Early rehabilitation reduces the likelihood of developing intensive care unit-acquired weakness: a systematic review and meta-analysis

Physiotherapy
David E AnekweJadranka Spahija

Abstract

Intensive care unit-acquired weakness (ICUAW) is associated with significant impairments in body structure and function, activity limitation, and participation restriction. The etiology and management of ICUAW remain uncertain. To estimate the extent to which early rehabilitation interventions (early mobilization [EM] and/or neuromuscular electrical stimulation [NMES]) compared to usual care reduce the incidence of ICUAW in critically ill patients. We searched MEDLINE, EMBASE, CINAHL, Cochrane Central and Physiotherapy Evidence Database databases from inception to May 1st, 2017. Randomized controlled trials of EM and/or NMES interventions in critically ill adults. Data on the incidence of ICUAW and secondary outcomes were extracted. Both odds and risk ratios for ICUAW were pooled using the random-effects model. We identified 1421 reports after duplicate removal. Nine studies including 841 patients (419 intervention and 422 usual care) were included in the final analysis. The interventions involved EM in five trials, NMES in three trials, and both EM and NMES in one trial. Early rehabilitation decreased the likelihood of developing ICUAW: odds ratio of 0.63 (95% CI: 0.43 to 0.92) in the screened population, and 0.71 (95% CI: 0.5...Continue Reading

Citations

Aug 3, 2020·Current Opinion in Clinical Nutrition and Metabolic Care·Jennifer R A Jones, David M Griffith
Oct 30, 2020·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Karen ChoongSapna R Kudchadkar
Nov 23, 2020·Military Medical Research·Peng-Cheng XuBiao Cheng
Feb 28, 2021·Physiotherapy·Victoria A GoodwinSarah E Lamb
Apr 2, 2021·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Brenda M Morrow
May 1, 2021·Journal of Clinical Medicine·Robert T MankowskiScott C Brakenridge
May 18, 2021·Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology·Nazzareno FagoniMassimiliano Gobbo

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