Concern with reproducibility of rehabilitation after critical illness and hospital discharge,Critical Care

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Concern with reproducibility of rehabilitation after critical illness and hospital discharge
Critical Care ( IF 15.1 ) Pub Date : 2021-09-15 , DOI: 10.1186/s13054-021-03745-9
Kota Yamauchi ₁ , Shunsuke Kina ₂ , Shunsuke Taito _{3,

4}

Affiliation

To the editor,

We read with great interest the article by Major and colleagues, who examined the feasibility of an interdisciplinary rehabilitation program designed for patients with physical impairment of post-intensive care syndrome (PICS) who are discharged home [1]. However, we would like to highlight two concerns regarding this study.

First, the intervention of the REACH study was highly feasible and led to higher patient satisfaction; however, it is unclear how the intervention differs from usual care (UC). All patients in the intervention group received physical therapy (PT), but after 3 months, one-third of the intervention group had completed PT. The frequency of intervention was higher in UC, which is presumed to be based on the Dutch practical recommendation for PT [2]. In addition, the intervention rate of occupational therapy (OT) increased 2.5 times in 3–6 months compared to 0–3 months, showing an increase in contrast to PT. If more detailed information is provided regarding the termination criteria for PT and OT for intervention groups, it will be easier to reproduce high feasibility and patient satisfaction for patients with PICS.

Second, the high return to work (RTW) in the REACH study might be due to failure to return to the same job prior to the disease onset. The problem with RTW for critical illness survivors is the imbalance between the job workload and functional ability [3]. A recent review reported a 5%–84% worsening employment status and 17–66% occupation change in previously employed survivors of critical illness [4]. If the percentage of patients in each group returning to the same work as before the onset and the time to RTW is indicated, readers can understand how to support interdisciplinary collaboration and highly satisfied reinstatement.

Elucidating the aforementioned factors might help in better interpretation of the results and establish a better home-based interdisciplinary rehabilitation program for physical impairment from PICS.

Not applicable.

1.
Major ME, Dettling-Ihnenfeldt D, Ramaekers SPJ, Engelbert RHH, van der Schaaf M. Feasibility of a home-based interdisciplinary rehabilitation program for patients with Post-Intensive Care Syndrome: the REACH study. Crit Care. 2021;25(1):279.
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2.
Kwakman RCH, Major ME, Dettling-Ihnenfeldt DS, Nollet F, Engelbert RHH, van der Schaaf M. Physiotherapy treatment approaches for survivors of critical illness: a proposal from a Delphi study. Physiother Theor Pract. 2020;36(12):1421–31.
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3.
Su H, Hopkins RO, Kamdar BB, May S, Dinglas VD, Johnson KL et al. Association of imbalance between job workload and functional ability with return to work in ARDS survivors. Thorax. 2021 :thoraxjnl-2020-216586
4.
Kamdar BB, Suri R, Suchyta MR, Digrande KF, Sherwood KD, Colantuoni E, et al. Return to work after critical illness: a systematic review and meta-analysis. Thorax. 2020;75(1):17–27.
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Affiliations

Department of Rehabilitation, Steel Memorial Yawata Hospital, Harunomachi 1-1-1, Yahatahigashi-ku, Kitakyushu, Fukuoka, 805-8508, Japan
Kota Yamauchi
Department of Rehabilitation, Nakagami Hospital, Noborikawai 610, Okinawa, 904-2195, Japan
Shunsuke Kina
Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Kasumi 1-2-3, Minami-ku, Hiroshima, 734-8551, Japan
Shunsuke Taito
Systematic Review Workshop Peer Support Group (SRWS-PSG), Osaka, Japan
Shunsuke Taito

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Kota YamauchiView author publications
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Shunsuke KinaView author publications
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Shunsuke TaitoView author publications
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Contributions

SK and ST critically revised the manuscript for important intellectual content. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kota Yamauchi.

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The authors declare that they have no competing interests.

