Physical therapy utilization in intensive care units: Results from a national survey

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Abstract
Objective: Patients who survive admission to the intensive care unit (ICU) commonly complain of fatigue, weakness, and poor functional status. This study sought to determine the utilization of inpatient physical therapy (PT) for patients recovering from critical illness. Design: Surveys were mailed to 984 physical therapists from across the United States. Each survey included questions concerning staffing and availability of physical therapists for ICU patients, and the utilization of PT for six patient scenarios requiring ICU admission and mechanical ventilation. Main Results: Overall, 482 physical therapists completed their survey. The majority of hospitals (89%) at which the physical therapists were employed require a physician consultation to initiate PT for ICU patients. Established hospital criteria for the initiation of PT in the ICU were present at only 10% of the hospitals. Community hospitals were more likely to routinely provide PT on weekends compared with academic hospitals (p = 0.03). The likelihood of routine PT involvement varied significantly with the clinical scenario (highest 87% status postcerebrovascular accident, lowest 64% chronic obstructive pulmonary disease, p < 0.001). The most common types of PT that would be performed on these critically ill patients were functional mobility retraining and therapeutic exercise. The type of PT identified by the physical therapists as having the most positive impact also significantly varied according to the clinical scenario (p < 0.001). Conclusions: PT is commonly administered to ICU patients during the recovery from critical illness in the United States. However, the frequency and the type of PT significantly varies based on the type of hospital and the clinical scenario.