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Intensive Care AND Physiotherapy

Anastasia N L Newman, Janelle Gravesande, Stephanie Rotella, Stephen S Wu, Nam Topp-Nguyen, Michelle E Kho, Jocelyn E Harris, Alison Fox-Robichaud, Patricia Solomon
PURPOSE: This scoping review summarizes the literature on the safety and effectiveness of physiotherapy interventions in patients with neurological and/or traumatic injuries in the intensive care unit (ICU), identifies literature gaps and provides recommendations for future research. MATERIALS AND METHODS: We searched five databases from inception to June 2, 2018. We included published retrospective studies, case studies, observation and randomized controlled trials describing physiotherapy interventions in ICU patients with neurotrauma injuries...
October 3, 2018: Journal of Critical Care
Paula Soukkio, Sara Suikkanen, Sanna Kääriä, Hannu Kautiainen, Sarianna Sipilä, Katriina Kukkonen-Harjula, Markku Hupli
BACKGROUND: Health concerns, such as frailty and osteoporotic fractures decrease functional capacity and increase use of health and social care services in the aging population. The ability to continue living at home is dependent on functional capacity, which can be enhanced by rehabilitation. We study the effects of a 12-month home-based physiotherapy program with 12-month follow-up on duration of living at home, functional capacity, and the use of social and health care services among older persons with signs of frailty, or with a recently operated hip fracture...
October 1, 2018: BMC Geriatrics
Qi Zhang, Shujun Jiang, Lufei Young, Feng Li
Group-based physiotherapy-led behavioral psychological interventions (GPBPIs) are an emerging treatment for chronic low back pain (CLBP), but the efficacy of these interventions is uncertain. A review of relevant randomized controlled trials and a meta-analysis was conducted to evaluate the effectiveness of GPBPIs on pain relief in adults with CLBP. Literature databases, Google Scholar, bibliographies, and other relevant sources were searched. Thirteen (13) intervention studies published from 1998 to 2013 were included...
October 2, 2018: American Journal of Physical Medicine & Rehabilitation
Pamela Nery Borges, Laurie Snider, José Simon Camelo, Boychuck Zachary, Khodary Fatima, Goldschleger Jessica, Majnemer Annette
Rehabilitation specialists are an integral part of the team in the neonatal intensive care unit (NICU). New approaches to rehabilitation practice in the NICU have evolved over the past decade that aim to promote child health and development. AIMS: The aim of this study was to describe the current roles of the occupational therapist (OT), physical therapist (PT) and speech-language pathologist (SLP) in Canadian NICUs as compared to the roles documented in an earlier national survey conducted 15 years ago...
September 28, 2018: Physical & Occupational Therapy in Pediatrics
Tsung-Hsien Wang, Chin-Pyng Wu, Li-Ying Wang
BACKGROUND: Extubation failure can lead to a longer intensive care unit (ICU) stay, higher mortality rate, and higher risk of requiring tracheostomy. Chest physiotherapy (CPT) can help patients in reducing the accumulation of airway secretion, preventing collapsed lung, improving lung compliance and reducing comorbidities. Much research has investigated the correlation between CPT and respiratory system clearance. However, few studies have investigated the correlation between CPT and failed ventilator extubation...
September 28, 2018: Clinical Respiratory Journal
Diana P Pozuelo-Carrascosa, Ana Torres-Costoso, Celia Alvarez-Bueno, Iván Cavero-Redondo, Purificación López Muñoz, Vicente Martínez-Vizcaíno
QUESTION: In intubated adult patients receiving mechanical ventilation, does multimodality respiratory physiotherapy prevent ventilator-associated pneumonia, shorten length of intensive care unit (ICU) stay, and reduce mortality? DESIGN: A systematic review with meta-analysis of randomised controlled trials. PARTICIPANTS: Intubated adult patients undergoing mechanical ventilation who were admitted to an intensive care unit. INTERVENTION: More than two respiratory physiotherapy techniques such as positioning or postural drainage, manual hyperinflation, vibration, rib springing, and suctioning...
