Flashcards in Literature Summary Deck (8)
Khan & Hoffman. Systematic Review of multidisciplinary rehabilitation in patients with multiple trauma.
Low-level evidence from observational studies found functional ability/QoL improved following rehabilitation
Physiotherapy was effective in restoring daily life activities
Concluded rehab is expensive resource and evidence to support its justification is urgently needed
Parry. Electrical Muscle Stimulation in the Intensive Care Setting: A Systematic Review
NMES is a promising intervention. However, conflicting evidence for its effectiveness when administered acutely.
Outcome measure at heterogenous, small sample sizes
Neuromuscular Electrical Stimulation for Preventing Skeletal Muscle Weakness and Wasting in Critically Ill Patients: A Systematic Review
This systematic review provides evidence that adding NMES therapy to usual care is more effective than usual care alone or sham NMES in preventing ICUAW
There is inconclusive evidence about the effectiveness for the preservation of muscle mass in ICU patients.
Kayambu. (2013). Physical Therapy for the Critically Ill in the ICU. A Systematic Review and Meta-Analysis
Physical therapy in the ICU appears to have significant benefit in improving QOL, physical function, peripheral and respiratory muscle strength, increasing ventilator free days and decreasing hospital and ICU stay
However, better quality and larger sample sizes are required to verify the strength of these results
Hodgson. (2013) Clinical Review; Early Patient Mobilization in the ICU.
Several studies suggested that different forms of early mobilisation may be both safe and feasible in ICU patients, including those receiving mechanical ventilation
However, these studies had limitations such as having limited external validity and highly variable control treatments
EM may yield clinical benefits, but it is also labour-intensive and requires appropriate staffing and equipment
More research is required to identify optimal EM techniques and appropriate outcome measures before it can be introduced to routine care of critically ill patients
Paulus. (2012). Benefits and Risks of Manual Hyperinflation in Intubated and mechanically ventilated intensive care unit patients: a systematic review.
Concluded studies have failed to show that MH benefits critically ill intubated and mechanically ventilated patients
But MH MAY improve pulmonary compliance, arterial oxygenation and clearance of airway secretions
Therefore, MH MAY benefit intubated and mechanically ventilated critically ill patients
Better evidence to support use of manual hyperinflation is required.
Evidence Inspiratory Muscle Training
Significant improvements in strength but no significant differences in likelihood of weaning, duration of ventilation and survival.
Systematic Review -> moodie, julie