Effects of Early Exercise Rehabilitation on Functional Recovery in Patients with Severe Sepsis.
10.3349/ymj.2018.59.7.843
- Author:
Jin Young AHN
1
;
Je Eun SONG
;
Hea Won ANN
;
Yongduk JEON
;
Mi Young AHN
;
In Young JUNG
;
Moo Hyun KIM
;
Wooyoung JEONG
;
Su Jin JEONG
;
Nam Su KU
;
June Myung KIM
;
Sungwon NA
;
Sung Rae CHO
;
Jun Yong CHOI
Author Information
1. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. seran@yuhs.ac
- Publication Type:Original Article
- Keywords:
Sepsis;
septic shock;
exercise rehabilitation;
functional outcome;
functional recovery
- MeSH:
Activities of Daily Living;
APACHE;
Case-Control Studies;
Hospitalization;
Humans;
Korea;
Linear Models;
Prospective Studies;
Rehabilitation*;
Sepsis*;
Shock, Septic;
Tertiary Care Centers
- From:Yonsei Medical Journal
2018;59(7):843-851
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Severe sepsis is associated with functional disability among patients surviving an acute phase of infection. Efforts to improve functional impairment are important. We assessed the effects of early exercise rehabilitation on functional outcomes in patients with severe sepsis. MATERIALS AND METHODS: A prospective, single-center, case-control study was conducted between January 2013 and May 2014 at a tertiary care center in Korea. Patients with severe sepsis and septic shock were enrolled and randomized to receive standard sepsis treatment or intervention. Intervention involved early targeted physical rehabilitation with sepsis treatment during hospitalization. Participants were assessed at enrollment, hospital discharge, and 6 months after enrollment. Functional recovery was measured using the Modified Barthel Index (MBI), Functional Independence Measure (FIM), and Instrumental Activities of Daily Living (IADL). RESULTS: Forty participants (21 intervention patients) were included in an intention-to-treat analysis. There were no significant differences in baseline MBI, FIM, and IADL between groups. Intervention yielded greater improvement of MBI, FIM, and IADL in the intervention group at hospital discharge, but not significantly. Subgroup analysis of patients with APACHE II scores ≥10 showed significantly greater improvement of physical function at hospital discharge (MBI and FIM) in the intervention group, compared to the control group (55.13 vs. 31.75, p=0.048; 52.40 vs. 31.25, p=0.045). Intervention was significantly associated with improvement of MBI in multiple linear regression analysis (standardized coefficient 0.358, p=0.048). CONCLUSION: Early physical rehabilitation may improve functional recovery at hospital discharge, especially in patients with high initial severity scores.
