RT Journal Article SR Electronic T1 Home rehabilitation to improve respiratory muscles in patients recovering from a prolonged ICU stay and in-hospital rehabilitation JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP P621 VO 44 IS Suppl 58 A1 Michele Vitacca A1 Luca Barbano A1 Fabio Vanoglio A1 Alberto Luisa A1 Amerigo Giordano A1 Enrica Bertella A1 Mara Paneroni YR 2014 UL http://erj.ersjournals.com/content/44/Suppl_58/P621.abstract AB Forty-eight miscellaneous patients (66±12 years) with recent acute respiratory failure necessitating a prolonged ICU stay and an in-hospital rehabilitation were randomized in two groups: treatment (T) and control (C).T underwent a 6-month home-based rehabilitation program (2 sessions/day, 7 days/week of mobilization, cardiorespiratory training, walking, limb strength exercises supervised by caregiver, periodic home-visits/phone reinforcements) while C underwent standard care.Maximum inspiratory and expiratory pressures (MIP, MEP), dynamic volumes (FEV1, FVC), arterial blood gases, dyspnea, basal activities daily life, peripheral force measurements, Takahashi and 6 min walking distance tests, quality of life, safety, adherence, patient satisfaction, survival, readmissions and costs were evaluated.After 6 months, T showed more improvement than C in MIP (14±17 vs. -0.2±14 cmH20) and MEP (27±27 vs. 6±21 cmH20) (all p<0.019); 83% of T patients had their tracheostomy withdrawn vs. 14% of C (p<0.0128). The only significant difference in T vs. C was FEV1 (p<0.0252). Patients who had home physiotherapy, were less disabled or had a better oxygen exchange level were, respectively, 5-, 7- and 4-times more likely to improve MIP (all p<0.04). Compliance was 74±25% without side effects. 87.4% expressed positive satisfaction about treatment. Mortality and hospitalizations were higher in C but not significantly. Costs were 459 euro/patient/month.In prolonged ICU-stay survivors discharged after rehabilitation, a 6-month, home-based, relatively low-cost, safe, caregiver-guided physiotherapy intervention had positive effects only on respiratory muscles.