Physical rehabilitation and critical illness

Abstract

With the evolution of interventions in the intensive care unit (ICU), an increasing number of patients are surviving critical illness. Survivors of critical illness commonly experience post-intensive care syndrome (PICS), which encompasses a range of physical, cognitive, social, and psychological impairments that persist well beyond discharge from hospital. Physical rehabilitation is an intervention that is implemented to prevent and treat the physical impairments that manifest as part of PICS. There is significant evidence to support functional, goal-directed physical rehabilitation interventions in ICU as it is shown to improve physical function without increasing the risk of adverse events. There are clear guidelines that outline the specific safety criteria for commencing physical rehabilitation in ICU, however, there is further research warranted to determine the optimal dosage. Beyond the ICU admission, there are limited recommendations regarding ongoing physical rehabilitation however there is emerging evidence to support the implementation of home-based telehealth programmes to help improve patient's strength, endurance, and quality of life. Regardless, it is recommended that physical rehabilitation is delivered as part of routine care during an ICU admission and continue throughout the transitions of care to enable the best possible recovery.