| 摘要: | IMPORTANCE: Physical rehabilitation interventions has been recommended for preventing intensive care unit – acquired weakness (ICUAW). Previous meta-analyses have reported the beneficial effects of physical rehabilitation interventions in ICU population. However, knowledge regarding the optimal physical rehabilitation interventions on treating short-term desirable outcomes remains unknow.
OBJECTIVE: To compare the effects of various physical rehabilitation interventions for preventing ICUAW, improving global muscle strength, shortening length of stay in ICU, and reducing the duration of mechanical ventilation.
DATA SOURCES: We systematically searched the PubMed, EMBASE, ProQuest Dissertations and Theses A&I databases, Scopus, and Cumulative Index to Nursing and Allied Health Literature from the inception to June 14, 2021.
STUDY SELECTION: Only randomised controlled trials (RCTs) comparing physical rehabilitation intervention with either another physical rehabilitation intervention or routine care in critically ill adults were included.
DATA SYNTHESIS: We identified 29 RCTs with 2688 critically ill patients. Neuromuscular electrical stimulation (NMES) combined with progressive mobility was ranked the optimal intervention for reduced the likelihood of developing ICUAW (odd ratio = 0.08, 95% confidence interval = 0.01 – 0.59) compared with routine care. NMES combined with interactive video game, cycle ergometry, and progressive mobility as well as NMES combined with progressive mobility were more likely to be best therapies for shortening length of stay in ICU (Mean difference: -6.05 and -5.54 days), respectively, compared with routine care. Either NMES or cycle ergometry combined with progressive mobility appeared to be the effective treatment for reducing duration of mechanical ventilation (Standardized mean difference: -1.08 and -1.07), respectively, compared to routine care. No superior therapy was found in terms of improving global muscle strength.
CONCLUSION: NMES combined with progressive mobility, a multicomponent therapy, seems to be the optimal physical rehabilitation intervention for preventing ICUAW in critically ill patients. Future RCTs investigating in short-term effects of novel modalities of physical rehabilitation interventions should be conducted to verified our findings. |
