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Available online 28 October 2025
Early mobilization during intensive care admission and perceived quality of life in the course of the COVID-19 pandemic – A prospective cohort study and propensity score matching
Movilización precoz durante el ingreso en la unidad de cuidados intensivos y calidad de vida percibida durante la pandemia de COVID-19 - Estudio prospectivo de cohortes y emparejamiento por puntuación de propensión
Beatriz Lobo Valbuenaa,b,
, Lourdes Manglano-Cerratoc, Ana Rodríguez Alcaraza, Raúl Castañeda-Vozmedianod, Rosario Molina Loboa,b, Alejandro Alcinac, Pedro Benavidesc, Jesús Juárezc, Federico Gordoa,b
a Intensive Care Unit, Hospital Universitario del Henares, Coslada, Madrid, Spain
b Critical Pathology Researh Group (Grupo de Investigación en Patología Crítica), Facultad de Medicina, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
c Rehabilitation and Physiotherapy Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
d Department of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
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Table 1. Demographic and clinical data after propensity score matching.
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Table 2. Quality of life questionnaires during the study period for propensity score matching population.
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Abstract
Objective

To analyze the effect of early physiotherapy (ePHYS) on patients' functional quality of life one year after discharge.

Design

Prospective observational study.

Settings

Adult polyvalent ICU.

Patients or participants

Patients with SARS-CoV2 pneumonia requiring invasive mechanical ventilation between March 2020 and July 2022.

Intervention

Early physiotherapy.

Main variables of interest

Quality of life measured by CFS, Barthel and SF36 on ICU admission, at hospital discharge and one year after hospital discharge.

Results

Ninety-nine patients included. In the raw data analysis we observed statistically significant differences in SAPS-3 (MdnNo-ePHYS = 59 [53.5–64.5]; MdnYes-ePHYS = 53 [47–58]; P = .001). After propensity score, we did not observe statistically significant differences except for two SF-36 items: social activities (MdnNo-ePHYS = 56.2 [37.5−71.9]; MdnYes-ePHYS = 75 [62.5−97.5]; P = .004; Wilcoxon r effect size = 0.5) and one-year health transition (MdnNo-ePHYS = 50 [50−75]; MdnYes-ePHYS = 75 [50−100]; P = .031; Wilcoxon r effect size = 0.29), where patients who belonged to NO-ePHYS had lower scores than those who did receive ePHYS.

Conclusions

Despite not having found statistically significant differences in most of the items assessed, we should highlight that patients who received ePHYS reported a clear positive influence on their lives.

Keywords:
Critical care
Rehabilitation
Activities of daily living
Health-related quality of life
Post-intensive care syndrome
Abbreviations:
BI
CFS
DNR
ePHYS
hDC
IMS
ICU
ICU-AW
IQR
MoCA
MRC
MV
PICS
RCT
SAPS-3
SRT
SARS-CoV-2
SF-36
Yr
Resumen
Objetivo

Analizar el efecto de la fisioterapia precoz (FTSPe) sobre la calidad de vida funcional de los pacientes un año después del alta.

Diseño

Estudio observacional prospectivo.

Ámbito

UCI polivalente de adultos.

Pacientes o participantes

Pacientes con neumonía por SARS-CoV2 que requirieron ventilación mecánica invasiva entre marzo de 2020 y julio de 2022.

Intervenciones

Fisioterapia precoz.

Variables de interés principales

Calidad de vida medida mediante CFS, Barthel y SF36 al ingreso en UCI, al alta hospitalaria y un año después del alta hospitalaria.

Resultados

Ninety-nine pacientes incluidos. En el análisis de datos brutos observamos diferencias estadísticamente significativas en SAPS-3 (MdnNo-FTSPe = 59 [53,5–64,5]; MdnSí-FTSPe = 53 [47–58]; P = ,001). Tras la puntuación de propensión, no observamos diferencias estadísticamente significativas excepto en dos ítems del SF-36: actividades sociales (MdnNo-FTSPe = 56,2 [37,5–71,9]; MdnYes-FTSPe = 75 [62,5–97,5]; P = ,004; tamaño del efecto de Wilcoxon r = 0.5) y la transición de salud a un año (MdnNo-FTSPe = 50 [50−75]; MdnSí-FTSPe = 75 [50−100]; P = ,031; tamaño del efecto r de Wilcoxon = 0,29), donde los pacientes que pertenecían a NO-FTSPe tenían puntuaciones más bajas que los que sí recibieron FTSPe.

Conclusiones

A pesar de no haber encontrado diferencias estadísticamente significativas en la mayoría de los ítems evaluados, cabe destacar que los pacientes que recibieron ePHYS refirieron una clara influencia positiva en sus vidas.

Palabras clave:
Cuidados críticos
Rehabilitación
Actividades básicas de la vida diaria
Calidad de vida relacionada con la salud
Síndrome post-cuidados intensivos

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