title: Intensive Early Rehabilitation in the Intensive Care Unit for Liver Transplant Recipients: A Randomized Controlled Trial.
abstract: To validate the feasibility and tolerance of an intensive rehabilitation protocol initiated during the postoperative period in an intensive care unit (ICU) in liver transplant recipients.
  
  
  
  Prospective randomized study.
  
  
  
  ICU.
  
  
  
  Liver transplant recipients over a period of 1 year (N=40).
  
  
  
  The "usual treatment group" (n=20), which benefited from the usual treatment applied in the ICU (based on physician prescription for the physiotherapist, with one session a day), and the experimental group (n=20), which followed a protocol of early and intensive rehabilitation (based on a written protocol validated by physicians and an evaluation by physiotherapist, with 2 sessions a day), were compared.
  
  
  
  Our primary aims were tolerance, assessed from the number of adverse events during rehabilitation sessions, and feasibility, assessed from the number of sessions discontinued.
  
  
  
  The results revealed a small percentage of adverse events (1.5% in the usual treatment group vs 1.06% in the experimental group) that were considered to be of low intensity. Patients in the experimental group sat on the edge of their beds sooner (2.6 vs 9.7d; P=.048) and their intestinal transit resumed earlier (5.6 vs 3.7d; P=.015) than patients in the usual treatment group. There was no significant difference between the 2 arms regarding length of stay (LOS), despite a decrease in duration in the experimental group.
  
  
  
  The introduction of an intensive early rehabilitation program for liver transplant recipients was well tolerated and feasible in the ICU. We noted that the different activities proposed were introduced sooner in the experimental group. Moreover, there is a tendency to decreased LOS in the ICU for the experimental group. These results now need to be confirmed by studies on a larger scale.
authors.affiliation: Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Department of Physical Medicine and Rehabilitation, Hôpital de la Conception, Marseille, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Maffei
authors.affiliation: Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Intensive Care Department, Hôpital de la Conception, Marseille, France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Wiramus
authors.affiliation: Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Department of Physical Medicine and Rehabilitation, Hôpital de la Conception, Marseille, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Bensoussan
authors.affiliation: Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Department of Physical Medicine and Rehabilitation, Hôpital de la Conception, Marseille, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Bienvenu
authors.affiliation: Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Department of Physical Medicine and Rehabilitation, Hôpital de la Conception, Marseille, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Haddad
authors.affiliation: Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Clinical Evaluation Unit, Hôpital de la Conception, Marseille, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Morange
authors.affiliation: Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Clinical Evaluation Unit, Hôpital de la Conception, Marseille, France.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Fathallah
authors.affiliation: Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Department of General Surgery and Liver Transplantation, Hôpital de la Conception, Marseille, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Hardwigsen
authors.affiliation: Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Department of Physical Medicine and Rehabilitation, Hôpital de la Conception, Marseille, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Viton
authors.affiliation: Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Department of General Surgery and Liver Transplantation, Hôpital de la Conception, Marseille, France.
authors.forename: Y Patrice
authors.initials: YP
authors.lastname: Le Treut
authors.affiliation: Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Intensive Care Department, Hôpital de la Conception, Marseille, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Albanese
authors.affiliation: Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Department of General Surgery and Liver Transplantation, Hôpital de la Conception, Marseille, France. Electronic address: emilie.gregoire@ap-hm.fr.
authors.forename: Emilie
authors.initials: E
authors.lastname: Gregoire
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D007902:Length of Stay; D016031:Liver Transplantation / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011184:Postoperative Period; D011446:Prospective Studies
keywords: Intensive care units; Liver transplantation; Rehabilitation