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Meta-Analysis
. 2022 Mar 1;50(3):375-388.
doi: 10.1097/CCM.0000000000005285.

Physical Rehabilitation in the ICU: A Systematic Review and Meta-Analysis

Yi Tian Wang  1   2 , Jenna K Lang  3 , Kimberley J Haines  3   4 , Elizabeth H Skinner  1   3 , Terry P Haines  1   5
Affiliations
Meta-Analysis

Physical Rehabilitation in the ICU: A Systematic Review and Meta-Analysis

Yi Tian Wang et al. Crit Care Med. .

Abstract

Objectives: Significant variability exists in physical rehabilitation modalities and dosage used in the ICU. Our objective was to investigate the effect of physical rehabilitation in ICU on patient outcomes, the impact of task-specific training, and the dose-response profile.

Data sources: A systematic search of Ovid MEDLINE, Cochrane Library, EMBASE, and CINAHL plus databases was undertaken on the May 28, 2020.

Study selection: Randomized controlled trials and controlled clinical trials investigating physical rehabilitation commencing in the ICU in adults were included. Outcomes included muscle strength, physical function, duration of mechanical ventilation, ICU and hospital length of stay, mortality, and health-related quality of life. Two independent reviewers assessed titles, abstracts, and full texts against eligibility criteria.

Data extraction: Details on intervention for all groups were extracted using the template for intervention description and replication checklist.

Data synthesis: Sixty trials were included, with a total of 5,352 participants. Random-effects pooled analysis showed that physical rehabilitation improved physical function at hospital discharge (standardized mean difference, 0.22; 95% CI, 0.00-0.44), reduced ICU length of stay by 0.8 days (mean difference, -0.80 d; 95% CI, -1.37 to -0.23 d), and hospital length of stay by 1.75 days (mean difference, -1.75 d; 95% CI, -3.03 to -0.48 d). Physical rehabilitation had no impact on the other outcomes. The intervention was more effective in trials where the control group received low-dose physical rehabilitation and in trials that investigated functional exercises.

Conclusions: Physical rehabilitation in the ICU improves physical function and reduces ICU and hospital length of stay. However, it does not appear to impact other outcomes.

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Conflict of interest statement

Mr. Wang received funding from the Australian Postgraduate Award. Dr. Skinner’s institution (Western Health) received funding from the Australian Institute of Musculoskeletal Science. Prof. T. P. Haines received funding from K&L Gates Law Firm and Minter Ellison Law Firm. The remaining authors have disclosed that they do not have any potential conflicts of interest.

Comment in

References

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