Effect of physiotherapy on regaining independent walking in patients with intensive-care-unit-acquired muscle weakness: A cohort study

Objectives: To describe physiotherapeutic interventions used in the post-acute inpatient rehabilitation of chronic critically ill patients with intensive-care-unit-acquired muscle weakness, and to determine the influence of such interventions on patients’ ability to walk. Methods: Chronic critically ill patients with intensive-care-unit-acquired muscle weakness who were in post-acute and rehabilitation units were included in a cohort study. During post-acute rehabilitation, the patients’ functional status at baseline, all daily physiotherapeutic interventions, and ability to walk were documented. Results: A total of 150 patients were investigated. In patients who regained walking ability, the most frequent interventions in the first 2 weeks of post-acute rehabilitation were practicing walking, sit-to-stand training, and balance training while sitting (total time per week: 48.03 (standard deviation (SD) 41.10), 20.13 (SD 21.12), and 12.37 (SD 26.95) min, respectively). The most frequent interventions in those who did not regain walking ability were passive-assistive movements, sit-to-stand training, and balance training while sitting (total time per week: 15.29 (SD 22.93), 15.15 (SD 22.75), and 14.85 (SD 16.99) min, respectively). The time spent walking increased the chance of regaining walking ability (adjusted hazard ratio=1.017 per min walking, p<0.0001). Conclusion: These results suggest that physiotherapy interventions in the rehabilitation of chronic critically ill patients with intensive-care-unit-acquired muscle weakness may stimulate walking function.