Physical training is beneficial to functional status and survival in patients with prolonged mechanical ventilation

Shiauyee Chen, Chien-Ling Su, Ying Tai Wu, Li Ying Wang, Chin Pyng Wu, Huey Dong Wu, Ling Ling Chiang

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background/purpose: Early physical training is necessary for severely deconditioned patients undergoing prolonged mechanical ventilation (PMV), because survivors often experience prolonged recovery. Long-term outcomes after physical training have not been measured; therefore, we investigated outcome during a 1-year period after physical training for the PMV patients. Methods: We conducted a prospective randomized control trial in a respiratory care center. Thirty-four patients were randomly assigned to the rehabilitation group (n = 18) and the control group (n = 16). The rehabilitation group participated in supervised physical therapy training for 6 weeks, and continued in an unsupervised maintenance program for 6 more weeks. The functional independence measurement (FIM) was used to assess functional status. Survival status during the year after enrollment, the number of survivors discharged, and the number free from ventilator support were collected. These outcome parameters were assessed at entry, immediately after the 6 weeks physical therapy training period, after 6 weeks unsupervised maintenance exercise program, and 6 months and 12 months after study entry. Results: The scores of total FIM, motor domain, cognitive domain, and some sub-items, except for the walking/wheelchair sub-item, increased significantly in the rehabilitation group at 6 months postenrollment, but remained unchanged for the control group. The eating, comprehension, expression, and social interaction subscales reached the 7-point complete independence level at 6 months in the rehabilitation group, but not in the control group. The 1-year survival rate for the rehabilitation group was 70%, which was significantly higher than that for the control group (25%), although the proportion of patients discharged and who were ventilator-free in the rehabilitation and control groups did not differ significantly. Conclusion: Six weeks physical therapy training plus 6 weeks unsupervised maintenance exercise enhanced functional levels and increased survival for the PMV patients compared with those with no such intervention. Early physical therapy interventions are needed for the PMV patients in respiratory care centers.

Original languageEnglish
Pages (from-to)572-579
Number of pages8
JournalJournal of the Formosan Medical Association = Taiwan yi zhi
Volume110
Issue number9
DOIs
Publication statusPublished - Sep 2011

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Artificial Respiration
Rehabilitation
Survival
Control Groups
Respiratory Center
Maintenance
Mechanical Ventilators
Survivors
Exercise
Wheelchairs
Interpersonal Relations
Secondary Prevention
Walking
Therapeutics
Survival Rate
Eating

Keywords

  • Functional status
  • Physical therapy training
  • Prolonged mechanical ventilation
  • Survival

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Physical training is beneficial to functional status and survival in patients with prolonged mechanical ventilation. / Chen, Shiauyee; Su, Chien-Ling; Wu, Ying Tai; Wang, Li Ying; Wu, Chin Pyng; Wu, Huey Dong; Chiang, Ling Ling.

In: Journal of the Formosan Medical Association = Taiwan yi zhi, Vol. 110, No. 9, 09.2011, p. 572-579.

Research output: Contribution to journalArticle

Chen, Shiauyee ; Su, Chien-Ling ; Wu, Ying Tai ; Wang, Li Ying ; Wu, Chin Pyng ; Wu, Huey Dong ; Chiang, Ling Ling. / Physical training is beneficial to functional status and survival in patients with prolonged mechanical ventilation. In: Journal of the Formosan Medical Association = Taiwan yi zhi. 2011 ; Vol. 110, No. 9. pp. 572-579.
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abstract = "Background/purpose: Early physical training is necessary for severely deconditioned patients undergoing prolonged mechanical ventilation (PMV), because survivors often experience prolonged recovery. Long-term outcomes after physical training have not been measured; therefore, we investigated outcome during a 1-year period after physical training for the PMV patients. Methods: We conducted a prospective randomized control trial in a respiratory care center. Thirty-four patients were randomly assigned to the rehabilitation group (n = 18) and the control group (n = 16). The rehabilitation group participated in supervised physical therapy training for 6 weeks, and continued in an unsupervised maintenance program for 6 more weeks. The functional independence measurement (FIM) was used to assess functional status. Survival status during the year after enrollment, the number of survivors discharged, and the number free from ventilator support were collected. These outcome parameters were assessed at entry, immediately after the 6 weeks physical therapy training period, after 6 weeks unsupervised maintenance exercise program, and 6 months and 12 months after study entry. Results: The scores of total FIM, motor domain, cognitive domain, and some sub-items, except for the walking/wheelchair sub-item, increased significantly in the rehabilitation group at 6 months postenrollment, but remained unchanged for the control group. The eating, comprehension, expression, and social interaction subscales reached the 7-point complete independence level at 6 months in the rehabilitation group, but not in the control group. The 1-year survival rate for the rehabilitation group was 70{\%}, which was significantly higher than that for the control group (25{\%}), although the proportion of patients discharged and who were ventilator-free in the rehabilitation and control groups did not differ significantly. Conclusion: Six weeks physical therapy training plus 6 weeks unsupervised maintenance exercise enhanced functional levels and increased survival for the PMV patients compared with those with no such intervention. Early physical therapy interventions are needed for the PMV patients in respiratory care centers.",
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AU - Wu, Huey Dong

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