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Physiotherapy in intensive care: an updated systematic review
1Physiotherapy Department, Royal Adelaide Hospital, Adelaide, SA, Australia.
Chest
|June 1, 2013
Summary
Physiotherapy, including early progressive mobilization, is beneficial for adult patients in the intensive care unit (ICU). This approach improves function and reduces ICU and hospital length of stay, supporting its priority implementation.
Area of Science:
- Critical Care Medicine
- Rehabilitation
- Respiratory Therapy
Background:
- Physiotherapy is common in ICUs, but its effectiveness is debated.
- This review updates evidence on physiotherapy for intubated, mechanically ventilated adult ICU patients.
Purpose of the Study:
- To systematically review evidence on physiotherapy effectiveness for adult, intubated, mechanically ventilated ICU patients.
- To update a previous systematic review from 2000.
Main Methods:
- Searched PubMed, MEDLINE, CINAHL, Embase, Cochrane Library, and PEDro databases.
- Included studies published from 1999 onwards, with no limitations on study design or outcomes.
- Conducted a descriptive review due to heterogeneity of study designs, precluding meta-analysis.
Main Results:
- Reviewed 55 clinical and 30 non-clinical studies.
- Evidence for routine multimodality respiratory physiotherapy is conflicting.
- Early progressive mobilization physiotherapy is feasible, safe, and improves function, shortening ICU and hospital stays.
Conclusions:
- New evidence since 1999 indicates physiotherapy, specifically early progressive mobilization, benefits adult ICU patients.
- Early progressive mobilization positively impacts functional ability and reduces ICU and hospital length of stay.
- Recommends priority implementation of early progressive mobilization in all adult ICUs.
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