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Effectiveness of Different Physiotherapy Protocols in Children in the Intensive Care Unit: A Randomized Clinical

Gabrielle Sousa Barros Souza1, Mariana Furtado Marques Novais, Guilherme Euzébio Lemes

  • 1Federal University of São Paulo (Mss Souza and Novais), São Paulo, Brazil; Santa Casa de Misericórdia Foundation of Pará (Ms Lemes and Drs de Mello and de Sales), Belém, Brazil; Universidade do Estado do Pará (Dr Cunha), Marabá, Brazil; Universitary Center of Pará (Dr de Oliveira Rocha), Belém, Brazil; Universidade Federal do Pará (Dr Avila), Belém, Brazil; Department of Human Movement Sciences (Dr Rocha), State University of Pará (UEPA), Belém, Brazil.

Pediatric Physical Therapy : the Official Publication of the Section on Pediatrics of the American Physical Therapy Association
|December 7, 2021
PubMed

Insights

Physical exercise-based physical therapy improved heart rate variability in children requiring mechanical ventilation. This approach also reduced the duration of ventilation and hospital stay.

Area of Science:

  • Pediatrics
  • Intensive Care Medicine
  • Cardiology

Background:

  • Autonomic dysfunction is common in critically ill children.
  • Mechanical ventilation can impact cardiovascular health and prolong hospital stays.
  • Optimizing physical therapy protocols is crucial for recovery in pediatric intensive care units.

Purpose of the Study:

  • To compare the effectiveness of a novel physical exercise-based physical therapy protocol versus standard care.
  • To evaluate the impact on autonomic modulation of heart rate (HRV).
  • To assess changes in the duration of invasive mechanical ventilation (IMV) and length of hospital stay.

Main Methods:

  • A randomized clinical study involving 20 pediatric patients in an intensive care unit (ICU).
  • Participants were assigned to either a control group (standard physical therapy) or an experimental group (physical exercise-based physical therapy).
  • Data collection occurred between July 2018 and September 2019.

Main Results:

  • The experimental group demonstrated significantly higher heart rate variability (HRV) compared to the control group.
  • A notable reduction in the time of invasive mechanical ventilation (IMV) was observed in the experimental group.
  • The length of stay in the ICU was significantly shorter for children in the experimental group.

Conclusions:

  • Physical exercise-based physical therapy enhances autonomic modulation of heart rate in critically ill children.
  • This specialized physical therapy protocol effectively reduces the duration of mechanical ventilation and overall hospital stay.
  • Implementing exercise-focused physical therapy can lead to improved clinical outcomes for pediatric ICU patients.
Abstract

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