Effect of Early Rehabilitation in the Intensive Care Unit by a Dedicated Therapist Using a Rehabilitation Protocol: A Single-center Retrospective Study

Prog Rehabil Med. 2021 Aug 4;6:20210030. doi: 10.2490/prm.20210030. eCollection 2021.

Abstract

Objectives: This study investigated retrospectively the effect of early rehabilitation in the intensive care unit (ICU) by a dedicated therapist using a rehabilitation protocol.

Methods: The subjects comprised patients admitted to our emergency ICU. A dedicated therapist and a rehabilitation protocol were instigated in April 2018. We enrolled 330 patients in phase I (April 2016-March 2018) and 383 patients in phase II (April 2018-March 2020). Patients in the ICU for only one night and pediatric patients were excluded. The following data were accessed from medical records: sex, height, age, Sequential Organ Failure Assessment, rehabilitation intervention, ventilation at admission, duration of mechanical ventilation, extubation, reintubation, tracheotomy, length of ICU stay, length of hospital stay, and outcome. The effectiveness of rehabilitation was assessed using the time from ICU admission to the first rehabilitation session, first sitting exercise, and first standing exercise. Clinical outcomes were analyzed separately for subjects discharged to home or transferred to another hospital.

Results: The percentage of subjects undergoing rehabilitation intervention increased significantly from 23.4% to 56.7% (P<0.001) in phase II. Moreover, reintubation (P=0.045); the length of ICU stay (P=0.022); and the time from ICU admission to the first rehabilitation session (P<0.001), the first sitting exercise (P=0.001), and the first standing exercise (P=0.047) significantly decreased in phase II. Furthermore, the duration of mechanical ventilation (P=0.007) and the length of ICU stay (P=0.036) were significantly reduced in the transfer group.

Conclusions: Although the effectiveness of early intervention was suggested, prospective multicenter studies are required to confirm this finding.

Keywords: dedicated therapist; early rehabilitation; intensive care unit; rehabilitation protocol; retrospective study.