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, JunYong Choi

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)843-851
Number of pages9
JournalYonsei medical journal
Volume59
Issue number7
DOIs
Publication statusPublished - 2018 Sep 1

Fingerprint

Exercise Therapy
Sepsis
Activities of Daily Living
Rehabilitation
Intention to Treat Analysis
APACHE
Korea
Septic Shock
Tertiary Care Centers
Case-Control Studies
Linear Models
Hospitalization
Regression Analysis
Control Groups
Therapeutics
Infection

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Ahn, Jin Young ; Song, Je Eun ; Ann, Hea Won ; Jeon, Yongduk ; Ahn, Mi Young ; Jung, In Young ; Kim, Moo Hyun ; Jeong, Wooyoung ; Jeong, Su Jin ; Ku, Nam Su ; Kim, June Myung ; Na, Sungwon ; Cho, Sung-Rae ; Choi, JunYong. / Effects of Early Exercise Rehabilitation on Functional Recovery in Patients with Severe Sepsis. In: Yonsei medical journal. 2018 ; Vol. 59, No. 7. pp. 843-851.
@article{aa6905257b1145549687cfb24f76db5b,
title = "Effects of Early Exercise Rehabilitation on Functional Recovery in Patients with Severe Sepsis",
abstract = "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.",
author = "Ahn, {Jin Young} and Song, {Je Eun} and Ann, {Hea Won} and Yongduk Jeon and Ahn, {Mi Young} and Jung, {In Young} and Kim, {Moo Hyun} and Wooyoung Jeong and Jeong, {Su Jin} and Ku, {Nam Su} and Kim, {June Myung} and Sungwon Na and Sung-Rae Cho and JunYong Choi",
year = "2018",
month = "9",
day = "1",
doi = "10.3349/ymj.2018.59.7.843",
language = "English",
volume = "59",
pages = "843--851",
journal = "Yonsei Medical Journal",
issn = "0513-5796",
publisher = "Yonsei University College of Medicine",
number = "7",

}

Ahn, JY, Song, JE, Ann, HW, Jeon, Y, Ahn, MY, Jung, IY, Kim, MH, Jeong, W, Jeong, SJ, Ku, NS, Kim, JM, Na, S, Cho, S-R & Choi, J 2018, 'Effects of Early Exercise Rehabilitation on Functional Recovery in Patients with Severe Sepsis', Yonsei medical journal, vol. 59, no. 7, pp. 843-851. https://doi.org/10.3349/ymj.2018.59.7.843

Effects of Early Exercise Rehabilitation on Functional Recovery in Patients with Severe Sepsis. / Ahn, Jin Young; Song, Je Eun; Ann, Hea Won; Jeon, Yongduk; Ahn, Mi Young; Jung, In Young; Kim, Moo Hyun; Jeong, Wooyoung; Jeong, Su Jin; Ku, Nam Su; Kim, June Myung; Na, Sungwon; Cho, Sung-Rae; Choi, JunYong.

In: Yonsei medical journal, Vol. 59, No. 7, 01.09.2018, p. 843-851.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effects of Early Exercise Rehabilitation on Functional Recovery in Patients with Severe Sepsis

AU - Ahn, Jin Young

AU - Song, Je Eun

AU - Ann, Hea Won

AU - Jeon, Yongduk

AU - Ahn, Mi Young

AU - Jung, In Young

AU - Kim, Moo Hyun

AU - Jeong, Wooyoung

AU - Jeong, Su Jin

AU - Ku, Nam Su

AU - Kim, June Myung

AU - Na, Sungwon

AU - Cho, Sung-Rae

AU - Choi, JunYong

PY - 2018/9/1

Y1 - 2018/9/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85052554062&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85052554062&partnerID=8YFLogxK

U2 - 10.3349/ymj.2018.59.7.843

DO - 10.3349/ymj.2018.59.7.843

M3 - Article

VL - 59

SP - 843

EP - 851

JO - Yonsei Medical Journal

JF - Yonsei Medical Journal

SN - 0513-5796

IS - 7

ER -