Feasibility and impact of a structured, exercise-based rehabilitation programme for intensive care survivors

Our objective was to assess the impact of an outpatient physiotherapy-led rehabilitation programme on exercise capacity and anxiety and depression scores in a cohort of adult intensive care survivors. In a prospective study in a teaching hospital, 38 general intensive care survivors following hospital discharge underwent an established physiotherapy-led outpatient rehabilitation programme. The programme involved 2 hours of supervised exercise and education sessions each week and two unsupervised exercise sessions each week for 6 weeks. Assessments took place 1 week before and 1 week after completing the programme. Primary outcome measures were changes in exercise capacity measured using the 6-minute walk test (6MWT) and incremental shuttle walk test (ISWT). Secondary outcome measures were changes in anxiety and depression scores using the Hospital Anxiety and Depression Scale (HADS). Median distance covered in the 6MWT improved by 160 metres (p<0.001), and median distance covered in the ISWT also improved by 160 metres (p < 0.001). Significant improvement in anxiety (p = 0.001) and depression (p = 0.001) scores were also seen. Outpatient, physiotherapy-lead rehabilitation appears to improve both exercise capacity and anxiety and depression scores in a cohort of intensive care survivors. A similar programme should be tested in a randomised controlled trial.