Seminars in respiratory and critical care medicine
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Critical illness has many devastating sequelae, including profound neuromuscular weakness and psychological and cognitive disturbances that frequently result in long-term functional impairments. Early rehabilitation begun in the intensive care unit (ICU) is emerging as an important strategy both to prevent and to treat ICU-acquired weakness, in an effort to facilitate and improve long-term recovery. ⋯ Studies conducted to date suggest that such ICU-based rehabilitation is feasible, safe, and effective for carefully selected patients. Further research is needed to identify the optimal patient candidates and procedures and for providing rehabilitation in the ICU.
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Semin Respir Crit Care Med · Dec 2009
ReviewHow do we increase activity and participation in our patients?
Patients with chronic respiratory disease such as chronic obstructive pulmonary disease (COPD) are generally very inactive physically, and this physical inactivity is detrimental to their health. Physical inactivity not only impairs quality of life, it probably shortens life expectancy. Therefore, increasing physical activity should be a prominent goal in pulmonary rehabilitation. ⋯ Indeed, an emerging medical literature suggests that this is so. We still need to know how effective we are in this area because meaningful changes in some of our outcomes, such as activity counts from motion detectors, have not been established. Pulmonary rehabilitation should incorporate specific interventions to make increased activity and participation specific goals of this comprehensive intervention.