NEW YORK (MainStreet) — Teri Ingenito has been providing physical therapy to cardiovascular intensive care unit patients for more than 25 years. Ingenito, an assistant professor of physical therapy at NYIT School of Health Professions, points out that only in the last five to seven years has the medical field realized how critical movement is to critically ill patients.
Up until recently, conventional wisdom dictated that patients sick enough to be placed in the intensive care unit (ICU) required strict bed rest, but recent research at Johns Hopkins took the opposite approach. Researchers there found that while it seems counterintuitive to take a critically ill patient who requires ICU treatment and give him physical therapy, it’s a necessity in order to prevent permanent loss of strength.
“We previously thought that bed rest and sedation in an ICU were helpful for patients, but we’re finding this approach to care is actually harmful to the long-term recovery of many,” says Dale M. Needham, an associate professor of medicine and of physical medicine and rehabilitation at the Johns Hopkins University School of Medicine and senior author of the study described in the April issue of Critical Care Medicine.
The results of the study showed that for every day of bed rest, patients lost between 3% and 11% of muscle strength in the following months and years and had “substantial” physical impairments as much as two years after discharge. In fact, just one day of bed rest in the ICU had a lasting impact of muscle weakness, according to Needham. More than a third of patients showed weakness at discharge. Although many patients did show improvement in muscle strength over time, the weakness impacted their physical functioning and quality of life, he says. Age also played a role.
The researchers looked at 222 ICU acute lung injury patients from four Baltimore-area hospitals.
The critically ill aren’t the only unlikely ones who benefit from getting up and moving. Research funded by the U.S. Department of Agriculture found that elderly who had relatively little muscle mass benefited from exercise. The typical 40% muscle loss by age 80 years compared with age 20 years can result in fractures from falls, leading to hospitalizations and surgeries, both financially costly and physically detrimental to this population at increased risk.
The Tufts University researchers studied data collected on 177 elderly people aged 70 to 89 years old taken during the Lifestyle Interventions and Independence for Elders study in which one group participated in exercise. The researchers found that despite their age, these patients were able to improve their balance, strength, and walking.
The study was published this month in the Journal of Nutrition, Health, and Aging.
—Written by S.Z. Berg for MainStreet