Six-month trajectory of physical function in ICU survivors: Experience from an Eastern Cape centre.
Elizabeth van der Merwe, Louise Stroud, Gary Sharp and 2 others
PMID 40950567WHAT IT FOUND
Walking distance improved from 6 weeks to 6 months, but 53 of 99 ICU survivors still walked less than 80% of expected distance for age, height, sex and weight at 6 months.
Poorer walking was linked to lower physical and mental quality of life.
Key findings
01The median six-minute walk distance increased from 405 m at 6 weeks to 470 m at 6 months.
02At 6 months, 53 of 99 patients still walked less than 80% of the predicted six-minute walk distance.
03Patients who walked less than 80% of predicted distance at 6 months had lower median SF-36 physical summary scores (42.1 vs 53.3) and mental summary scores (45.6 vs 55.2).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
It was a single centre observational study, so it cannot show that physiotherapy or occupational therapy caused any improvement. It used international predicted six-minute walk distances because South African norms were not available, which may have misclassified some patients. The study was conducted during COVID-19 waves, and pandemic triage, COVID-19-related ARDS and fewer trauma, surgical and HIV cases may have affected the results. The MRC score is subjective and ordinal, especially for distinguishing grades 4 and 5, so it may miss subtle weakness. Patients who did not survive to 6 months or did not complete the 6-month assessment were excluded from the final analysis. The study did not explore why patients did not receive rehabilitation.
Declared interests
The supplied text does not report a funding source or conflict-of-interest declaration.
The easy way to misread this
Do not conclude that outpatient physiotherapy improved walking distance. The study did not assign or compare treatment groups. Only 16 patients had attended outpatient physiotherapy after hospital discharge, and none had received occupational therapy.