Home rehabilitation to improve respiratory muscles in patients recovering from a prolonged ICU stay and in-hospital rehabilitation

Forty-eight miscellaneous patients (66±12 years) with recent acute respiratory failure necessitating a prolonged ICU stay and an in-hospital rehabilitation were randomized in two groups: treatment (T) and control (C). T underwent a 6-month home-based rehabilitation program (2 sessions/day, 7 days/week of mobilization, cardiorespiratory training, walking, limb strength exercises supervised by caregiver, periodic home-visits/phone reinforcements) while C underwent standard care. Maximum inspiratory and expiratory pressures (MIP, MEP), dynamic volumes (FEV1, FVC), arterial blood gases, dyspnea, basal activities daily life, peripheral force measurements, Takahashi and 6 min walking distance tests, quality of life, safety, adherence, patient satisfaction, survival, readmissions and costs were evaluated. After 6 months, T showed more improvement than C in MIP (14±17 vs. -0.2±14 cmH20) and MEP (27±27 vs. 6±21 cmH20) (all p In prolonged ICU-stay survivors discharged after rehabilitation, a 6-month, home-based, relatively low-cost, safe, caregiver-guided physiotherapy intervention had positive effects only on respiratory muscles.