Improving physical function during and after critical care

PURPOSE OF REVIEW: Although it has been demonstrated that physical functional impairments are common among survivors of critical illness, few studies have proven benefits of intervention. This review will discuss assessment of physical functional impairment, recent and ongoing interventional studies, and implementation of rehabilitation beginning in the ICU, hospital ward, and after hospital discharge. RECENT FINDINGS: New studies confirm challenges around measurement of physical function both during and after critical illness, and offer potential new modalities that could inform mechanism and treatment. Longitudinal cohort studies emphasize the importance of recognition and measurement of premorbid status. Although no recent studies have proven new approaches to improving physical function in survivors of critical illness, emerging data support the safety, feasibility, and cost-effectiveness of providing physical rehabilitation early in the course of critical illness. Pilot and ongoing studies hold promise for improving physical function and quality of life for future survivors of critical illness. SUMMARY: Improving physical function for survivors of critical illness will require careful application of current knowledge, as well as rigorous investigation into causes, research methodologies, and implementation of results of future interventional studies.