Can Early Rehabilitation on the General Ward After an Intensive Care Unit Stay Reduce Hospital Length of Stay in Survivors of Critical Illness?

Published on September 1, 2017 by Gruther W, Pieber K, Steiner I, Hein C, Hiesmayr J, Paternostro-Sluga T

Key Takeaway

Post-ICU early rehabilitation on general wards is safe and may reduce hospital stay and costs, first signs for the effectiveness of early rehabilitation.

Gruther W., Pieber K., Steiner I., Hein C., Hiesmayr J., Paternostro-Sluga T.. (2017). Can Early Rehabilitation on the General Ward After an Intensive Care Unit Stay Reduce Hospital Length of Stay in Survivors of Critical Illness?. https://doi.org/10.1097/phm.0000000000000718

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What this study found

This randomized controlled trial evaluated 53 survivors of critical illness to determine if structured, early rehabilitation on a general medical ward after intensive care unit (ICU) discharge improves recovery and reduces hospital stay. In the per-protocol analysis, patients receiving the early rehabilitation program had a significantly shorter general ward stay (median 14 days) compared to those receiving standard, on-demand physical therapy (median 21 days). However, this benefit was not statistically significant in the intention-to-treat analysis (16 vs. 21 days). Secondary outcomes, including functional recovery and psychological measures, were similar between groups, and the intervention proved safe and cost-effective.

Why it matters

Survivors of critical illness frequently suffer from post-intensive care syndrome (PICS) and severe muscle wasting. When patients transition from the ICU to general wards, rehabilitation momentum is often lost due to fragmented care or delayed physical therapy orders. This study highlights that a proactive, structured rehabilitation protocol on general wards is safe and can potentially accelerate hospital discharge. For referring clinicians, it underscores the value of continuity in mobilization strategies immediately following ICU discharge rather than relying on reactive, standard-care referrals.

Limitations

The primary limitation is the small sample size (53 patients), which limits statistical power. Additionally, the discrepancy between the per-protocol and intention-to-treat analyses indicates that the intervention’s real-world success heavily relies on protocol adherence and patient tolerance, which can be challenging in recovering, medically complex patients.

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