Intensive care: Patients' experiences

Physiotherapy on the ward

While people are ill in the intensive care unit, they lose weight and can lose about 2% of their muscle mass per day during their illness. This means muscles get weaker, which can result in severe physical disability. Rebuilding these muscles takes time and in some cases can take over a year. If people are immobile (not moving) for some time, their joints may become stiff. To help them recover muscle strength, physiotherapists help them with exercises to restore their mobility.

Most people discussed the physiotherapy they received on the ward and the progress they made daily with the support of physiotherapists. This ranged from moving arms and legs, gripping, walking with a Zimmer frame and crutches, taking their first steps alone, to being able to walk across the ward and, finally, up and down stairs. Many talked about the goal-setting physiotherapists used, which sometimes pushed them to achieve just that little bit more than they felt capable of. At times, some said it felt like 'bullying' and they only really appreciated the physiotherapy with hindsight. One man said the physiotherapists were 'wonderful but cruel' because they made him exercise even when he felt too weak or tired for it.

Some people stressed how physiotherapists were key in helping them regain strength, mobility and confidence, at this stage in their treatment. Some didn't enjoy physiotherapy at first or particularly like their physiotherapists but, as they grew stronger, looked forward to their exercises. Physiotherapy was 'the highlight' of some people's day. Others wanted to do as much physiotherapy as possible, eager to rebuild their strength and go home.

Some noted that, like the nurses on the general ward, many of the physiotherapists were also extremely busy and sometimes didn't visit them. Others said that, if they'd been asleep when the physiotherapist had visited, they would miss physiotherapy that day. One of these people fell from his Zimmer frame on one occasion and said he was quickly helped and encouraged to use it again shortly afterwards.

Another man was unhappy because he'd waited an extremely long time to have his tracheostomy reviewed. He described how he got strong enough to walk his Zimmer frame to the doctor's office and complain.

Many praised the physiotherapists who had helped them, and described them as 'fantastic', encouraging and kind.

National Institute for Health and Care Excellence (NICE) CG83 - 2009 recommends:
 
"While a patient is on the ward, s/he should be given another health check (short clinical assessment) to identify any physical or psychological problems.
 
If the health check shows that the patient could benefit from more structured support, or if this was identified earlier, s/he should then be given a more detailed health check (comprehensive clinical assessment) to identify the patient’s current rehabilitation needs.
 
The healthcare team should talk to each patient about their rehabilitation goals and rehabilitation programme, both of which should take into account the results of their health checks and be tailored to the individual’s needs."

Last reviewed May 2015.

Last updated November 2012.

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