Effect of Home Care on Physical Function in Post-Intensive Care Unit Patients: A Meta-Analysis

Area of Science:

• Rehabilitation Medicine
• Critical Care Medicine
• Physical Therapy

Background:

• Patients often experience a decline in physical function after hospital discharge, particularly those requiring mechanical ventilation in the intensive care unit (ICU).
• Restoring physical function post-ICU is crucial for patient recovery and quality of life.

Purpose of the Study:

• To conduct a meta-analysis examining home-based or combined outpatient and home-based interventions.
• To assess the effectiveness of these interventions in improving physical function for patients post-ICU mechanical ventilation.

Main Methods:

• Systematic literature search adhering to PRISMA guidelines.
• Inclusion of 11 studies (mostly RCTs) involving adult patients post-ICU mechanical ventilation receiving home-based or outpatient+home-based physical function interventions.
• Calculation of pooled effect sizes (Hedges' g) using random effects models for various physical function measurements.

Main Results:

• The 6-minute walk test showed a pooled effect size of 0.32 (95% CI: 0.05 to 0.58).
• The Timed Up and Go test yielded a pooled effect size of 1.38 (95% CI: -0.09 to 2.84).
• The SF-36 Physical Function subscale demonstrated a pooled effect size of 0.31 (95% CI: 0.09 to 0.52).

Conclusions:

• Home-based or outpatient+home-based intervention programs can lead to improvements in physical function for patients after ICU mechanical ventilation.
• The effect sizes observed are generally small, indicating a need for further research into optimizing these interventions to maximize patient gains in physical function.