The impact of early rehabilitation in intensive care unit for COVID-19 patients

Disabil Rehabil. 2023 Aug 9:1-9. doi: 10.1080/09638288.2023.2243595. Online ahead of print.

Abstract

Purpose: To evaluate the impact of early rehabilitation in intensive care unit (ICU) on the survival and functional outcomes of COVID-19 patients admitted to ICU at acute phase.

Materials and methods: We conducted a prospective quasi-experimental study including 346 eligible COVID-19 patients from all admitted cases in an ICU in Vietnam, divided into three groups: no rehabilitation (n = 32), late rehabilitation (n = 109), and early rehabilitation (n = 205). Baseline characteristics and survival information of patient were collected with BORG-CR10 scale and PFIT; the data were collected at different time points: before intervention, when switching to oxygen-therapy, and at discharge.

Results: The control group (patients not using rehabilitation therapy) has worse survival than both early rehabilitation group (hazard ratio [HR] 0.553; 95% confidence interval [CI] 0.380-0.806; p value < 0.001) and late rehabilitation group (HR 0.374; CI 0.235-0.594; p value < 0.001). Regarding functional improvement, during the first five days, rehabilitation did not make a significant impact on the patients (p value > 0.05), however if continued from day 5 to day 20, the early-rehabilitation patients obtained a statistically significant improvement for BORG-CR10 (p value < 0.01). No clear association was found for PFIT (p value > 0.05).

Conclusion: The research emphasises the benefits of the early rehabilitation in ICU for COVID-19 patients.

Keywords: BORG-CR10; COVID-19; ICU; PFIT; rehabilitation.

Plain language summary

Rehabilitation for severe COVID-19 patients in the intensive care unit (ICU) can improve patient survival during the ICU stay.This study suggests the benefit of early rehabilitation in ICU for COVID-19 patients.Early rehabilitation shows statistically significant improvement for exertion in patients who underwent rehabilitation at least 5 d.