Early Physical Rehabilitation Correlates With Improved Physical Function at Discharge for ICU Patients With COVID-19

Aug 22, 2024

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The following is a summary of “Early physical rehabilitation dosage in the intensive care unit associates with hospital outcomes after critical COVID-19,” published in the July 2024 issue of Critical Care by Mayer et al.

Researchers conducted a retrospective study exploring the impact of physical rehabilitation parameters, including dosage quantification, on hospital outcomes in critical patients with COVID-19.

They involved 3,780 adult patients with COVID-19 diagnosis in ICU at 4 medical institutions (March 2020 to April 2021). Physical rehabilitation treatments delivered in the ICU and patient outcomes were measured, which included mortality, discharge disposition, and physical function at hospital discharge, assessed using the Activity Measure-Post Acute Care (AM-PAC) “6-Clicks” (scores ranging from 6 to 24, with 24 indicating greater functional independence). The dosage of physical rehabilitation was defined as the average mobility level scores from the first 3 sessions (serving as a proxy for intensity) multiplied by the frequency of rehabilitation sessions (physical therapy plus occupational therapy frequency in the hospital).

The result showed patients with an average age of 64 ± 16 years, with 41% being female, a mean BMI of 32 ± 9 kg/m², and 46% (n = 1739) requiring MV. Among the 2,191 patients who received rehabilitation, a moderate positive association between the rehabilitation dosage and AM-PAC scores at discharge was observed (Spearman’s rho [r] = 0.484, P<0.001). Multivariate linear regression analysis (model adjusted R² = 0.68, P<0.001) indicated that MV (β = −0.86, P=0.001), average mobility score in the first 3 sessions (β = 2.6, P<0.001), and physical rehabilitation dosage (β = 0.22, P=0.001) were significant predictors of AM-PAC scores at discharge, after adjusting for age, sex, BMI, and ICU length of stay.