1. Ceri Battle Clinical Specialist Physiotherapist in Critical Care Research team: Ceri Battle, Dr Paul Temblett, Karen James, Sandra Jones, Dr Hayley Hutchings

2. Introduction  Critical illness affects over 1000 adults in Swansea per year with a mortality rate of 20%. (ICNARC)  Severe weakness is common in patients with prolonged critical illness  Rehabilitation after critical illness is neglected when compared with other patient groups. The NICE 83 guidelines ‘Rehabilitation in Critical Care’

3. Studies EBM Jones et al 2003 Lau et al 2005 PIX study Mc Williams et al 2009 EPIC study

4. Methodology RRandomised controlled trial PParticipants RRecruitment SStratified randomisation IInterventions OOutcome measures AAnalysis

5. Recruitment Randomisation Baseline testing Exercise programme Re-testing both groups Follow up

6. Results (so far…) Exercise

10. Conclusions Rehabilitation in ICU survivors is recommended (NICE83) Early results indicate the exercise group have better outcomes than the control group Anxiety is increased in the exercise group Feasible to introduce this programme with minimal additional resources Subjective feedback is very positive

11. References  Jones C, Skirrow P, Griffiths R. Rehabilitation after critical illness: a randomised controlled trial. Crit Care Med. 2003;31:2456-2460.  Lau H et al. A randomised controlled trial of the effectiveness of an exercise training program in patients recovering from severe acute respiratory distress syndrome. Aust J of Physiotherapy. 2005;51:213-217.  McWilliams et al. Feasibility and impact of a structured exercise-based rehabilitation programme for intensive care survivors. Physiotherapy Theory and Practice. 2009;25:566-571.  NICE Guidelines 83: Critical Illness Rehabilitation CG83.

12. Thanks for listening. Any questions?