Advances in the rehabilitation of intensive care unit acquired weakness: A case report on the promising use of robotics and virtual reality coupled to physiotherapy

• Published in: Medicine (Baltimore) Vol. 99; no. 28; p. e20939
• Main Authors: Chillura, Antonino, Bramanti, Alessia, Tartamella, Francesco, Pisano, Maria Francesca, Clemente, Elvira, Lo Scrudato, Marzia, Cacciato, Giuseppe, Portaro, Simona, Calabrò, Rocco Salvatore, Naro, Antonino
• Format: Journal Article
• Language: English
• Published: United States the Author(s). Published by Wolters Kluwer Health, Inc 10-07-2020; Wolters Kluwer Health
• Subjects: Clinical Case Report; Combined Modality Therapy; Humans; Intensive Care Units; Male; Middle Aged; Muscle Weakness - etiology; Muscle Weakness - rehabilitation; Physical Therapy Modalities; Robotics; Virtual Reality
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000020939

Traditional physiotherapy is currently the best approach to manage patients with intensive care unit acquired weakness (ICUAW). We report on a patient with ICUAW, who was provided with an intensive, in-patient regimen, that is, conventional plus robot-assisted physiotherapy. Aim of this case study was to assess the efficacy of a combined approach (conventional plus robot-assisted physiotherapy), on muscle strength, overall mobility, and disability burden in a patient with ICUAW in post-ICU intensive rehabilitation setting.
A 56-years-old male who was unable to stand and walk independently after hospitalization in an Intensive Care Unit. He initially was provided with daily sessions of conventional physiotherapy for 2 months, with mild results.
The patient was affected by ICUAW.
Given that the patient showed a relatively limited improvement after conventional physiotherapy, he was provided with daily sessions of robot-aided training for upper and lower limbs and virtual reality-aided rehabilitation for other 4 months, beyond conventional physiotherapy.
At the discharge (6 months after the admission), the patient reached the standing station and was able to ambulate with double support.
Our case suggests that patients with ICUAW should be intensively treated in in-patient regimen with robot-aided physiotherapy. Even though our approach deserves confirmation, the combined rehabilitation strategy may offer some advantage in maximizing functional recovery and containing disability.