title: Physical therapy management and patient outcomes following ICU-acquired weakness: a case series.
abstract: OBJECTIVE
  Individuals with critical illness experience dysfunction of many body systems including the neuromuscular system. Neuromuscular impairments result in a syndrome referred to as intensive care unit (ICU)-acquired weakness, which may lead to difficulty with activities and participation. The purposes of this case series were to (1) describe safety and feasibility of physical intervention in individuals with ICU-acquired weakness mechanically ventilated for at least 7 days and (2) characterize physical therapist management and patient outcomes.
  
  
  METHODS
  Nineteen patients with ICU-acquired weakness who required mechanical ventilation for at least 7 days were enrolled over a 1-year period.
  
  
  METHODS
  Physical therapy (PT) was provided 5 d/wk for 30 minutes per session.
  
  
  RESULTS
  Outcome measures included manual muscle tests and item scores from the Functional Independence Measure. Participants completed 170 PT sessions. Only 20 sessions (12%) were stopped before 30 minutes. Seventeen participants survived to discharge; no PT-related adverse events occurred. At discharge, participants who went home showed a trend toward greater independence and strength than those who were discharged to another level of care. Median total hospital days was 28 for those discharged to home and 22 for those discharged to other level of care.
  
  
  CONCLUSIONS
  This case series demonstrates safety and feasibility of PT intervention for patients with ICU-acquired weakness requiring mechanical ventilation for at least 7 days. The examination and intervention procedures are described and could be implemented with other similar individuals in the hospital setting. Future studies should investigate frequency and duration of physical intervention, both during hospitalization and postdischarge, and how these factors influence outcomes.
authors.affiliation: Department of Physical Medicine and Rehabilitation-Physical Therapy Program, University of Colorado, Aurora, CO, USA. amy.nordon-craft@unthsc.edu
authors.forename: Amy
authors.initials: A
authors.lastname: Nordon-Craft
authors.forename: Margaret
authors.initials: M
authors.lastname: Schenkman
authors.forename: Kyle
authors.initials: K
authors.lastname: Ridgeway
authors.forename: Alexander
authors.initials: A
authors.lastname: Benson
authors.forename: Marc
authors.initials: M
authors.lastname: Moss
mesh_terms: D000328:Adult; D000368:Aged; D003422:Critical Care; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D010865:Pilot Projects; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000009:adverse effects; D016896:Treatment Outcome