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Effects of Early Exercise Rehabilitation on Functional Recovery in Patients with Severe Sepsis

 Jin Young Ahn  ;  Je Eun Song  ;  Hea Won Ann  ;  Yongduk Jeon  ;  Mi Young Ahn  ;  In Young Jung  ;  Moo Hyun Kim  ;  Wooyoung Jeong  ;  Su Jin Jeong  ;  Nam Su Ku  ;  June Myung Kim  ;  Sungwon Na  ;  Sung-Rae Cho  ;  Jun Yong Choi 
 Yonsei Medical Journal, Vol.59(7) : 843-851, 2018 
Journal Title
 Yonsei Medical Journal 
Issue Date
Activities of Daily Living ; Adult ; Aged ; Case-Control Studies ; Exercise Therapy* ; Female ; Humans ; Middle Aged ; Outcome Assessment (Health Care)* ; Patient Discharge ; Prospective Studies ; Recovery of Function* ; Regression Analysis ; Republic of Korea ; Sepsis/rehabilitation* ; Shock, Septic/rehabilitation*
Sepsis ; exercise rehabilitation ; functional outcome ; functional recovery ; septic shock
PURPOSE: Severe sepsis is associated with functional disability among patients surviving an acute phase of infection. Efforts to improve functional impairment are important. We assessed the effects of early exercise rehabilitation on functional outcomes in patients with severe sepsis. MATERIALS AND METHODS: A prospective, single-center, case-control study was conducted between January 2013 and May 2014 at a tertiary care center in Korea. Patients with severe sepsis and septic shock were enrolled and randomized to receive standard sepsis treatment or intervention. Intervention involved early targeted physical rehabilitation with sepsis treatment during hospitalization. Participants were assessed at enrollment, hospital discharge, and 6 months after enrollment. Functional recovery was measured using the Modified Barthel Index (MBI), Functional Independence Measure (FIM), and Instrumental Activities of Daily Living (IADL). RESULTS: Forty participants (21 intervention patients) were included in an intention-to-treat analysis. There were no significant differences in baseline MBI, FIM, and IADL between groups. Intervention yielded greater improvement of MBI, FIM, and IADL in the intervention group at hospital discharge, but not significantly. Subgroup analysis of patients with APACHE II scores ≥10 showed significantly greater improvement of physical function at hospital discharge (MBI and FIM) in the intervention group, compared to the control group (55.13 vs. 31.75, p=0.048; 52.40 vs. 31.25, p=0.045). Intervention was significantly associated with improvement of MBI in multiple linear regression analysis (standardized coefficient 0.358, p=0.048). CONCLUSION: Early physical rehabilitation may improve functional recovery at hospital discharge, especially in patients with high initial severity scores.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 1. Journal Papers
Yonsei Authors
구남수(Ku, Nam Su) ORCID logo https://orcid.org/0000-0002-9717-4327
김준명(Kim, June Myung)
나성원(Na, Sungwon) ORCID logo https://orcid.org/0000-0002-1170-8042
송제은(Song, Je Eun)
안진영(Ahn, Jin Young) ORCID logo https://orcid.org/0000-0002-3740-2826
정수진(Jeong, Su Jin) ORCID logo https://orcid.org/0000-0003-4025-4542
조성래(Cho, Sung-Rae) ORCID logo https://orcid.org/0000-0003-1429-2684
최준용(Choi, Jun Yong) ORCID logo https://orcid.org/0000-0002-2775-3315
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