Format

Send to

Choose Destination
Yonsei Med J. 2018 Sep;59(7):843-851. doi: 10.3349/ymj.2018.59.7.843.

Effects of Early Exercise Rehabilitation on Functional Recovery in Patients with Severe Sepsis.

Author information

1
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
2
Department of Internal Medicine, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea.
3
AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.
4
Department of Anesthesiology, Yonsei University College of Medicine, Seoul, Korea.
5
Department of Rehabilitation Medicine and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.
6
AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea. seran@yuhs.ac.

Abstract

PURPOSE:

Severe sepsis is associated with functional disability among patients surviving an acute phase of infection. Efforts to improve functional impairment are important. We assessed the effects of early exercise rehabilitation on functional outcomes in patients with severe sepsis.

MATERIALS AND METHODS:

A prospective, single-center, case-control study was conducted between January 2013 and May 2014 at a tertiary care center in Korea. Patients with severe sepsis and septic shock were enrolled and randomized to receive standard sepsis treatment or intervention. Intervention involved early targeted physical rehabilitation with sepsis treatment during hospitalization. Participants were assessed at enrollment, hospital discharge, and 6 months after enrollment. Functional recovery was measured using the Modified Barthel Index (MBI), Functional Independence Measure (FIM), and Instrumental Activities of Daily Living (IADL).

RESULTS:

Forty participants (21 intervention patients) were included in an intention-to-treat analysis. There were no significant differences in baseline MBI, FIM, and IADL between groups. Intervention yielded greater improvement of MBI, FIM, and IADL in the intervention group at hospital discharge, but not significantly. Subgroup analysis of patients with APACHE II scores ≥10 showed significantly greater improvement of physical function at hospital discharge (MBI and FIM) in the intervention group, compared to the control group (55.13 vs. 31.75, p=0.048; 52.40 vs. 31.25, p=0.045). Intervention was significantly associated with improvement of MBI in multiple linear regression analysis (standardized coefficient 0.358, p=0.048).

CONCLUSION:

Early physical rehabilitation may improve functional recovery at hospital discharge, especially in patients with high initial severity scores.

KEYWORDS:

Sepsis; exercise rehabilitation; functional outcome; functional recovery; septic shock

PMID:
30091317
PMCID:
PMC6082977
DOI:
10.3349/ymj.2018.59.7.843
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Yonsei University College of Medicine Icon for PubMed Central
Loading ...
Support Center