Effect of long-term rehabilitation on takotsubo syndrome-induced severe intensive care unit-acquired weakness: a case report.
Yoshitaka Shimizu, Ryoko Someya, Yugo Minamimoto and 2 others
PMID 39493685WHAT IT FOUND
In a single patient with extremely severe ICU-acquired weakness, muscle strength score rose from 16 to 58, walking distance rose from 385 m to 473 m, and heart-failure quality-of-life score reached 100 during acute, convalescent, and outpatient cardiac rehabilitation.
Key findings
01The patient's MRC-sum score was 16 on days 16 and 17 and 46 by day 67, still below the ICU-AW cut-off of 48.
02The Barthel Index was 0 until transfer on day 67, then 100 after 86 days of inpatient rehabilitation at a convalescent hospital, when MRC-sum score was 53.
03After 3 months of outpatient cardiac rehabilitation, MRC-sum score was 58, 6-minute walk distance was 473 m from 385 m, and KCCQ was 100 from 88.6.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
This is a single patient, so it cannot show that rehabilitation caused the improvement. She received many treatments at once, including mechanical ventilation, IMPELLA, ECMO, midazolam, rocuronium, inotropic agents, hydrocortisone, antibiotics, tracheostomy, inpatient rehabilitation, outpatient cardiac rehabilitation, and nutritional advice. Her Takotsubo-related cardiac function may have recovered on its own, which could also affect walking, symptoms, and quality of life. There was no comparison group, blinding, or randomisation. She did not perform the home walking exercise as instructed. The report is of an older Japanese woman with hypertension, so it may not apply to other patients.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not conclude that long-term rehabilitation alone caused this recovery. The patient also received mechanical ventilation, IMPELLA, ECMO, midazolam, rocuronium, inotropic agents, hydrocortisone, antibiotics, tracheostomy, inpatient rehabilitation, outpatient cardiac rehabilitation, and nutritional advice, and her Takotsubo-related cardiac function may have recovered.