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Am J Respir Crit Care Med. 2016 May 15;193(10):1101-10. doi: 10.1164/rccm.201505-1039OC.

A Randomized Trial of an Intensive Physical Therapy Program for Patients with Acute Respiratory Failure.

Author information

1
1 Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine.
2
2 Physical Therapy Program, and.
3
3 The Medical Center of Aurora, Aurora, Colorado; and.
4
4 Division of Pulmonary Medicine, National Jewish Health, Denver, Colorado.
5
5 Colorado Health Outcomes Group, University of Colorado School of Medicine, Aurora, Colorado.

Abstract

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).

KEYWORDS:

acute respiratory failure; critical care; mechanical ventilation; physical therapy

PMID:
26651376
PMCID:
PMC4872662
DOI:
10.1164/rccm.201505-1039OC
[Indexed for MEDLINE]
Free PMC Article

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