Physical Activity Levels in Survivors of Critical Illness Six Months After Hospitalization

Abstract RATIONALE. Limited data exists on physical activity levels in patients who survive the intensive care unit (ICU) as they recover and transition back into the community. Prior data demonstrate that survivors of ICU have low levels of physical activity in the first week returning home from hospital. It remains unknown how activity levels change over the first 6 months after discharge. The purpose of this study is to quantify daily step counts in ICU survivors across three time points for the first 6 months of recovery. METHODS: We conducted a 6-month prospective observational study of adult survivors of ICU. Patients diagnosed with acute hypoxic respiratory failure or sepsis (≥18 years) who were ambulatory prior to hospitalization were enrolled in the study within 30 days of discharge. Patients wore a Garmin Vivo-Fit for a minimum of 10 days to establish mean daily step counts at three time points: post hospital discharge, 3 months, and 6 months. Mean and standard deviations were calculated for step counts and paired t-tests determined significant differences (p=<0.05). Bonferroni corrections were used for multiple comparison of step counts at post-discharge, 3 and 6 months. RESULTS: Forty-three participants had a mean age of 55.9 ± 12.9 years and 40% female. Clinical metrics included an average hospital stay of 25.4 days (± 20.5 days), mechanical ventilation duration of 5.1 ± 7.2 days, and Body Mass Index of 28.5 ± 6.3. At hospital discharge, 77% returned home, while 16% went to acute rehabilitation hospitalization, and 7% went to long-term care facility. Step counts averaged 2,558 ± 2,044 steps at post-discharge, 3,860 ± 2741 at 3 months, and 3,551 ± 2,000 at 6 months after discharge, showing a significant increase from post-discharge to 3 months (p=0.009) but no significant change from 3 to 6 months (p=0.559; Figure 1). At 6 months, the mean step counts were below the typical range for healthy adults aged 55 years (4,000-18,000 steps) and fell short of the Centers for Disease Control guidelines of 30 minutes of moderate-intensity physical activity (8,000-11,000 steps) for free-living adults. CONCLUSIONS. The findings emphasize that survivors of critical illness may require dedicated follow up and encouragement up to six months following hospitalization to regain normal aged, related levels of physical activity.