

, et al. Physiotherapy for adult patients with critical illness: recommendations of the European respiratory society and European Society of Intensive Care Medicine Task force on physiotherapy for critically ill patients. Intensive Care Med 2008; 34: 1188–1199.

Hashem

Nallagangula

Nalamalapu

, et al. Patient outcomes after critical illness: a systematic review of qualitative studies following hospital discharge. Crit Care 2016; 20: 345.

Zorowitz

. ICU-acquired weakness: a rehabilitation perspective of diagnosis, treatment, and functional management. Chest 2016; 150: 966–971.

Tipping

Harrold

Holland

, et al. The effects of active mobilisation and rehabilitation in ICU on mortality and function: a systematic review. Intensive Care Med 2017; 43: 171–183.

Connolly

Salisbury

O'Neill

, et al. Exercise rehabilitation following intensive care unit discharge for recovery from critical illness. Cochrane Database Syst Rev 2015; 6: CD008632.

Denehy

Skinner

Edbrooke

, et al. Exercise rehabilitation for patients with critical illness: a randomized controlled trial with 12 months of follow-up. Crit Care 2013; 17: R156.

10.

Connolly

O'Neill

Salisbury

. Blackwood B; enhanced recovery after critical illness programme group. Physical rehabilitation interventions for adult patients during critical illness: an overview of systematic reviews. Thorax 2016; 71: 881–890.

11.

Page

McKenzie

Bossuyt

, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Int J Surg 2021; 88: 105906.

12.

Higgins

JPT

Thomas

Chandler

, et al. Cochrane Handbook for Systematic Reviews of Interventions version 6.2 (updated February 2021). Cochrane, 2021. Available from www.training.cochrane.org/handbook.

13.

Olivo

Macedo

Gadotti

, et al. Scales to assess the quality of randomized controlled trials: a systematic review. PhysTher 2008; 88: 156–175.

14.

Maher

Sherrington

Herbert

, et al. Reliability of the PEDro scale for rating of quality randomized controlled trials. Phys Ther 2003; 83: 713–721.

15.

Wan

Wang

Liu

, et al. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol 2014; 14: 135.

16.

Higgins

Thompson

Deeks

, et al. Measuring inconsistency in meta-analyses. Br Med J 2003; 327: 557–560.

17.

Review Manager (RevMan) [Computer program]. Version 5.4, The Cochrane Collaboration, 2020.

18.

Katri Maria

Laura

Erja

, et al. Effects of a home-based rehabilitation program in community-dwelling older people after discharge from hospital: a subgroup analysis of a randomized controlled trial. Clin Rehabil 2021; 35: 1257–1265.

19.

Turunen

Aaltonen-Määttä

Törmäkangas

, et al. Effects of an individually targeted multicomponent counseling and home-based rehabilitation program on physical activity and mobility in community-dwelling older people after discharge from hospital: a randomized controlled trial. Clin Rehabil 2020; 34: 491–503.

20.

Sunde

Hesseberg

Skelton

, et al. Effects of a multicomponent high intensity exercise program on physical function and health-related quality of life in older adults with or at risk of mobility disability after discharge from hospital: a randomised controlled trial. BMC Geriatr 2020; 20: 464.

21.

Battle

James

Temblett

, et al. Supervised exercise rehabilitation in survivors of critical illness: a randomised controlled trial. J Intensive Care Soc 2019; 20: 18–26.

22.

McDowell

O'Neill

Blackwood

, et al. Effectiveness of an exercise programme on physical function in patients discharged from hospital following critical illness: a randomised controlled trial (the REVIVE trial). Thorax 2017; 72: 594–595.

23.

McWilliams

Benington

Atkinson

. Outpatient-based physical rehabilitation for survivors of prolonged critical illness: a randomized controlled trial. Physiother Theory Pract 2016; 32: 179–190.

24.

Vitacca

Barbano

Vanoglio

, et al. Does 6-month home caregiver-supervised physiotherapy improve post-critical care outcomes?: a randomized controlled trial. Am J Phys Med Rehabil 2016; 95: 571–579.

25.

Connolly

Thompson

Douiri

, et al. Exercise-based rehabilitation after hospital discharge for survivors of critical illness with intensive care unit-acquired weakness: a pilot feasibility trial. J Crit Care 2015; 30: 589–598.

26.

Batterham

Bonner

Wright

, et al. Effect of supervised aerobic exercise rehabilitation on physical fitness and quality-of-life in survivors of critical illness: an exploratory minimized controlled trial (PIX study). Br J Anaesth 2014; 113: 130–137.

27.

Sherrington

Lord

Vogler

, et al. A post-hospital home exercise program improved mobility but increased falls in older people: a randomised controlled trial. PLoS ONE 2014; 9: e104412.

28.

Brovold

Skelton

Bergland

. Older adults recently discharged from the hospital: effect of aerobic interval exercise on health-related quality of life, physical fitness, and physical activity. J Am Geriatr Soc 2013; 61: 1580–1585.

29.

Brovold

Skelton

Bergland

. The efficacy of counseling and progressive resistance home-exercises on adherence, health-related quality of life and function after discharge from a geriatric day-hospital. Arch Gerontol Geriatr 2012; 55: 453–459.

30.

Jackson

Ely

Morey

, et al. Cognitive and physical rehabilitation of intensive care unit survivors: results of the RETURN randomized controlled pilot investigation. Crit Care Med 2012; 40: 1088–1097.

31.

Elliott

McKinley

Alison

, et al. Health-related quality of life and physical recovery after a critical illness: a multi-centre randomised controlled trial of a home-based physical rehabilitation program. Crit Care 2011; 15: R142.

32.

Timonen

Rantanen

Mäkinen

, et al. Effects of a group-based exercise program on functional abilities in frail older women after hospital discharge. Aging Clin Exp Res 2006; 18: 50–56.

33.

McPeake

Iwashyna

Henderson

, et al. Long term outcomes following critical care hospital admission: a prospective cohort study of UK biobank participants. Lancet Reg Health Eur 2021; 6: 100121.

34.

Herridge

Tansey

Matté

, et al. Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med 2011; 364: 1293–1304.

35.

Billett

Campanharo

CRV

Lopes

MCBT

, et al. Functional capacity and quality of life of hospitalized octogenarians. Rev Bras Enferm 2019; 72: 43–48.

36.

Meira

Lavoura

Ferreira

, et al. Impact of hospitalization in the functionality and quality of life of adults and elderlies. Eur Respir J 2015; 46: PA3547.

37.

Alzahrani

. The effect of hospitalization on patients’ emotional and psychological well-being among adult patients: an integrative review. Appl Nurs Res 2021; 61: 151488.

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Effects of exercise interventions on functioning and health-related quality of life following hospital discharge for recovery from critical illness: A systematic review and meta-analysis of randomized trials

Abstract

Objective

Design

Data sources

Review methods

Results

Conclusion

Keywords

Get full access to this article

References

Supplementary Material