PURPOSE: We have previously shown that a 6-week physical training program improves limb muscle strength, ventilator-free time, and functional outcomes in patients requiring prolonged mechanical ventilation (PMV). The aim of the present study was to examine the effects of this program after 1 year of follow-up.
METHODS: From January 2003 through September 2004, 39 patients with PMV were enrolled. Subjects were assigned to either a treatment group (n=20) receiving physical training 5 days a week for 6 weeks or a control group (n=19) receiving standard care. Baseline characteristics were similar between the groups. The outcome measures at 1 year were the mortality, weaning outcome, disposition, the functional status assessed by the Functional Independence Measure (FIM), and the quality of life measured by 12-item short-form (SF-12) Health Survey.
RESULTS: The overall cumulative probabilities of death were 25% and 70% at 1 year for patients in the treatment and control group, respectively. One patient and 4 patients were weaned from the ventilator and 1 and 5 patients were living at home at 1 year follow-up in the treatment and control group, respectively. No significant differences in the SF-12 physical component score between the 2 groups were noted, and the SF-12 mental component score were significantly higher in the treatment group at 1 year follow-up. The treatment group scored significantly higher, compared with the control patients, on the total (78 vs. 31, respectively, p<0.05) and all subscale FIM scores at 1 year follow-up.
CONCLUSION: This preliminary report demonstrates that a 6-week physical training program is effective in improving long-term outcome, i.e., functional status, overall survival, and health-related quality of life in patients with PMV.
CLINICAL IMPLICATIONS: Early referral for physical training in appropriate cases required prolonged mechanical ventilation might benefit overall long-term outcome.
DISCLOSURE: Li-Ying Wang, No Financial Disclosure Information; No Product/Research Disclosure Information