Physiotherapy in ICU

During a patient’s stay in intensive care, he or she will be seen and treated by a physiotherapist. Physiotherapists try to make sure the patient’s lungs are kept clear by carrying out physiotherapy on their chest. They also exercise the patient’s arms and legs when they are asleep to work the muscles and stop the joints becoming stiff. If a patient was ventilated (connected to a machine to help them breathe) in the ICU, the physiotherapist will give them exercises to help strengthen their lungs and breathing muscles so they can breathe without the machine as they get better. This will reduce the chances of getting a lung infection.
As the patient gets better, physiotherapists also help with exercises to get the patient strong enough to get out of bed. When they’re ready, physios will help them get up and moving about again.
While a patient is in critical care, he or she should be given a health check (called a short clinical assessment) to identify:
  • any physical or psychological problems
  • the likelihood of any problems developing in the future, and
  • their current rehabilitation needs.
If the health check shows that the patient could benefit from more structured support, he or she should be given a more detailed health check (called a comprehensive clinical assessment) to identify their rehabilitation needs. The healthcare team should talk to each patient about their rehabilitation goals, involving the family and/or carer if the patient is unconscious or unable to give formal consent.*
Many people talked about the physiotherapy they had in intensive care.

Some people had vague memories of having physiotherapy while they were sedated. Others discussed the gentle exercises they did daily in order to re-build their strength. The support of physiotherapists helped others to make progress. Some of these people recalled being ‘suctioned’ or having their lungs cleared to prevent the build-up of secretions.

The physiotherapists encouraged her to walk even though she was weak and found it difficult to eat.

Age at interview 44

Gender Female

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She found the physiotherapists kind and encouraging, and the exercises made her feel she could do…

Age at interview 47

Gender Female

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Being moved or ‘hoisted’ from the bed to a chair was a sign of improvement for many people. Some, however, found this uncomfortable, painful and embarrassing. Others had found the physiotherapy painful or tiring, and had dreaded their physiotherapists’ visits.

She was embarrassed when she was hoisted from the bed to a chair and surprised at how weak she…

Age at interview 23

Gender Female

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He disliked having physiotherapy but knew he needed it and appreciated the physiotherapists…

Age at interview 46

Gender Male

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Some people noted how different they now looked, compared to when they were first admitted. Depending on their illness or injuries, some had swollen up, while others had lost a lot of weight. Many praised the ICU staff and treatments they were given to help them survive and regain strength, and the physiotherapy they received on a general ward (see ‘Physiotherapy on the ward’).

‘Several studies have shown that early rehabilitation, beginning at a point when the patient is physiologically stable and continuing through the critical care stay, might improve physical functioning and so contribute to an early discharge from critical care (Bailey et al. 2007).’ – National Institute for Health and Care Excellence (NICE) CG83 2009.

* Information from ICU steps.

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