Effect Of Early Exercise In Intensive Care Unit Acquired Weakness

Objective1. To discuss the clinical effects of early exercise on the MRC-score and intensivecare unit acquired weakness(ICU-AW) incident for ICU patients.2. To discuss the clinical effects of early exercise on the independent functionalstatus for ICU patients.3. To discuss the clinical effects of early exercise on the activity of daily living forICU patients.4. To discuss the clinical effects of early exercise on the time of therapy for ICUpatients.MethodsPatints in the ICU who had been on mechanical ventilation for less than72h, andwho met criteria for baseline functional independence were eligible for enrolment inthis randomised controlled trial at first affiliated hoslital of Dalian MedicalUniversity. We randomly assigned84patients by computer-generated, permutedblock randomisation to early exercise (intervention; n=42) or to exerciseinterruption according to the Dalian Medical University ICU routine nursing(control;n=42).The primary endpoint is Medical Research Council score（MRC-score）andprevalence of ICU-AW. The secondary endpoints-the number of patients returningto independent functional status at hospital discharge-was defined as the ability toperform six activities of daily living and the ability to walk independently.Therapistswho undertook patient assessments were blinded to treatment assignment. The lastendpoints included duration of delirium and ventilator-free days during the first28days of hospital stay.Statistical analysis: all data have been made statistie alanalysis with SPSS16.0.All statistical tests were two-sided test, significance level a=0.05. Results1. Baselinedata: there were nosignificant differences statistically of two groups inthe aspect of age，gender，diagnostic type，BMI，etc (P>0.05).The were nosignificant differences statistieally of two groups in the aspect of BI, APACHEⅡ, The prevalence of risk factors before nursing intervention(P>0.05). Baselinedata were consistent and comparable.2. The prevalence rate of ICU-AW: after the intervention, the differences of theprevalence between the tow groups were statistically significant (P<0.05). Theprevalence rate of ICU-AW in the intervention group was lower than that ofcontrol group.3. Return to independent functional status at hospital discharge: after theintervention, the differences of the independent functional status between thetow groups were statistically significant (P<0.05). The independent functionalstatus of ICU-AW in the intervention group was higher than that of controlgroup.4. The length of independent complete ADL: after the intervention, the differencesof the length of independent complete ADL between the tow groups werestatistically significant (P<0.05). The ADL time in the intervention group washigher than that of control group.5. Barthel Index score at hospital discharge: after the intervention, the differencesof the Barthel Index score between the tow groups were statistically significant(P<0.05). The Barthel Index score in the intervention group was higher than thatof control group.6. The time of therapy: after the intervention, the differences of the length of stayin hospital and length of stay in ICU between the tow groups were statisticallysignificant (P<0.05). The time of therapy in the intervention group was lowerthan that of control group.7. Duration of mechanical ventilation: after the intervention, the differences of theDuration of mechanical ventilation in ICU between the tow groups werestatistically significant (P<0.05). Duration of mechanical ventilation in theintervention group was lower than that of control group.Conelusions1. Early exercise can improve the MRC-score of ICU Patients in the inrecovery Stage, reduce the incidence of ICU-AW, effieacy of the intervention group betterthan that of the control group.2. Early exercise can improve activities of daily live, efficacy of the interventiongroup is batter than that of the control group.3. Early exercise can be shortened the length of stay in hospital of ICU patient, andsignificantly reduce the duration of mechanical ventilation in ICU patients,reduce the patient’s medical expenses.