1. Has InS:PIRE changed the ICU? Physiotherapy
Helen devine

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

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

4. MSK findings

5. Incidence of chronic pain (n=48)

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

7. Location of pain

8. 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

9. 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

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

11. 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
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.