Resumo

VAN DER MERWE, Elizabeth et al. Six-month trajectory of physical function in ICU survivors: Experience from an Eastern Cape centre. SAJPHYS [online]. 2025, vol.81, n.1, pp.1-10. ISSN 2410-8219.  https://doi.org/10.4102/sajp.v81i1.2228.

BACKGROUND: Physical impairment affects up to 60% of intensive care unit (ICU) survivors due to factors such as ICU-acquired neuromuscular weakness (ICU-AW), chronic pain, deconditioning and reduced organ and metabolic function. This impairment is linked to lower health-related quality of life (HRQOL). OBJECTIVES: Our study aimed to assess physical impairment and HRQOL among critically ill patients post hospital discharge METHOD: Intensive care unit survivors were assessed six weeks and six months post hospital discharge. Physical performance was evaluated using the six-minute walk test (6MWT) and muscle strength with the Medical Research Council (MRC) score. Patients' HRQOL was determined using the Rand Short Form-36 questionnaire. RESULTS: A total of 107 patients (median age 42 years), including 50% with COVID-19, completed the 6-month follow-up. Although significant improvements were observed, 53.5% walked less than 80% of the predicted 6MWT distance at six months, with females disproportionately affected. Poor physical performance was associated with lower physical and mental HRQOL. Pain interfering with activities was reported by 26.2% at six months. Only 2% met full criteria for ICU-AW at six months. By six weeks, only 15% had attended physiotherapy. CONCLUSION: Intensive care unit survivors exhibited a high incidence of physical impairment and pain at six months, impacting HRQOL. Very few patients met full ICU-AW criteria. CLINICAL IMPLICATIONS: Physical impairment after critical illness is multifactorial and is not only attributable to muscle weakness. The recovery process of young, previously non-frail ICU survivors in the public healthcare setting may be improved by introducing rehabilitation pathways.

Palavras-chave : critical care; physical impairment; ICU-acquired weakness; Medical Research Council score; six-minute walk test; health-related quality of life; post ICU pain; post ICU syndrome.

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