Johanna Weghorn, Melanie Finsterhölzl, Franziska Wippenbeck, Klaus Jahn, Marion Egger, Jeannine Bergmann
{"title":"危重疾病幸存者感觉运动功能的长期恢复和参与预测:一项前瞻性队列研究。","authors":"Johanna Weghorn, Melanie Finsterhölzl, Franziska Wippenbeck, Klaus Jahn, Marion Egger, Jeannine Bergmann","doi":"10.1186/s40560-025-00808-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Survivors of critical illness frequently face physical, cognitive and psychological impairments after intensive care. Sensorimotor impairments potentially have a negative impact on participation. However, comprehensive understanding of sensorimotor recovery and participation in survivors of critical illness is limited. Therefore, the aims of this study were to quantify long-term sensorimotor recovery in survivors of critical illness, to examine participation in daily life 1.5 years after illness onset, and to assess the predictive capacity of sensorimotor assessments for future participation.</p><p><strong>Methods: </strong>Survivors of critical illness who were mechanically ventilated ≥ 5 days on the ICU and who were admitted with weakness to neurorehabilitation were included in this single-center prospective cohort study. Time effects on sensation, muscle strength, balance, walking and dexterity were described at admission to and at discharge from rehabilitation, and 1.5 years after critical illness onset. Participation was assessed with the Reintegration to Normal Living Index. A multiple linear regression with sensorimotor outcomes at rehabilitation admission was conducted to find predictive associations with participation. The model was compared to an extended regression model containing demographic variables and factors known to be associated with participation or quality of life.</p><p><strong>Results: </strong>All sensorimotor outcomes among participants (n = 250, median age 63 (54-73) years) improved over time. However, in most patients some deficits remained after rehabilitation and on long-term follow-up. Good participation (≥ 75%) was achieved by 60.2% of survivors 1.5 years after critical illness onset. Concerning participation, the Mini Balance Evaluation Systems Test (Mini-BESTest) together with the Box-and-Block-Test, the Five-Times-Sit-to-Stand-Test, and the Medical Research Council score at rehabilitation admission formed a predictive model (R<sup>2</sup> = 0.157, p < 0.001). The extended regression analysis resulted in a model (R<sup>2</sup> = 0.357, p < 0.001) with the variables depression, duration of mechanical ventilation, cognitive function, Mini-BESTest, comorbidities, sex and cerebral lesion.</p><p><strong>Conclusions: </strong>We observed significant improvements in sensorimotor function, albeit with lingering deficits in sensation, strength, balance, dexterity and participation. Sensorimotor functions at rehabilitation start have limited explanatory power in predicting participation 1.5 years after disease onset. Trial registration German Clinical Trial Register, DRKS00021753. Date of registration: September 03, 2020.</p>","PeriodicalId":16123,"journal":{"name":"Journal of Intensive Care","volume":"13 1","pages":"49"},"PeriodicalIF":4.7000,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418612/pdf/","citationCount":"0","resultStr":"{\"title\":\"Long-term recovery of sensorimotor functions and prediction of participation in survivors of critical illness: a prospective cohort study.\",\"authors\":\"Johanna Weghorn, Melanie Finsterhölzl, Franziska Wippenbeck, Klaus Jahn, Marion Egger, Jeannine Bergmann\",\"doi\":\"10.1186/s40560-025-00808-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Survivors of critical illness frequently face physical, cognitive and psychological impairments after intensive care. Sensorimotor impairments potentially have a negative impact on participation. However, comprehensive understanding of sensorimotor recovery and participation in survivors of critical illness is limited. Therefore, the aims of this study were to quantify long-term sensorimotor recovery in survivors of critical illness, to examine participation in daily life 1.5 years after illness onset, and to assess the predictive capacity of sensorimotor assessments for future participation.</p><p><strong>Methods: </strong>Survivors of critical illness who were mechanically ventilated ≥ 5 days on the ICU and who were admitted with weakness to neurorehabilitation were included in this single-center prospective cohort study. Time effects on sensation, muscle strength, balance, walking and dexterity were described at admission to and at discharge from rehabilitation, and 1.5 years after critical illness onset. Participation was assessed with the Reintegration to Normal Living Index. A multiple linear regression with sensorimotor outcomes at rehabilitation admission was conducted to find predictive associations with participation. The model was compared to an extended regression model containing demographic variables and factors known to be associated with participation or quality of life.