Physiotherapy: rehabilitation

The Physiotherapists’ role within ICU can be separated into two key areas Respiratory Care and Rehabilitation (below).

During critical illness patients can become weak very quickly. They can also experience joint stiffness, muscle tightness and reduced fitness affecting balance and function. Rehabilitation means recovery of activity and independence. Daily individual assessment is completed to evaluate if rehabilitation is indicated and is based on patients’ medical status & level of wakefulness and is tailored to each individual’s own needs. When it is appropriate, rehabilitation is a very necessary part of the recovery process. Research and NICE guidelines prove that this is both safe and effective.

Exercises / movements (in bed):

• Actively or with assistance. This helps to maintain joint range of movement & muscle strength and is started in the early stages of intensive care stay.
• Stretches or splints for hands or feet to prevent muscle and joint stiffness.

Early mobilisation:

• Bed mobility
  • to encourage independence with rolling and moving within bed
• Sitting
  • position in bed, over the edge of the bed or sitting in a chair
  • to increase function, strengthen muscles and regain balance
• to assist with clearing secretions from the chest
• Standing & walking
• Sit to stand, balance, marching on spot and moving from bed to chair
  • to improve balance
  • to continue to strengthen muscles
  • increase normal activity

All these activities will help to increase awareness of surroundings and help to return the patient to a more normal routine

• These activities can be safely achieved whilst still requiring ventilation. It is normal to feel tired and possibly breathless with the exercises, treatment can feel like hard work, but it is important to participate to enhance both immediate and later recovery.
• A functional score called the CPAx is used to review physical activity and independence.

If you have any questions regarding the physiotherapy on critical care please do contact us either directly or ask the nursing staff to contact us.