Early Rehabilitation Interventions by Physical Therapists for Severe COVID-19 Patients Were Associated With Decreased Incidence of Post-ICU Physical Impairment.

IF 2.1 Q1 REHABILITATION Annals of Rehabilitation Medicine-ARM Pub Date : 2025-02-01 Epub Date: 2025-02-28 DOI:10.5535/arm.240066

Shinya Oku, Junji Hatakeyama, Keibun Liu, Kentaro Tojo, Masafumi Idei, Shigeaki Inoue, Kazuma Yamakawa, Takeshi Nishida, Shinichiro Ohshimo, Satoru Hashimoto, Shuhei Maruyama, Yoshitaka Ogata, Daisuke Kawakami, Hiroaki Shimizu, Katsura Hayakawa, Yuji Fujino, Taku Oshima, Tatsuya Fuchigami, Hironori Yawata, Kyoji Oe, Akira Kawauchi, Hidehiro Yamagata, Masahiro Harada, Yuichi Sato, Tomoyuki Nakamura, Kei Sugiki, Takahiro Hakozaki, Satoru Beppu, Masaki Anraku, Noboru Kato, Tomomi Iwashita, Hiroshi Kamijo, Yuichiro Kitagawa, Michio Nagashima, Hirona Nishimaki, Kentaro Tokuda, Osamu Nishida, Kensuke Nakamura

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Abstract

Objective: To implement early rehabilitation interventions by physical therapists is recommended. However, the effectiveness of early rehabilitation for severe coronavirus disease 2019 (COVID-19) patients in the prevention of post-intensive care syndrome (PICS) is unclear. We analyzed a multicenter prospective observational study (Post-Intensive Care outcomeS in patients with COronaVIrus Disease 2019) to examine the association between early rehabilitation interventions and PICS physical impairment.

Methods: An analysis was performed on COVID-19 patients who were admitted to intensive care units (ICUs) between March 2020 and March 2021, and required mechanical ventilation. The primary outcome was the incidence of PICS physical impairment (Barthel Index≤90) after one year. Multivariate logistic regression analysis was used to estimate the association between early rehabilitation interventions and PICS physical impairment by adjusting ICU mobility scale (IMS) during seven-day following ICU admission, and clinically relevant risk factors.

Results: The analysis included 259 patients, 54 of whom developed PICS physical impairment one year later. In 81 patients, physical therapists intervened within seven days of ICU admission. There was no significant difference in mean IMS by day seven of admission between the early and non-early rehabilitation patients (0.70 and 0.61, respectively). Multivariate logistic regression analysis showed that early rehabilitation interventions were significantly associated with a low incidence of PICS physical impairment (odds ratio, 0.294; 95% confidence interval, 0.123-0.706; p=0.006).

Conclusion: Early rehabilitation interventions by physical therapists were an independent factor associated with the decreased development of PICS physical impairment at one year, even though early rehabilitation had no significant effect on IMS.

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目标：建议由理疗师实施早期康复干预。然而，重症冠状病毒病 2019（COVID-19）患者早期康复对预防重症监护后综合征（PICS）的效果尚不明确。我们分析了一项多中心前瞻性观察研究（2019年冠状病毒病患者重症监护后结果），以研究早期康复干预与PICS身体损伤之间的关联：对2020年3月至2021年3月期间入住重症监护病房（ICU）并需要机械通气的COVID-19患者进行了分析。主要结果是一年后PICS身体损伤（Barthel指数≤90）的发生率。采用多变量逻辑回归分析估计早期康复干预与PICS肢体损伤之间的关系，方法是调整ICU入院后七天内的ICU移动量表（IMS）和临床相关风险因素：分析包括 259 名患者，其中 54 人在一年后出现了 PICS 身体损伤。在 81 名患者中，物理治疗师在他们入住 ICU 后七天内进行了干预。早期康复患者和非早期康复患者入院第七天的平均 IMS 没有明显差异（分别为 0.70 和 0.61）。多变量逻辑回归分析显示，早期康复干预与PICS肢体损伤的低发生率显著相关（几率比为0.294；95%置信区间为0.123-0.706；P=0.006）：结论：尽管早期康复对 IMS 没有显著影响，但物理治疗师的早期康复干预是减少一年后 PICS 身体损伤发生的一个独立因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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