Evaluation of exercise rehabilitation for survivors of intensive care

重症监护医学提高了危重病人的生存率。然而，国际文献报道，与同龄人群相比，ICU幸存者的生活质量和身体结果较差。此外，需要延长ICU住院时间的患者需要消耗大量的资源。该项目旨在测试早期ICU物理治疗师指导的运动康复计划是否持续到出院后，与接受标准护理的患者相比，将改善患者的生活质量，身体功能和减少卫生资源的使用。康复组的患者将参加物理治疗运动康复计划，包括出院后返回门诊病人班。物理治疗师在住院期间每天对患者进行治疗，出院后每周两次，持续8周。所有患者将完成两份生活质量问卷，身体功能将通过一项为急性ICU住院开发的新测试进行评估，即6分钟步行测试，该测试测量患者在6分钟内能快速走多远。还将使用计时起身和行走测试，它可以测量患者从椅子上站起来走路的速度。在出院后的一段时间内，佩戴在手腕上的活动监测器将测量患者在家中的运动量和活动量。测量将由一名物理治疗师进行，对患者随机分配的组进行盲测，在患者进入ICU时（仅通过代理评估生活质量），从ICU出院时，出院时以及出院后3、6、12个月。将利用问卷资料进行经济评价，以检查资源的总体使用情况。

Intensive care medicine has improved survival in critically ill patients. However, international literature reports poor quality of life and physical outcomes in ICU survivors compared to people of the same age. In addition, patients who require a prolonged ICU stay consume a large amount of resources. This project is testing whether an early ICU physiotherapist-directed exercise rehabilitation program continuing until after hospital discharge will improve patient's quality of life, physical function and decrease the use of health resources compared with patients' receiving standard care. Patients in the rehabilitation group will take part in a physiotherapy exercise rehabilitation program including returning to out patient classes after discharge. The physiotherapist will treat patients daily during hospital stay then twice weekly for 8 weeks after discharge. All patients will complete 2 quality of life questionnaires and physical function will be assessed using a new test developed for the acute ICU stay the 6 minute walk test, which measures how far patients can walk quickly in 6 minutes. The timed up and go test will also be used and it measures how quickly patients can get up from a chair and walk. An activity monitor, worn on the wrist, for some of the time after discharge will measure how much exercise and moving about patients are doing at home. Measurements will performed by a physiotherapist, blinded to the group to which patients were randomly allocated, on admission to the ICU (quality of life only by proxy), on discharge from the ICU, discharge from hospital and at 3, 6, 12 months after discharge. Economic evaluation will be performed to examine overall use of resources using information from the questionnaires.