Post-intensive care syndrome is now recognised as a spectrum of physical, cognitive and emotional problems that can stem from even reletively shorts stays in critical care units.
Over 100,000 patients will be treated in critical care units each year in England and Wales alone. Most are discharged to home but a significant percentage will have persistent problems.
This presentation by Derek Jones describes how motion therapy combined with a form of FES Cycling (Letto2 with FES) can help boost vital signs in even unconcious patients. The FES enhanced exercise preserves muscle mass and improves the speed and quality of rehabilitation.
1. Enhancing Recovery
from Critical Care
Combining Movement Therapy
and Functional Electrical Stimulation
Derek Jones PhD, MBA
Director, Anatomical Concepts (UK) Ltd
2. Rehabilitation after
critical illness
• Approx 110,000 in critical care each year in
England & Wales
• Significant percentage have long-term
problems
• Recognised issues - weakness, muscle loss,
PTS, anxiety, depression, cognitive disfunction
• Patients at risk - start rehabilitation as early
as clinically possible
NICE Guidelines - CG83
4. Exercise is a therapeutic agent
First recognised over a
thousand years ago
Exercise is
Medicine
5. Movement therapy -
machines that move the limbs
through a range of motion
Early Exercise in Critically Ill Patients Enhances Short-Term Functional Recovery
Chris Burtin et al, Crit Care Med. 2009;37(9):2499-2505.
7. What Can We Expect
Improved vital signs
Preserved muscle mass
Reduced risk of Post-Intensive
care syndrome & ICU-AW?
Reduced risk of pressure
sores
Combining Movement and
Functional Electrical
Stimulation (FES)
Faster Rehabilitation
8. FES Cycling - used by clinics
and individuals at home all
over the world
Cardiovascular fitness
Muscle tissue bulk
Bone density improvement
Activate Paralysed Muscle
via Intact Lower Motor
Neurons
9. Application of FES
• Absolute
contraindications
• Unhealed fractures in
the limbs to be
stimulated
• Pregnancy
• Relative
Contraindications
• Denervated muscle
• Severe spasticity
• Limited range of hip/
knee joint motion
• Severe osteoporosis
• Open wounds in
current path
20. How could it be used?
• 3 to 4 days after admission to critical care
• Electrodes on Quads & Hamstrings,
Gastronemius, Gluteals
• Stimulation intensity individually
determined
• Sessions 5 times per week - up to an hour
per day
21. Images on Page 2 - David Graham, “No Diving” ISBN 978-0-9557465-1-2
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