A randomised trial of an intensive physiotherapy program for patients in intensive care [commentary]

AuthorBerney, SC.
TypeJournal Article (Original Research)
JournalJournal of Physiotherapy
PubMed ID26947004
Year of Publication2016
Download 2016_July_Berney.pdf (80.9 KB)
Survivors of acute respiratory failure requiring intensive care unit (ICU) admission and mechanical ventilation frequently suffer enduring impairments of physical function.1 To date, no trial, including that of Moss and colleagues, which commenced an intervention during hospitalisation, has impacted performance-based measures of physical function after hospital discharge. The authors are to be applauded for conducting a trial with high treatment fidelity, and that achieved separation and sample size, as these elements have not always been achieved in rehabilitation trials.2 and 3 However, the results must be viewed with caution. Firstly, the primary outcome (Physical Functional Performance Test score) is not validated in critical illness survivors. The test exhibited a substantial floor effect at the primary time point, with a completion rate of 33% of participants. This increased to 48% at 3 months and 43% at 6 months. Furthermore, as measured by the short form of the Continuous Scale Physical Functional Performance Test score, two participants achieved functional independence on completion of physiotherapy treatment (both in the control group), despite 50% of participants being discharged home. Secondly, a significant between-group difference in age was observed and, although not significant, the intervention group were weaker, had lower bed mobility scores and completed less available rehabilitation days in ICU than the standard care arm, suggesting important differences may have been present at randomisation. Thirdly, although described as an early intervention, intensive treatment was not initiated until a median of 8 days (IQR 6 to 11). Despite the results of this and other rehabilitation trials for critical illness survivors, these studies consistently report a perilous state of physical function beyond hospital discharge.1 and 2 It is important that we continue to seek interventions to improve these outcomes. However, the results of the AVERT trial3 are a salient reminder that we don't yet understand the who, when and how of rehabilitation for survivors of critical illness.


< More publications


Interstitial lung disease (ILD) is a chronic lung condition that causes stiff lungs and restricts sufferers from taking a deep breath. Exercise in a gym, such as walking or riding a bike, can help make...


Each year in Australia 260 people sustain a SCI, with over half losing full function in their arms and legs (quadriplegia). In addition to the primary disability, there is a very high rate of Obstructive...

Notch monitoring in sleepNOTCH MONITORING IN SLEEP

Sleep apnea is a condition where breathing is abnormal during sleep. There are two main forms of sleep apnea: obstructive and central. For obstructive sleep apnea, breathing is reduced because the airway...

Do you have Spinal cord injury? Tired?  Get treated!DO YOU HAVE SPINAL CORD INJURY? TIRED? GET TREATED!

Melbourne researchers have found that 80 percent of people with quadriplegic spinal injuries have sleep apnoea. It's having a big effect on their lives but they don't know they have it, and they don't know it can be treated.

World 1st heavy vehicle driver fatigue study releasedWORLD 1ST HEAVY VEHICLE DRIVER FATIGUE STUDY RELEASED

The National Transport Commission (NTC) and the Cooperative Research Centre for Alertness, Safety and Productivity (Alertness CRC) have released the results of what is hailed as a world-first study into heavy vehicle driver fatigue.

AAMRI Election Statement released on 25th March 2019AAMRI ELECTION STATEMENT RELEASED ON 25TH MARCH 2019

AAMRI released its election statement calling on politicians to commit to three main priorities: ensuring the MRFF reaches $20 billion by 2020-21, provide continued strong support for the NHMRC, and develop sustainable and rewarding career pathways.

Portrait unveiled at Canberra's Parliament HousePORTRAIT UNVEILED AT CANBERRA'S PARLIAMENT HOUSE

IBAS Director Anna Burke had barely got into the swing of her speech at the unveiling of her portrait at Canberra's Parliament House when the ringing of bells caused half her audience to hurry away.

Institute for Breathing and Sleep

Level 5, Harold Stokes Building, Austin Hospital
145 Studley Road
Heidelberg, Victoria, 3084

(03) 9496 5390

Email Us