Physical Therapy Utilization in Intensive Care Units

Abstract

Objective: This study aimed to investigate the utilization of inpatient physical therapy (PT) for patients recovering from critical illness, focusing on factors such as staffing, PT availability, hospital criteria for initiating PT in the intensive care unit (ICU), and the types of PT commonly provided.

Design: Surveys were distributed to 984 physical therapists. The surveys included inquiries about the availability of PT staff for ICU patients, hospital protocols requiring physician consultation for initiating PT, established criteria for PT initiation in the ICU, and PT utilization for six specific patient scenarios involving ICU admission and mechanical ventilation.

Main Results: Out of 984 surveys distributed, 482 physical therapists responded. The majority of hospitals (89%) where these therapists worked mandated physician consultation for initiating PT in the ICU. Only 10% of hospitals had established criteria for PT initiation in the ICU. Community hospitals were more likely than academic hospitals to provide PT on weekends (p=0.03). The likelihood of PT involvement varied significantly among different clinical scenarios (highest at 87% for post-cerebrovascular accident patients, lowest at 64% for chronic obstructive pulmonary disease patients, p<0.001). The most common PT interventions for critically ill patients included functional mobility retraining and therapeutic exercise. Physical therapists reported varying perceptions of which PT interventions had the most positive impact, depending on the clinical scenario (p<0.001).

Conclusions: IPT is frequently administered to ICU patients during their recovery from critical illness. However, the frequency and types of PT interventions vary significantly based on hospital type and the specific clinical scenario.