TY - JOUR 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 VL - 44 IS - Suppl 58 SP - P621 AU - Michele Vitacca AU - Luca Barbano AU - Fabio Vanoglio AU - Alberto Luisa AU - Amerigo Giordano AU - Enrica Bertella AU - Mara Paneroni Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P621.abstract N2 - 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0.019); 83% of T patients had their tracheostomy withdrawn vs. 14% of C (p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. ER -