Early exercise rehabilitation of muscle weakness in acute respiratory failure patients

Abstract

Acute respiratory failure patients experience significant muscle weakness, which contributes to prolonged hospitalization and functional impairments after hospital discharge. Based on our previous work, we hypothesize that an exercise intervention initiated early in the intensive care unit aimed at improving skeletal muscle strength could decrease hospital stay and attenuate the deconditioning and skeletal muscle weakness experienced by these patients.

Figures

Figure 1

The image on the left shows the tibialis anterior muscle in cross-section at baseline. The image on the right shows the same tibialis anterior muscle after the patient has been in the ICU for 14 days. After the prolonged ICU stay the muscle has lost its normal echotexture and is hyperechoic with a homogeneous, ground-glass appearance. (Reprinted from (11). Copyright © 2012 John Wiley and Sons. Used with permission.)

Figure 2

Passive range of motion (ROM) therapy started on day 1 of protocol (level I). As patients demonstrated consciousness and increased strength, they were moved to the next higher level. Physical therapy (PT) would be first attempted at level II. The protocol’s intervention ceased as a patient was transferred to a bed in a general care area, and then patients within both “protocol” and “usual care” groups would receive usual care mobility therapy (MT) as dictated by the physician teams in the general care areas. ICU, intensive care unit; OOB ,out of bed; q2Hr, every 2 hours; 3x/d, 3 times a day. (Reprinted from (35). Copyright © 2008. Wolters Kluwer Health. Used with permission.)

Figure 3

Acute Respiratory Failure patient performing elbow extension exercises with elastic band.