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Yamauchi, K., Kina, S. & Taito, S. Concern with reproducibility of rehabilitation after critical illness and hospital discharge. Crit Care 25, 332 (2021). https://doi.org/10.1186/s13054-021-03745-9

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Received: 21 August 2021
Accepted: 23 August 2021
Published: 15 September 2021
DOI: https://doi.org/10.1186/s13054-021-03745-9

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Keywords

Post-intensive care syndrome
Critical illness
Rehabilitation
Return to work

中文翻译：

关注危重病出院后康复的可重复性

致编辑，

我们饶有兴趣地阅读了 Major 及其同事撰写的文章，他们研究了为出院回家的重症监护后综合征 (PICS) 身体损伤患者设计的跨学科康复计划的可行性 [1]。然而，我们想强调关于这项研究的两个问题。

首先，REACH 研究的干预是高度可行的，并导致更高的患者满意度；然而，目前尚不清楚干预与常规护理 (UC) 有何不同。干预组的所有患者都接受了物理治疗（PT），但3个月后，干预组有三分之一的患者完成了物理治疗。UC 的干预频率更高，据推测这是基于荷兰对 PT 的实用建议 [2]。此外，职业治疗（OT）的干预率在3-6个月内比0-3个月增加了2.5倍，与PT相比呈上升趋势。如果提供有关干预组 PT 和 OT 终止标准的更详细信息，将更容易重现 PICS 患者的高可行性和患者满意度。

其次，REACH 研究中的高回报工作 (RTW) 可能是由于未能在疾病发作前返回同一工作。重病幸存者 RTW 的问题是工作量和职能能力之间的不平衡 [3]。最近的一项审查报告称，先前受雇的危重疾病幸存者的就业状况恶化了 5%–84%，职业发生了 17%–66% 的变化 [4]。如果指出每组患者恢复与发病前相同的工作的百分比和 RTW 时间，读者可以了解如何支持跨学科合作和高度满意的复职。

阐明上述因素可能有助于更好地解释结果，并为 PICS 的身体损伤建立更好的基于家庭的跨学科康复计划。

不适用。

1.
Major ME、Dettling-Ihnenfeldt D、Ramaekers SPJ、Engelbert RHH、van der Schaaf M。针对重症监护后综合征患者的家庭跨学科康复计划的可行性：REACH 研究。暴击护理。2021;25(1):279。
文章谷歌学术
2.
Kwakman RCH、Major ME、Dettling-Ihnenfeldt DS、Nollet F、Engelbert RHH、van der Schaaf M。危重病幸存者的物理治疗方法：来自德尔福研究的建议。物理其他理论实践。2020;36(12):1421-31。
文章谷歌学术
3.
Su H、Hopkins RO、Kamdar BB、May S、Dinglas VD、Johnson KL 等。ARDS 幸存者的工作工作量和功能能力之间的不平衡与重返工作之间的关联。胸部。2021 :thoraxjnl-2020-216586
4.
Kamdar BB、Suri R、Suchyta MR、Digrande KF、Sherwood KD、Colantuoni E 等。重病后重返工作岗位：系统评价和荟萃分析。胸部。2020；75(1):17–27。
文章谷歌学术

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隶属关系

805-8508 日本福冈市北九州市八幡东区春町 1-1-1 钢铁纪念八幡医院康复科
山内幸太
康复科，中上医院，登川 610，冲绳，904-2195，日本
纪那俊介
日本广岛市南区霞 1-2-3 广岛大学医院临床实践和支持部康复科 734-8551
台东俊介
系统审查研讨会同行支持小组 (SRWS-PSG)，日本大阪
台东俊介

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Kota Yamauchi查看作者出版物
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Shusuke Kina查看作者出版物
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台东俊介查看作者出版物
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贡献

SK 和 ST 对手稿的重要知识内容进行了批判性修改。所有作者阅读并认可的终稿。

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与山内幸太的通信。

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