"Back in the saddle": early training in critical care: effects of early training and evaluation of physical function and activity in mechanically ventilated, critically ill adults

This thesis investigated the effects of early training and recovery and studied methods to evaluate physical function and activity in mechanically ventilated, critically ill adults. Early training was found to be safe but did not improve functional outcomes at hospital discharge compared to usual care. Muscle weakness at ICU discharge was associated with subsequent, short-term functional disability. Variations in cardiorespiratory parameters during training were common and mainly associated with training type, mobilisation level, patient participation, and training duration. Thus, therapists are advised to individually tailor and adjust training. To assess patients’ physical function and activity, the German CPAx version was created and tested. The CPAx was equivalent to the original version and valid across three time-points in the pathway of recovery. It may also be used to identify candidates in need of further rehabilitation. Overall, this thesis informs clinical practice and forthcoming research about neuromuscular complications, thereby contribution to improving future management and outcomes for this critically ill population.