KINETIC-FUNCTIONAL PROFILE OF PATIENTS AT ICU DISCHARGE: A PILOT, CROSS-SECTIONAL STUDY

Abstract

Introduction: With the advances in the pathophysiological knowledge of comorbidities associated with excessive bed rest, it is of great importance for the physical therapist to know how to identify these comorbidities, through the use of instruments that assess and determine the patient's functionality and are related to important clinical outcomes. Objectives: To trace the kinetic-functional profile of patients at discharge after admission to intensive care in the verticalization, peripheral muscle strength and functionality domains and to analyze their respective correlations. Methods: This is an observational, cross-sectional and analytical pilot study carried out in patients hospitalized in the General and Coronary ICUs of the Agamenon Magalhães Hospital, Recife-PE. Data were obtained on patient verticalization (passive and active sedation, bipedaling), peripheral muscle strength, and functionality at ICU discharge of patients undergoing and not undergoing Mechanical Ventilation (MV). Results: The total number of participants in the sample consisted of 19. It was composed of 63.2% males, with a mean age of 65.7 years. An average of 23.6 days of hospitalization was recorded, where 47.4% of the patients needed to undergo Mechanical Ventilation (MV). Regarding the functional milestones, the 1st Passive Sedation took place on average 10.7 days after admission, while the 1st Active Sedation took an average of 10.7 days and the 1st Standing Station took an average of 13.3 days. The dynamometry resulted in an average of 21.35±7.48 Kgf for men and 16; 28±3.19 for women. MRC, on the other hand, recorded an average of 54.6 points. The functional level was assessed using the PERME and IMS scales, which obtained averages of 22.8 and 6.8; respectively. It was possible to identify a significantly statistical difference between patients who underwent ventilation and those who did not in relation to the days of ICU stay, verticalization, dynamometry (Kgf), MRC, PERME scale, and IMS at discharge. It was also possible to identify a strong correlation between the time taken to reach the functional milestones of verticalization and the length of stay in the ICU. Conclusion: The limitations related to the study design, sampling power and inferential analyses limit the generalization of the data, but it was observed that multimodal kinetic-functional evaluation is able to identify impairments in muscle strength and functionality in patients exposed to bed immobility, making it possible to measure the effectiveness of physical therapy interventions practiced in the study population as essential measures for the prevention and/or recovery of decline functional.