scholarly journals Effect of Early Rehabilitation Program on Mechanically Ventilated Patient's Outcomes

2016 ◽  
Vol 4 (9) ◽  
pp. 25-42
Keyword(s):  
Rehabilitation Program ◽  
Early Rehabilitation ◽  
Mechanically Ventilated

Progressive Early Rehabilitation Program Applied to Patients with Acute Cerebrovascular Accident

2020 ◽  
Vol 25 (3) ◽  
pp. 17-25 ◽  
Author(s):  
G. R. Ramazanov ◽  
L. B. Zavaliy ◽  
L. L. Semenov ◽  
S. A. Abudeev ◽  
A. O. Ptitsyn ◽  
...  
Keyword(s):  
Cerebrovascular Accident ◽  
Lung Ventilation ◽  
Rehabilitation Program ◽  
Artificial Lung ◽  
Early Rehabilitation ◽  
Gravity Gradient ◽  
Acute Cerebrovascular Accident ◽  
Artificial Lung Ventilation ◽  
Bed Days ◽  
Severity Of The Disease

Abstract. Early rehabilitation (ER) of patients with acute cerebrovascular accident (ACA) is one of the priority tasks of the vascular centers; the issue of increasing the volume of rehabilitation measures in the resuscitation and intensive care units (ICU) is relevant. Objective. To evaluate the safety and effectiveness of the progressive ER program in patients with ACA. Material and research methods. The study included 129 patients with ACA in ICU. Each patient of the main group (MGr, n = 61) underwent progressive ER: at least 4–5 vertical adjustments per day, passive mode Kinesiotherapy 49 ± 9.3 minutes, a double load of physiotherapy exercises, preventive physiotherapy; the total time of classes reached 240 minutes per day. In the comparison group (СGr, n = 68), standard ER was performed no more than 120 minutes per day. The groups are comparable by sex, age, severity of the disease and comorbidity. The severity of ACA, the gravity gradient, patient mobility, functional status, degree of dependence, and the presence of complications were evaluated. Results. During a month of work with the MGr, 102 ICU bed-days, 94 days of the artificial lung ventilation use, p < 0.05 were saved. Mortality in MGr decreased -— 8 patients (13.1%) versus 14 (20.6%) in CGr (p < 0.05). In patients within CGr, pulmonary thromboembolism developed in 8.8%, in MGr – in 3.3%. The severity of the apoplectic attack decreased ( by 28% in MGr, and by 20% in CGr ), mobility increased. Comparing the modalities of post resuscitationsyndrome in MGr, it was noted that the score decreased by 2 times from 6 [5; 6] to 3 [2.3; 3.3], but it has not changed in the CGr. Patients in the MGr were 2-–3 days earlier adapted to the vertical adjustment. Conclusions. The progressive ER program in ICU is safe, effective, realisable, and allows reducing the number of bed-days in ICU, the number of days of the artificial lung ventilation use, complications, and mortality in comparison with standard medical care.

scholarly journals Early Rehabilitation Program and Vitamin D Supplementation Improves Sensitivity of Balance and the Postural Control in Patients after Posterior Lumbar Interbody Fusion: A Randomized Trial

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 2202 ◽  
Author(s):  
Wojciech Skrobot ◽  
Ewelina Liedtke ◽  
Katarzyna Krasowska ◽  
Katarzyna P. Dzik ◽  
Damian J. Flis ◽  
...  
Keyword(s):  
Vitamin D ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Recovery Process ◽  
Rehabilitation Program ◽  
Vitamin D Supplementation ◽  
Early Rehabilitation ◽  
Lumbar Interbody Fusion ◽  
Postoperative Rehabilitation ◽  
Risk Of Falls

Background: The introduction of early rehabilitation exercise is the foundation of treatment post-Posterior lumbar interbody fusion (PLIF) surgery, and the search for additional sources of reinforcement physiotherapy seems to be very important. Methods: The patients were randomly divided into the vitamin D3 (n = 15; D3) supplemented group and received 3200 IU per day for five weeks before surgery and the placebo group (n = 18; Pl) received vegetable oil during the same time. The patients began the supervisor rehabilitation program four weeks after surgery. Results: The limits of stability (LOS) were significantly improved in the D3 group after 5 and 14 weeks (p < 0.05), while in the Pl group, progress was only observed after 14 weeks (p < 0.05). The LOS were also higher in the D3 group than in the Pl group after five weeks of supervised rehabilitation (p < 0.05). In the postural stability (PST) test, significant progress was observed in the D3 group after 14 weeks (p < 0.02). In addition, neither rehabilitation nor supplementation had significant effects on the risk of falls (RFT). Conclusions: Vitamin D supplementation seems to ameliorate the effects of an early postoperative rehabilitation program implemented four weeks after posterior lumbar interbody fusion. Early physiotherapy treatment after PLIF surgery combined with vitamin D supplementation appears to be a very important combination with regard to the patients’ recovery process.

