Delirium management: Let's get physical? A systematic review and meta-analysis.

OBJECTIVE: To investigate whether physical training (alone or in a multi-component intervention) is effective in preventing delirium or improving outcomes for adult patients with delirium in the hospital setting.

METHODS: A systematic review, qualitative synthesis and meta-analysis of randomised controlled trials identified by searches of electronic databases, combining key concepts of delirium and physical training (the target intervention). Outcomes were incidence of delirium (for prevention trials) and delirium duration, delirium severity and hospital outcomes (for management trials).

RESULTS: Seven trials were included, five of which were multi-component. The odds of developing delirium were lower for patients who received physical training compared with a control intervention [odds ratio 0.46 (95% confidence interval 0.32-0.65), P < 0.01] (moderate-quality evidence). There was insufficient evidence to draw conclusions about managing established delirium.

CONCLUSIONS: Strategies incorporating physical training appear to prevent delirium in the hospital setting. More research is required regarding management of established delirium.