Physical Therapy Practice for Critically Ill Patients With COVID-19 in the Intensive Care Unit

Purpose: To describe physical therapist (PT) practice for patients with COVID-19 in the intensive care unit (ICU) at a tertiary hospital and to describe a novel clinical decision-making algorithm (nCDM) and its use in enhancing clinical practice for this patient population. Methods: This is a single-center, retrospective chart review. An nCDM was formulated to assist with best practice. The Activity Measure for Post-Acute Care “6 clicks” (AM-PAC) score, highest level of mobility, discharge destination, and observed clinical complications at hospital discharge were collected. Results: Seventy-seven patients received ICU PT services. Of these, twenty-six patients were outside previously established parameters for initiating PT intervention and forty-four patients were on mechanical ventilation during the initial PT evaluation. All groups showed a statistically significant improvement in their respective AM-PAC scores from initial PT evaluation to ICU discharge. Conclusion: The authors have described our PT practice for this patient population in our setting. Patients who were outside previously established parameters for initiating PT intervention were able to participate with PT and showed functional improvement. This nCDM shows a promising use in enhancing clinical decision-making for PT practice while treating patients with COVID-19 in the ICU.