scholarly journals Changes in the Cardiopulmonary Response to Exercise after Cardiac Transplantation in Patients Enrolled in an Early Rehabilitation Program

1997 ◽  
Vol 4 (2) ◽  
pp. 81-87 ◽  
Author(s):  
Lizanne M Bussières ◽  
Peter W Pflugfelder ◽  
Albert W Taylor ◽  
Dildar Ahmad ◽  
Corinne Weernink ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Exercise Capacity ◽  
Marked Improvement ◽  
Cardiac Transplantation ◽  
Blood Pressure Response ◽  
Minute Ventilation ◽  
Rehabilitation Program ◽  
Early Rehabilitation ◽  
Cardiac Transplant ◽  
Response To Exercise

OBJECTIVE: To evaluate the changes in the cardiopulmonary response to exercise in the first year after cardiac transplantation in patients enrolled in a rehabilitation program in the first three months post-transplantation.METHODS: A graded cycle exercise test with mixed expired gas analysis was performed on patients with end-stage cardiac failure before and serially after cardiac transplantation at one, three and 12 months.RESULTS: Before cardiac transplantation, seven patients were fit enough to be tested. They had a low peak oxygen uptake (VO2 max) and a blunted heart rate and blood pressure response to exercise. They also displayed a restrictive pattern of ventilation during exercise. At three months following transplantation, patients (n=19) had a significantly higher VO2 max(19.9±5.3 versus 9.8±1.4 mL/kg/min, P<0.05), higher peak systolic blood pressure (177±22 versus 94±18 mmHg, P<0.05), greater peak minute ventilation (70±23 versus 34±5 L/min, P<0.05) and lower slope of minute ventilation to carbon dioxide output (35.4±6.2 versus 45.1±6.7, P<0.05) than before transplantation. The VO2 maxmeasured at 12 months post-transplant was similar to the three month value and was on average equal to 59% of the predicted value.CONCLUSIONS: These results indicate that there is a rapid and marked improvement in exercise capacity in patients following cardiac transplantation. These changes are associated with significant respiratory and cardiovascular adaptations. However, despite the marked improvement in exercise capacity, the VO2 maxof cardiac transplant recipients enrolled in an early rehabilitation program did not return to normal at 12 months after surgery.

scholarly journals Early rehabilitation relieves diaphragm dysfunction induced by prolonged mechanical ventilation: a randomised control study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zehua Dong ◽  
Ying Liu ◽  
Yubiao Gai ◽  
Pingping Meng ◽  
Hui Lin ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Prolonged Mechanical Ventilation ◽  
Controlled Trial ◽  
Early Rehabilitation ◽  
Control Group ◽  
Clinical Trial Registry ◽  
Diaphragm Dysfunction ◽  
Mechanically Ventilated ◽  
Rehabilitation Therapy ◽  
Randomised Controlled

Abstract Background Prolonged mechanical ventilation (MV) induces diaphragm dysfunction in patients in the intensive care units (ICUs). Our study aimed to explore the therapeutic efficacy of early rehabilitation therapy in patients with prolonged MV in the ICU. Methods Eighty eligible patients who underwent MV for > 72 h in the ICU from June 2019 to March 2020 were enrolled in this prospective randomised controlled trial. The patients were randomly divided into a rehabilitation group (n = 39) and a control group (n = 41). Rehabilitation therapy included six levels of rehabilitation exercises. Diaphragm function was determined using ultrasound (US). Results Diaphragmatic excursion (DE) and diaphragm thickening fraction (DTF) were significantly decreased in all patients in both groups after prolonged MV (p < 0.001). The rehabilitation group had significantly higher DTF (p = 0.008) and a smaller decrease in DTF (p = 0.026) than the control group after 3 days of rehabilitation training. The ventilator duration and intubation duration were significantly shorter in the rehabilitation group than in the control group (p = 0.045 and p = 0.037, respectively). There were no significant differences in the duration of ICU stay, proportion of patients undergoing tracheotomy, and proportion of recovered patients between the two groups. Conclusions Early rehabilitation is feasible and beneficial to ameliorate diaphragm dysfunction induced by prolonged MV and advance withdrawal from the ventilator and extubation in patients with MV. Diaphragm US is suggested for mechanically ventilated patients in the ICU. Trial registration Chinese Clinical Trial Registry, ID: ChiCTR1900024046, registered on 2019/06/23.

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