scholarly journals Physical Therapy on the Wards After Early Physical Activity and Mobility in the Intensive Care Unit

2012 ◽  
Vol 92 (12) ◽  
pp. 1518-1523 ◽  
Author(s):  
Ramona O. Hopkins ◽  
Russell R. Miller ◽  
Larissa Rodriguez ◽  
Vicki Spuhler ◽  
George E. Thomsen
Keyword(s):  
Physical Activity ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Physical Therapy ◽  
Activity Level ◽  
Activity Levels ◽  
Care Providers ◽  
Mobility Data ◽  
Icu Discharge ◽  
Icu Treatment

Background Weakness and debilitation are common following critical illness. Studies that assess whether early physical activity initiated in the intensive care unit (ICU) continues after a patient is transferred to a ward are lacking. Objective The purpose of this study was to assess whether physical activity and mobility initiated during ICU treatment were maintained after patients were discharged from a single ICU to a ward. Design This was a cohort study. Methods Consecutive patients who were diagnosed with respiratory failure and admitted to the respiratory ICU (RICU) at LDS Hospital underwent early physical activity and mobility as part of usual care. Medical data, the number of requests for a physical therapy consultation or nursing assistance with ambulation at ICU discharge, and mobility data were collected during the first 2 full days on the ward. Results Of the 72 patients who participated in the study, 65 had either a physical therapy consultation or a request for nursing assistance with ambulation at ward transfer. Activity level decreased in 40 participants (55%) on the first full ward day. Of the 61 participants who ambulated 100 ft (30.48 m) or more on the last full RICU day, 14 did not ambulate, 22 ambulated less than 100 ft, and 25 ambulated 100 ft or more on the first ward day. Limitations Limitations include lack of data regarding why activity was not performed on the ward, lack of longitudinal follow-up to assess effects of activity, and lack of generalizability to patients not transferred to a ward or not treated in an ICU with an early mobility program. Conclusions Despite the majority of participants having a physical therapy consultation or a request for nursing assistance with ambulation at the time of transfer to the medical ward, physical activity levels decreased in over half of participants on the first full ward day. The data suggest a need for education of ward staff regarding ICU debilitation, enhanced communication among care providers, and focus on the importance of patient-centered outcomes during and following ICU treatment.

scholarly journals Families' perception, knowledge, and psychological stressors associated with transition of care from the intensive care unit

2019 ◽  
Vol 2 (1) ◽  
pp. 53-56
Author(s):  
Gustavo Ferrer ◽  
Chi Chan Lee ◽  
Monica Egozcue ◽  
Hector Vazquez ◽  
Melissa Elizee ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Care Providers ◽  
Family Members ◽  
Expected Improvement ◽  
Transition Of Care ◽  
Care Providers ◽  
Icu Discharge ◽  
Family Perceptions

Background: During the process of transition of care from the intensive care setting, clarity, and understanding are vital to a patient's outcome. A successful transition of care requires collaboration between health-care providers and the patient's family. The objective of this project was to assess the quality of continuity of care with regard to family perceptions, education provided, and psychological stress during the process. Methods: A prospective study conducted in a long-term acute care (LTAC) facility. On admission, family members of individuals admitted to the LTAC were asked to fill out a 15-item questionnaire with regard to their experiences from preceding intensive care unit (ICU) hospitalization. The setting was an LTAC facility. Patients were admitted to an LTAC after ICU admission. Results: Seventy-six participants completed the questionnaire: 38% expected a complete recovery, 61% expected improvement with disabilities, and 1.3% expected no recovery. With regard to the length of stay in the LTAC, 11% expected < 1 week, 26% expected 1 to 2 weeks, 21% expected 3 to 4 weeks, and 42% were not sure. Before ICU discharge, 33% of the participants expected the transfer to the LTAC. Also, 72% did not report a satisfactory level of knowledge regarding their family's clinical condition or medical services required; 21% did not receive help from family members; and 50% reported anxiety, 20% reported depression, and 29% reported insomnia. Conclusion: Families' perception of patients' prognosis and disposition can be different from what was communicated by the physician. Families' anxiety and emotional stress may precipitate this discrepancy. The establishment of optimal projects to eliminate communication barriers and educate family members will undoubtedly improve the quality of transition of care from the ICU.

