Six-month trajectory of physical function in ICU survivors: Experience from an Eastern Cape centre

Physical impairment affects up to 60% of intensive care unit (ICU) survivors due to factors such as ICU-acquired neuromuscular weakness (ICU-AW), chronic pain, deconditioning and reduced organ and metabolic function. This impairment is linked to lower health-related quality of life (HRQOL).

Our study aimed to assess physical impairment and HRQOL among critically ill patients post hospital discharge.

Intensive care unit survivors were assessed six weeks and six months post hospital discharge. Physical performance was evaluated using the six-minute walk test (6MWT) and muscle strength with the Medical Research Council (MRC) score. Patients' HRQOL was determined using the Rand Short Form-36 questionnaire.

A total of 107 patients (median age 42 years), including 50% with COVID-19, completed the 6-month follow-up. Although significant improvements were observed, 53.5% walked less than 80% of the predicted 6MWT distance at six months, with females disproportionately affected. Poor physical performance was associated with lower physical and mental HRQOL. Pain interfering with activities was reported by 26.2% at six months. Only 2% met full criteria for ICU-AW at six months. By six weeks, only 15% had attended physiotherapy.

Intensive care unit survivors exhibited a high incidence of physical impairment and pain at six months, impacting HRQOL. Very few patients met full ICU-AW criteria.

Physical impairment after critical illness is multifactorial and is not only attributable to muscle weakness. The recovery process of young, previously non-frail ICU survivors in the public healthcare setting may be improved by introducing rehabilitation pathways.