</p><p><strong>Results: </strong>All sensorimotor outcomes among participants (n = 250, median age 63 (54-73) years) improved over time. However, in most patients some deficits remained after rehabilitation and on long-term follow-up. Good participation (≥ 75%) was achieved by 60.2% of survivors 1.5 years after critical illness onset. Concerning participation, the Mini Balance Evaluation Systems Test (Mini-BESTest) together with the Box-and-Block-Test, the Five-Times-Sit-to-Stand-Test, and the Medical Research Council score at rehabilitation admission formed a predictive model (R<sup>2</sup> = 0.157, p < 0.001). The extended regression analysis resulted in a model (R<sup>2</sup> = 0.357, p < 0.001) with the variables depression, duration of mechanical ventilation, cognitive function, Mini-BESTest, comorbidities, sex and cerebral lesion.</p><p><strong>Conclusions: </strong>We observed significant improvements in sensorimotor function, albeit with lingering deficits in sensation, strength, balance, dexterity and participation. Sensorimotor functions at rehabilitation start have limited explanatory power in predicting participation 1.5 years after disease onset. Trial registration German Clinical Trial Register, DRKS00021753. 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Long-term recovery of sensorimotor functions and prediction of participation in survivors of critical illness: a prospective cohort study.
Background: Survivors of critical illness frequently face physical, cognitive and psychological impairments after intensive care. Sensorimotor impairments potentially have a negative impact on participation. However, comprehensive understanding of sensorimotor recovery and participation in survivors of critical illness is limited. Therefore, the aims of this study were to quantify long-term sensorimotor recovery in survivors of critical illness, to examine participation in daily life 1.5 years after illness onset, and to assess the predictive capacity of sensorimotor assessments for future participation.
Methods: Survivors of critical illness who were mechanically ventilated ≥ 5 days on the ICU and who were admitted with weakness to neurorehabilitation were included in this single-center prospective cohort study. Time effects on sensation, muscle strength, balance, walking and dexterity were described at admission to and at discharge from rehabilitation, and 1.5 years after critical illness onset. Participation was assessed with the Reintegration to Normal Living Index. A multiple linear regression with sensorimotor outcomes at rehabilitation admission was conducted to find predictive associations with participation. The model was compared to an extended regression model containing demographic variables and factors known to be associated with participation or quality of life.
Results: All sensorimotor outcomes among participants (n = 250, median age 63 (54-73) years) improved over time. However, in most patients some deficits remained after rehabilitation and on long-term follow-up. Good participation (≥ 75%) was achieved by 60.2% of survivors 1.5 years after critical illness onset. Concerning participation, the Mini Balance Evaluation Systems Test (Mini-BESTest) together with the Box-and-Block-Test, the Five-Times-Sit-to-Stand-Test, and the Medical Research Council score at rehabilitation admission formed a predictive model (R2 = 0.157, p < 0.001). The extended regression analysis resulted in a model (R2 = 0.357, p < 0.001) with the variables depression, duration of mechanical ventilation, cognitive function, Mini-BESTest, comorbidities, sex and cerebral lesion.
Conclusions: We observed significant improvements in sensorimotor function, albeit with lingering deficits in sensation, strength, balance, dexterity and participation. Sensorimotor functions at rehabilitation start have limited explanatory power in predicting participation 1.5 years after disease onset. Trial registration German Clinical Trial Register, DRKS00021753. Date of registration: September 03, 2020.
期刊介绍:
"Journal of Intensive Care" is an open access journal dedicated to the comprehensive coverage of intensive care medicine, providing a platform for the latest research and clinical insights in this critical field. The journal covers a wide range of topics, including intensive and critical care, trauma and surgical intensive care, pediatric intensive care, acute and emergency medicine, perioperative medicine, resuscitation, infection control, and organ dysfunction.
Recognizing the importance of cultural diversity in healthcare practices, "Journal of Intensive Care" also encourages submissions that explore and discuss the cultural aspects of intensive care, aiming to promote a more inclusive and culturally sensitive approach to patient care. By fostering a global exchange of knowledge and expertise, the journal contributes to the continuous improvement of intensive care practices worldwide.