scholarly journals Quantifying Physical Activity Levels of Survivors of Intensive Care: A Prospective Observational Study

2012 ◽  
Vol 92 (12) ◽  
pp. 1507-1517 ◽  
Author(s):  
Linda Denehy ◽  
Sue Berney ◽  
Laura Whitburn ◽  
Lara Edbrooke
Keyword(s):  
Physical Activity ◽  
Intensive Care ◽  
Interquartile Range ◽  
Apache Ii Score ◽  
Activity Levels ◽  
Free Living ◽  
Factors Associated ◽  
Icu Admission ◽  
Icu Discharge ◽  
Physical Activity Levels

Background Promotion of increased physical activity is advocated for survivors of an intensive care unit (ICU) admission to improve physical function and health-related quality of life. Objective The primary aims of this study were: (1) to measure free-living physical activity levels and (2) to correlate the measurements with scores on a self-reported activity questionnaire. A secondary aim was to explore factors associated with physical activity levels. Design This was a prospective cohort study. Methods Nested within a larger randomized controlled trial, participants were block randomized to measure free-living physical activity levels. Included participants wore an accelerometer for 7 days during waking hours at 2 months after ICU discharge. At completion of the 7 days of monitoring, participants were interviewed using the Physical Activity Scale for the Elderly (PASE) questionnaire. Factors associated with physical activity were explored using regression analysis. Results The ICU survivors (median age=59 years, interquartile range=49–66; mean Acute Physiologic Chronic Health Evaluation [APACHE II] score=18, interquartile range=16–21) were inactive when quantitatively measured at 2 months after hospital discharge. Participants spent an average of 90% of the time inactive and only 3% of the time walking. Only 37% of the sample spent 30 minutes or more per day in the locomotion category (more than 20 steps in a row). Activity reported using the PASE questionnaire was lower than that reported in adults who were healthy. The PASE scores correlated only fairly with activity measured by steps per day. The presence of comorbidities explained one third of the variance in physical activity levels. Limitations Accelerometer overreading, patient heterogeneity, selection bias, and sample size not reached were limitations of the study. Conclusions Survivors of an ICU admission greater than 5 days demonstrated high levels of inactivity for prolonged periods at 2 months after ICU discharge, and the majority did not meet international recommendations regarding physical activity. Comorbidity appears to be a promising factor associated with activity levels.

scholarly journals Association of Physical activity levels and BMI Among Doctor of Physical Therapy Students of a Private College from Karachi

2019 ◽  
Vol 09 (04) ◽  
pp. 281-285
Author(s):  
Khalid Aziz ◽  
Ayesha Afridi ◽  
Abida Arif ◽  
Ghousia Shahid ◽  
Muhammad Faisal Fahim ◽  
...  
Keyword(s):  
Physical Activity ◽  
Physical Therapy ◽  
Physical Activity Level ◽  
Activity Level ◽  
Moderate Physical Activity ◽  
Activity Levels ◽  
Cross Sectional ◽  
Physically Active ◽  
High Physical Activity ◽  
Physical Activity Levels

Objective: To evaluate the physical activity levels among DPT students of Bahria University College of Physical therapy (BUCPT) by International Physical Activity Questionnaire (IPAQ) and to study the relationship between Body Mass Index (BMI) and Physical activity levels of DPT students of (BUCPT). Study design and Setting: This cross sectional study was conducted in BUCPT Bahria from March- April 2019 (1 month data collection). Methodology: Written consent form was obtained from each participant before taking part into study. Individual with cardio-respiratory diseases and fractures in last 12 months or any limb disability were excluded from the study. The study tool was IPAQ. Results:A total of 125 students were enrolled in this study. There were 121 (96.8%) female and 4 (3.2%) male observed. Mean age of students were 19.89±1.14 (18-22) years. In low physical activity level, 2 (28.6%) students were underweight, 8 (17.0%) were normal BMI, 3 (9.7%) were overweight and 6 (15.0%) were obese. In moderate physical activity level, 3 (42.9%) underweight, 22 (46.8%) normal, 19 (61.3%) overweight and 19 (47.5%) fall in obese criteria. High physical activity levels were found to be 2 (28.6%) in underweight group, 17 (36.2%) in normal group, 9 (29.0%) in overweight and 15 (37.5%) were obese. Conclusion: BUCPT students were moderately physically active and minority of them were low physically active and majority of them were lying the category of normal BMI. There was statistically insignificant relationship found between BMI and physical activities levels. Some students were obese and still have high physical activity level while some are normal in BMI and having low physical activity level

scholarly journals Primary Prevention in the Intensive Care Unit: A Prospective Single-Centre Study of the Risk Factors for Invasive Pneumococcal Disease

