ABSTRACT
Prolonged stay in Intensive Care Unit (ICU) can cause muscle weakness, physical deconditioning, recurrent symptoms, mood alterations and poor quality of life. Physiotherapy is probably the only treatment likely to increase in the short- and long-term care of the patients admitted to these units. Recovery of physical and respiratory functions, coming off mechanical ventilation, prevention of the effects of bed-rest and improvement in the health status are the clinical objectives of a physiotherapy program in medical and surgical areas. To manage these patients, integrated programs dealing with both whole-body physical therapy and pulmonary care are needed. There is still limited scientific evidence to support such a comprehensive approach to all critically ill patients; therefore we need randomised studies with solid clinical short- and long-term outcome measures.
Subject(s)
Critical Illness/therapy , Physical Therapy Modalities , HumansABSTRACT
Pulmonary rehabilitation is a relatively recent practice in pulmonary medicine which is classically described as a multidisciplinary program of care for patients with chronic respiratory impairment. There is solid evidence of effectiveness for the pulmonary rehabilitation and, with lower level of evidence, for some of its specific components. There is evidence of benefit for exercise tolerance, symptoms, Health-Related Quality of Life, and health care need with indirect evidence of positive effects on survival. One quarter to one third of patients do not have benefits from pulmonary rehabilitation, studies failing to identify any important predictors of treatment success or failure. Outcomes assessment in pulmonary rehabilitation is of main importance to evaluate its evidence-based effectiveness. Although, several questions remain unresolved, pulmonary rehabilitation programs should be included in the comprehensive treatment of patients with respiratory diseases.
