REHABILITATION AFTER CRITICAL ILLNESS: ADDRESSING FUNCTIONAL DECLINE IN ICU DISCHARGED PATIENTS

Abstract

Background:

Critically ill survivors usually develop persistent physical, psychological, and functional impairments following discharge from the Intensive Care Unit (ICU). The limitations, if left untreated, can lead to long-term disability, reduced quality of life, and readmission. The present study sought to assess the effect of a formal, multidisciplinary rehabilitation program on ICU-discharged patients' functional and psychological recovery.

Methods:
A prospective observational study was performed from January to June 2024 at Lady Reading Hospital, Peshawar. Sixty adult ICU survivors were recruited and followed up for three months. Assessments were done at ICU discharge and 2 weeks, 1 month, and 3 months using the Barthel Index, Medical Research Council (MRC) score, 6-Minute Walk Test (6MWT), and Hospital Anxiety and Depression Scale (HADS). A structured rehabilitation program of physiotherapy, nutritional support, and psychological counseling was provided.

Results:
Patients demonstrated notable improvement in functional status (Barthel Index: 42.3 to 83.7), muscle strength (MRC: 38.5 to 51.7), mobility (6MWT: 78.2 to 158.6 meters), and psychological well-being (HADS-anxiety: 13.4 to 9.2; HADS-depression: 12.7 to 8.1) within three months (p < 0.001). Readmission was 10%, and mortality was 1.7%.

Conclusion:
Organized post-ICU rehabilitation significantly improves physical and psychological recovery. Early intervention is crucial to minimize long-term complications and restore functional independence among ICU survivors.