2017 ◽  
Vol 45 (4) ◽  
pp. 448-452
Author(s):  
A. R. Chapman ◽  
E. L. Litton
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Invasive Pneumococcal Disease ◽  
Western Australia ◽  
Pneumococcal Disease ◽  
Primary Care Providers ◽  
Care Providers ◽  
Health Burden ◽  
Icu Discharge

Invasive pneumococcal disease is a significant health burden in Australia, with immunisation recommended for children and at-risk adults. Health benefits of immunisation are clear, but less effective when immunisation rates are low, as in Western Australia. We hypothesised that patients admitted unplanned to the intensive care unit (ICU) would have high eligibility for pneumococcal immunisation, but low rates of recorded vaccine administration. We performed a prospective observational study of 119 emergency admissions to Royal Perth ICU, a 20-bed mixed ICU at a tertiary teaching hospital in Western Australia. Each admission was screened for vaccine eligibility (age and risk factors as per Australian Technical Advisory Group of Immunisation guidelines), with patients’ health records examined and primary care providers contacted after ICU discharge. Risk factors for invasive pneumococcal disease were common, with 52% of the study population having one or more. Fifty-four of 119 admitted patients (45%) were assessed as eligible for immunisation after ICU discharge. ICU survivors represent a high-risk population for which intervention against modifiable targets, such as invasive pneumococcal disease, may reduce both their chronic health burden and future health expenditure. Future efforts should concentrate on assessing the feasibility of a screening program for modifiable factors in ICU survivors, and the logistics of delivering these interventions in a timely manner during their hospital stay.

scholarly journals Low FXIII activity levels in intensive care unit hospitalized COVID-19 patients

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yael Lichter ◽  
Tanya Badelbayov ◽  
Irina Shalev ◽  
Reut Schvartz ◽  
Yishay Szekely ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Laboratory Data ◽  
High Plasma ◽  
Activity Level ◽  
Activity Levels ◽  
Normal Range ◽  
Fviii Activity ◽  
Continuous Deposition ◽  
Fxiii Activity

Abstract Background COVID-19 infection is associated with a hypercoagulable state. Severe COVID-19 patients present with high plasma fibrinogen levels, continuous deposition of fibrin and the presence of microthrombi in their lungs, accompanied by significant fibrinolysis, resulting in high D-dimer levels. Due to the role of FXIII in fibrin crosslinking and clot stabilization, we analyzed its activity levels and dynamics in COVID-19 patients hospitalized in the intensive care unit (ICU). Methods FXIII levels were measured in thirty four COVID-19 patients hospitalized in the ICU and in fourteen non-severe COVID-19 patients. FVIII levels were measured for comparison. Laboratory data and clinical variables were recorded. Results The average FXIII activity level in 34 ICU hospitalized COVID-19 patients was 69.9±33 %, significantly lower compared to an average of 120±20.9 % FXIII activity in 14 non-severe COVID-19 patients. FXIII activity levels were below the low normal value (< 79 % FXIII activity) in 74 % of the ICU hospitalized COVID-19 patients. In contrast, high FVIII activity was measured among all severe COVID-19 patients. Consecutive measurements, performed in fourteen ICU hospitalized COVID-19 patients, pointed to a significant decrease in FXIII activity from the average of 85.7±28.2 %, (which is in the normal range), to an average of 68.0±20.4 %, below the low normal range, within 6.4±3.4 days of ICU hospitalization. Liver functions did not differentiate between patients with low and normal FXIII activity. No inhibitor to FXIII activity was found in the plasma of severe COVID-19 patients. Levels of FXIII-A antigen correlated with FXIII activity, and were low in severe COVID-19 patients. Conclusions Low FXIII activity levels were found in COVID-19 patients hospitalized in the ICU, with gradual decline during their hospitalization. A mechanism of consumption may account for the low FXIII activity in these patients.

