Effects of early physiotherapy with respect to severity of pneumonia of elderly patients admitted to an intensive care unit: a single center study in Japan

Abstract

[Purpose] We performed early physiotherapy for elderly patients with pneumonia admitted to an intensive care unit (ICU), and examined the effects of this early physiotherapy on the severity of pneumonia. [Subjects and Methods] Patients for whom physiotherapy was started the day after admission to the ICU (acute phase) were assigned to the early intervention group and compared with patients in the standard intervention group. All patients were divided into three groups (Groups I, II, and III) based on the severity of pneumonia. We evaluated the ICU admission period, hospitalization period, and activities of daily living (ADL) before and after admission. [Results] With respect to the severity of pneumonia, Group II showed significant differences in the ICU admission period and rates of change in the operating range, cognitive domain, and Functional Independence Measure (FIM). Group III showed significant differences in the ICU admission period and rate of change in the cognitive domain (FIM item). The results were more favorable in the early intervention group than in the standard intervention group. [Conclusion] The ICU admission period was shorter and a reduction in the ADL level was prevented in Groups II, and III compared to Group I. This may have occurred because of the early rehabilitation.

Prognosis of activities of daily living function in hospitalized patients with nursing and healthcare‐associated pneumonia due to COVID‐19

“…Hospital‐based physical therapy had benefits in reducing the 30‐day hospital readmission rate of acutely ill older adults with CAP and declining physical function. Chigira et al also demonstrated the early physiotherapy may shorten the intensive care unit admission period and prevent decline in ADL in elderly patients 13 . In our hospitals, patients with pneumonia usually took part in some form of physical rehabilitation program administered by physicians or physical therapists within 7 days after hospitalization.…”

“…Several studies demonstrated that early physiotherapy may prevent decline in ADL in elderly patients with pneumonia. 11 , 12 , 13 Yagi et al assessed the effect of early rehabilitation on improving ADL in elderly patients with aspiration pneumonia. 11 They showed that the early rehabilitation group exhibited significant improvement in ADL (OR 1.57, 95% CI 1.50–1.64, p < 0.001).…”

“…Chigira et al also demonstrated the early physiotherapy may shorten the intensive care unit admission period and prevent decline in ADL in elderly patients. 13 In our hospitals, patients with pneumonia usually took part in some form of physical rehabilitation program administered by physicians or physical therapists within 7 days after hospitalization. However, this program was not able to be applied for early rehabilitation in the COVID‐19 ward.…”

Suggested Exercise Protocol for High Risk Population with COVID-19

“…World health organization (WHO) in 18 th of March (2020) applied messages for older adults, people with underlying health condition to learn simple daily physical exercises to perform at home, in quarantine or isolation so can maintain mobility and reduce boredom, while they applied messages for people in isolation to exercise regularly to improve mental health and psychosocial considerations during theCOVID-19 outbreak [9]. Chigira et al (2015) [10] performed early physiotherapy for elderly patients with pneumonia admitted to an ICU and examined its influence on the severity of pneumonia. They compared the results of the standard and early intervention groups.…”

Early mobilisation of patients with community-acquired pneumonia reduce length of hospitalisation—a pilot study

“…Several studies document the effects of early mobilisation (EM) of patients in the intensive care unit (ICU) and in surgery units, and seems as a safe and effective intervention that can have a significant impact on functional outcomes 9 , 10 , 11 , 12 , 13 ) . However, to our knowledge, only one study documents the effects of early mobilisation of patients with CAP 14 ) .…”