Five Things About ICU Rehabilitation

Patients admitted to the Intensive-Care Unit (ICU) frequently suffer long-term physical and psychological complication. Prolonged stays in the intensive care unit are associated with muscle weakness, impaired quality of life, functional decline and increased morbidity, mortality, and even increased financial burden with prolonged hospital stay or an increased chance of hospital readmission.

Did you know? That in addition to doctors and nurses, there are a variety of people who work in the Intensive Care Unit (ICU) – including physiotherapists, dieticians, speech therapists and other support staff.

So, what do physiotherapists do in the ICU?

Physiotherapy is an important intervention that prevents and mitigates the adverse effects of prolonged bed rest and mechanical ventilation during critical illness. Rehabilitation delivered by the physiotherapist is tailored to patient needs and depends on the conscious state, psychological status and physical strength of the patient. It incorporates any active and passive therapy that promotes movement and includes mobilisation. Early progressive physiotherapy, with a focus on mobility and walking whilst ventilated, is essential in minimising functional decline.

Work as a Team

Physiotherapy is part of a multi-disciplinary approach to assess and manage the conditionof critically ill patients. Together with doctors, nurses and other allied health professionals, we work closely to keep you up to date with your loved one's progress.

Treat Chest Complications

Physiotherapy treatment is integral in promoting lung function, reducing the incidence of ventilator-associated pneumonia, facilitating weaning and promoting safe and early discharge from the intensive care unit. Chest physiotherapy helps to clear excess sputum while on artificial mechanical ventilation to reduce chances of chest infections and treating infections when they occur.

Prescribe Exercises at the Right Dosage

Physiotherapists hold a vital role of maintaining and improving muscle strength and joint movements in the critically ill with tailored exercise prescriptions. First, rehabilitation goals are set together with the patient, their family and the medical team. These can be short, medium or long term and change throughout the patient's recovery from critical illness.

Normalise the Environment

By designing exercises with the goal of returning to every day life, and encouraging regular interactions with family, we simulate an environment as close as possible to what is experienced in daily life.

Get you out of the ICU fast

ICU physiotherapy is proven to be safe and effective in reducing the length of stay in both and ICU and the hospital, which will reduce hospitalisation fees and save costs. Studies show that the rate of readmission into the ICU and mortality are higher in those who receive treatment more than 30 days after discharge.

By Kylie Siu

References:

Chartered Society of Physiotherapy, Physiotherapy works: critical care. Accessed on 2/6/19http://www.csp.org.uk/publications/physiotherapy-works-critical-care

Ista E, Scholefield BR, Manning JC, Harth I, Gawronski O, Bartkowska-Śniatkowska A, Ramelet AS, Kudchadkar SR. Mobilization practices in critically ill children: a European point prevalence study (EU PARK-PICU). Critical Care. 2020 Dec;24(1):1-1.