scholarly journals Osteoporosis-related life habits and knowledge about osteoporosis among women in Tabriz, Iran

2020 ◽  
Vol 8 (2) ◽  
Author(s):  
Rafraf M ◽  
Bazyun B ◽  
Afsharnia F
Keyword(s):  
Physical Activity ◽  
Health Care Providers ◽  
Calcium Intake ◽  
Physical Activity Level ◽  
Activity Level ◽  
Moderate Physical Activity ◽  
Activity Levels ◽  
Care Providers ◽  
Childbearing Age ◽  
Life Styles

Introduction: The objectives of this study were to investigate the calcium intake, physical activity level and knowledge about osteoporosis in women who attended health centers in Tabriz, Iran. Materials and Methods: Three hundred ninety-nine women of childbearing age were studied. Information was collected through face to face interviews with subjects. Results: The mean daily calcium intake was 689.08±393.15 mg. Majority of subjects had low or moderate physical activity levels. Only 8% of women reported high physical activity level. Knowledge about osteoporosis in majority of subjects (63.2%) was at moderate level. Educational status of subjects was positively correlated with calcium intake. There were no significant statistics relationship between calcium intake and physical activity with other studied variables. Conclusion: Public health programs are suggested to improve calcium intake of women and elevating healthy life styles. Establishment of educational workshops to health care providers and encourage and obligate them to proper consultation with women is suggested as a suitable approach for prevention of osteoporosis.

Measurement of physical activity levels in the Intensive Care Unit and functional outcomes: An observational study

2017 ◽  
Vol 40 ◽  
pp. 189-196 ◽  
Author(s):  
Lisa J. Beach ◽  
Kate Fetterplace ◽  
Lara Edbrooke ◽  
Selina M. Parry ◽  
Rachel Curtis ◽  
...  
Keyword(s):  
Physical Activity ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Study ◽  
Functional Outcomes ◽  
Activity Levels ◽  
Physical Activity Levels

scholarly journals Later sleep timing predicts accelerated summer weight gain among elementary school children: a prospective observational study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Jennette P. Moreno ◽  
Javad Razjouyan ◽  
Houston Lester ◽  
Hafza Dadabhoy ◽  
Mona Amirmazaheri ◽  
...  
Keyword(s):  
Physical Activity ◽  
Observational Study ◽  
Sleep Duration ◽  
Obesity Prevention ◽  
Prospective Observational Study ◽  
Light Exposure ◽  
Activity Level ◽  
Activity Levels ◽  
School Year ◽  
Children’S Sleep

Abstract Objectives and background Social demands of the school-year and summer environment may affect children’s sleep patterns and circadian rhythms during these periods. The current study examined differences in children’s sleep and circadian-related behaviors during the school-year and summer and explored the association between sleep and circadian parameters and change in body mass index (BMI) during these time periods. Methods This was a prospective observational study with 119 children ages 5 to 8 years with three sequential BMI assessments: early school-year (fall), late school-year (spring), and beginning of the following school-year in Houston, Texas, USA. Sleep midpoint, sleep duration, variability of sleep midpoint, physical activity, and light exposure were estimated using wrist-worn accelerometry during the school-year (fall) and summer. To examine the effect of sleep parameters, physical activity level, and light exposure on change in BMI, growth curve modeling was conducted controlling for age, race, sex, and chronotype. Results Children’s sleep midpoint shifted later by an average of 1.5 h during summer compared to the school-year. After controlling for covariates, later sleep midpoints predicted larger increases in BMI during summer, (γ = .0004, p = .03), but not during the school-year. Sleep duration, sleep midpoint variability, physical activity levels, and sedentary behavior were not associated with change in BMI during the school-year or summer. Females tended to increase their BMI at a faster rate during summer compared to males, γ = .06, p = .049. Greater amounts of outdoor light exposure (γ = −.01, p = .02) predicted smaller increases in school-year BMI. Conclusions Obesity prevention interventions may need to target different behaviors depending on whether children are in or out of school. Promotion of outdoor time during the school-year and earlier sleep times during the summer may be effective obesity prevention strategies during these respective times.

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