Has InS:PIRE changed the ICU? Physiotherapy Helen devine

Physiotherapy intervention Weekly exercise class Educational discussion 1:1 MSK assessment

September 2014 - What I expected? Muscle weakness Decreased joint range of movement Loss of appetite/weight Reduced physical function Reduced mobility

MSK findings

Incidence of chronic pain (n=48)

Evidence so far related to chronic pain post ICU? Boyle et al, 2004 Battle et al, 2013 Griffiths et al, 2013

Location of pain

Other findings: referrals 21% of patients already attending O/P PT Further 23% referred to PT services 19% to Live Active scheme (gym) or equivalent programme 21% to other services e.g. pulm rehab/dietitics

Impact on service Increased attention to specific joints Application for more equipment Conversations re: rehab plan Education and feedback to downstream wards and outpatient departments Downstream service

Plan from here? Collate findings up to one year follow-up Disseminate findings Ensure follow-up patients lead change for ICU!

References Boyle et al 2004,The effect of chronic pain on health related quality of life amongst intensive care survivors, Australian Critical Care, Vol 17, Issue 3, pp 104-113. Battle et al 2013, Chronic pain in survivors of critical illness: a retrospective analysis of incidence and risk factors, Critical Care, 2013, 17:R101. Griffiths et al 2013, An exploration of social and economic outcome and associated health-related quality of life after critical illness in general intensive care unit survivors: a 12-month follow-up study, Critical Care, R100.