Multidisciplinary rehabilitation in intensive care for COVID-19 - randomized controlled trial
- Ana Cristina Carvalho1,2⇑,
- Jorge Moreira3,
- Pedro Cubelo3,
- Pedro Cantista2,4,
- Catarina Aguiar Branco3,5 and
- Bruno Guimarães3,6
- 1Public Health Unit - Porto Oriental, ACeS Grande Porto VI, Porto, Portugal
- 2Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal
- 3Department of Physical and Rehabilitation Medicine, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
- 4Department of Physical and Rehabilitation Medicine, Centro Hospitalar Universitário do Porto, Porto, Portugal
- 5Department of PRM/ Integrated Clinic, Faculty of Dental Medicine, University of Porto, Porto, Portugal
- 6Cardiovascular Research Center, Faculty of Medicine, University of Porto, Porto, Portugal
- Corresponding author: Ana Cristina Carvalho (cristinapbcarvalho{at}gmail.com)
Abstract
The coronavirus disease 2019 (COVID-19) has led to an increasing number of patients in the intensive care units (ICU). The size of this post-ICU cohort will be unprecedented, with many patients vulnerable to post-intensive care syndrome. We analysed the respiratory and functional effects of a multidisciplinary rehabilitation program on functional performance, in patients hospitalized in ICU due to COVID-19.
We conducted a randomized controlled clinical trial. Ninety-six patients, who fulfilled the eligible criteria, were randomized into control or intervention group. The control group received standard of care in the ICU, and the intervention group received a functional and respiratory rehabilitation protocol, that included medical, nursing, physiotherapy, and occupational therapy interventions.
At discharge, the intervention group showed significantly better muscular strength and respiratory capacity, and significantly less days of hospitalization (12.90±5.8 versus 15.60±6.7 days, p=0.037). At the 4- and 12-week follow-up we applied our main outcome measure – 6-minute walking test. The intervention group had significantly better results than the control group on the 6-minute walking test at the 4-week follow-up (604±67 versus 571±57 m, p=0.018) and at the 12-week follow-up (639±53 37 versus 611±67, p=0.025).
These results support the role of a multidisciplinary rehabilitation program in COVID-19 patients hospitalized in ICU and adds evidence that the implementation of rehabilitation programs in ICU could result in beneficial outcomes for the critical ill patients.
Footnotes
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Conflict of interest: The authors declare they have no conflicts of interest.
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- Received July 14, 2022.
- Accepted September 20, 2022.
- Copyright ©The authors 2022
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