Effect of physical therapy on muscle strength, respiratory muscles and functional parameters in patients with intensive care unit-acquired weakness

Abstract

Objectives: The aim of this study was to evaluate the effect of an intensive physical therapy protocol in patients who contract 'intensive care unit-acquired weakness' (ICUAW), in terms of muscle strength, breathing and functional indices.

Methods: This was a prospective, single-blinded study in a general hospital intensive care unit (ICU). Patients who required mechanical ventilation longer than 48 h and who were expected to remain mechanically ventilated for at least another 48 h were randomly divided into two intervention groups: group I (n = 9) - the routine care group, received physical therapy according to our daily custom protocol; and group II (n = 9) - the intensive treatment group, were treated by the same protocol twice a day. The main outcome measures included the Medical Research Council (MRC) physical strength examination, maximal inspiratory pressure (MIP), hand grip dynamometer and sitting balance test.

Results: Significant strength improvement from first (T1) to second (T2) measurements was demonstrated for variables MIP and MRC physical strength examination in favor of the intensive treatment group (P < 0.05). The intensive treatment group also required shorter intensive care length of stay than the routine care group (P = 0.043).

Conclusions: It is possible that an intensive therapy protocol may facilitate the initial recovery process in patients who suffer from ICUAW.

Keywords: Medical Research Council physical strength examination; intensive care unit acquired weakness; maximal inspiratory pressure; sitting balance.