Evidence map›Paper›PMID 29730622›Full record

SynthesisBMJ open2018

Early rehabilitation to prevent postintensive care syndrome in patients with critical illness: a systematic review and meta-analysis.

Ryota Fuke, Toru Hifumi, Yutaka Kondo, Junji Hatakeyama, Tetsuhiro Takei, Kazuma Yamakawa, Shigeaki Inoue, Osamu Nishida

3 registry-linked trialsOpen access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 111 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
111citing papers in PubMed, 13 pooled it
16.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04914065 completednot on this mapstarted 2020, after this paper: background citation

Predictors of Prognosis in Patients With Critical Illness.

TypeobservationalSponsorTaoyuan General HospitalRan2020 to 2021Enrolled400ConditionsICU Acquired Weakness, Weaning Failure, Quality of LifeArmsRegular care in the surgery intensive care unit
NCT05209763 naunknown statusnot on this mapstarted 2022, after this paper: background citation

Standard vs Intensive Rehabilitation and Nutrition Regimen for Inpatients at the Intensive Care Unit

TypeinterventionalSponsorUniversity Hospital OstravaRan2022 to 2025Enrolled500ConditionsNutrition DisordersArmsMore intensive rehabilitation, More intensive nutrition
NCT07017517 narecruitingnot on this mapstarted 2026, after this paper: background citation

Effect of Physical Therapy on NLRP3 Inflammasome Activation and Muscle Atrophy in Critical Illness Myopathy (PT-NLRP3-CIM).

TypeinterventionalSponsorUniversity of ChileRan2026 to 2027Enrolled24ConditionsCritical Illness MyopathyArmsMotomed Letto® servo-assisted cycling + standard physiotherapy, Standard physiotherapy
3 · Its place in the literature

Who cites it

111 citing papers in PubMed, 13 syntheses or guidelines pooled it, 269 citations in OpenAlex.

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  11. ICU-acquired weakness.Intensive care medicine · 2020
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51 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 7 institutions in 1 country.

Ryota Fuke *Division of Infectious Diseases and Infection Control, Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan.
Toru Hifumi *Emergency Medical Center, Kagawa University Hospital, Kita-gun, Kagawa, Japan.
Yutaka KondoDepartment of Emergency and Critical Care Medicine, Graduate School of Medicine, University of the Ryukyus, Nakagami-gun, Okinawa, Japan.
Junji HatakeyamaDepartment of Intensive Care Medicine, Yokohama City Minato Red Cross Hospital, Yokohama, Kanagawa, Japan.
Tetsuhiro Takei
Kazuma YamakawaDivision of Trauma and Surgical Critical Care, Osaka General Medical Center, Osaka City, Osaka, Japan.
Shigeaki InoueDepartment of Emergency and Critical Care Medicine, Tokai University Hachioji Hospital, Hachioji, Tokyo, Japan.
Osamu NishidaDepartment of Anaesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
Fujita Health University · JPKagawa University Hospital · JPOsaka City General Hospital · JPTohoku Medical and Pharmaceutical University · JPTokai University Hachioji Hospital · JPUniversity of the Ryukyus · JPYokohama Municipal Minato Red Cross Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionWe examined the effectiveness of early rehabilitation for the prevention of postintensive care syndrome (PICS), characterised by an impaired physical, cognitive or mental health status, among survivors of critical illness.

methodsWe performed a systematic literature search of several databases (Medline, Embase and Cochrane Central Register of Controlled Trials) and a manual search to identify randomised controlled trials (RCTs) comparing the effectiveness of early rehabilitation versus no early rehabilitation or standard care for the prevention of PICS. The primary outcomes were short-term physical-related, cognitive-related and mental health-related outcomes assessed during hospitalisation. The secondary outcomes were the standardised, long-term health-related quality of life scores (EuroQol 5 Dimension (EQ5D) and the Medical Outcomes Study 36-Item Short Form Health Survey Physical Function Scale (SF-36 PF)). We used the Grading of Recommendations Assessment, Development and Evaluation approach to rate the quality of evidence (QoE).

resultsSix RCTs selected from 5105 screened abstracts were included. Early rehabilitation significantly improved short-term physical-related outcomes, as indicated by an increased Medical Research Council scale score (standardised mean difference (SMD): 0.38, 95% CI 0.10 to 0.66, p=0.009) (QoE: low) and a decreased incidence of intensive care unit-acquired weakness (OR 0.42, 95% CI 0.22 to 0.82, p=0.01, QoE: low), compared with standard care or no early rehabilitation. However, the two groups did not differ in terms of cognitive-related delirium-free days (SMD: -0.02, 95% CI -0.23 to 0.20, QoE: low) and the mental health-related Hospital Anxiety and Depression Scale score (OR: 0.79, 95% CI 0.29 to 2.12, QoE: low). Early rehabilitation did not improve the long-term outcomes of PICS as characterised by EQ5D and SF-36 PF.

conclusionsEarly rehabilitation improved only short-term physical-related outcomes in patients with critical illness. Additional large RCTs are needed.

Indexed as

Critical CareHealth StatusHospitalizationIntensive Care UnitsAdolescentAdultCognitionCritical IllnessDeliriumHumansMental HealthOutcome Assessment, Health CareQuality of LifeSurvivorsSyndromeearly rehabilitationintensive care unitpost-intensive care syndromesepsis

Identifiers

PMID29730622
PMCPMC5942437
OpenAlexW2800935289

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.