A discursive review of the effectiveness and utility of exercise therapy in the subacute stage of recovery from critical illness

Abstract

Background The coronavirus pandemic precipitated an increase in admissions to intensive care units (ICU). The related medium to long-term sequelae of critical illness posed a significant challenge to function and quality of life after discharge from the acute hospital, often requiring continued therapeutic input. Current evidence suggests that exercise therapy is effective in rehabilitating multiple systemic conditions. However, its role in post-ICU recovery remains unclear.

The objective of this article was to discuss the merits and demerits of the exercise in subacute post-ICU settings based on available evidence. Effective, evidence-based rehabilitation from critical illness is crucial due to the increased number of patients and the significant burden on care and participation of those individuals.

Methods The materials for this discursive review were selected after several database searches and analysis of available articles. As a result, six papers were found, four of which provided evidence for the beneficial effect of exercise in subacute rehabilitation of post-ICU patients, and two reported no differences between interventions and control groups.

Results Most of the studies found cardiovascular exercise to be safe and somewhat beneficial. However, adherence and attrition were problematic in this patient group, and the studies suffered methodological and measurement problems regarding group selection, exercise prescription and outcome measures applied.

Conclusion The existing evidence base did not allow an informed consensus regarding the value of exercise in the subacute post-ICU recovery or lack thereof. Therefore, further investigation into patient retention strategies, exercise prescription and the choice of appropriate outcome measures is necessary.