October 2018: Journal of Physiotherapy
Megan Whelan, Heleen van Aswegen, Evelyn Corner
Background: Critically ill patients following traumatic injury or major surgery are at risk of loss of skeletal muscle mass, which leads to decreased physical function. Early rehabilitation in an intensive care unit (ICU) is thought to preserve or restore physical functioning. The Chelsea critical care physical assessment (CPAx) is a measurement tool used to assess physical function in the ICU. Objectives: To determine whether the use of the CPAx tool as part of physiotherapy patient assessment, in two adult trauma and surgical ICU settings where early patient mobilisation forms part of standard physiotherapy practice, had an impact on ICU and hospital length of stay (LOS) through delivery of problem-oriented treatment plans...
2018: South African Journal of Physiotherapy
Rebekah Haylett, Owen Gustafson
PURPOSE: To report the feasibility of assessing pre-admission functional status of ICU trauma patients, with repeat assessment at six months post ICU discharge using a standardised measure. MATERIALS AND METHODS: A prospective longitudinal observational cohort design recruited consecutive adult major trauma admissions to a UK general ICU, between 1st November 2016 and 1st November 2017. The 12-item World Health Organisation Disability Schedule 2.0 was completed to assess pre-admission functional status as soon as possible after ICU admission...
August 26, 2018: Journal of Critical Care
Sue C Berney, Joleen W Rose, Linda Denehy, Catherine L Granger, George Ntoumenopoulos, Elise Crothers, Bronwyn Steel, Sandy Clarke, Elizabeth H Skinner
OBJECTIVES: To develop a decision tree that objectively identifies the most discriminative variables in the decision to provide out-of-bed rehabilitation, measure the impact of this decision and to identify the factors that intensive care unit (ICU) practitioners think most influential in that clinical decision. DESIGN: A prospective three-part study: i) consensus identification of influential factors in mobilization via survey, ii) development of an early rehabilitation decision tree and iii) measurement of practitioner mobilisation decision-making...
August 30, 2018: Archives of Physical Medicine and Rehabilitation
Carlos A Cuello-Garcia, Safiah Hwai Chuen Mai, Racquel Simpson, Samah Al-Harbi, Karen Choong
OBJECTIVE: To characterize how early mobilization is defined in the published literature and describe the evidence on safety and efficacy on early mobilization in critically ill children. STUDY DESIGN: Systematic search of randomized and nonrandomized studies assessing early mobilization-based physical therapy in critically ill children under 18 years of age in MEDLINE, Embase, CINAHL, CENTRAL, the National Institutes of Health, Evidence in Pediatric Intensive Care Collaborative, Physiotherapy Evidence Database, and the Mobilization-Network...
August 29, 2018: Journal of Pediatrics
Claire J Tipping, Anne E Holland, Meg Harrold, Tom Crawford, Nick Halliburton, Carol L Hodgson
BACKGROUND: The intensive care unit mobility scale (IMS) is reliable, valid and responsive. Establishing the minimal important difference (MID) of the IMS is important in order to detect clinically significant changes in mobilization. OBJECTIVE: To calculate the MID of the IMS in intensive care unit patients. METHODS: Prospective multi center observational study. The IMS was collected from admission and discharge physiotherapy assessments...
August 20, 2018: Heart & Lung: the Journal of Critical Care
Chunyan Zhu, Bao Liu, Tianjun Yang, Qing Mei, Aijun Pan, Dongsheng Zhao
OBJECTIVE: To investigate the effect of early rehabilitation physiotherapy on muscle quality and function in critical patients. METHODS: A prospective randomized controlled study was performed. Adult critically ill patients admitted to intensive care unit (ICU) of Anhui Provincial Hospital from October 1st, 2016 to August 31st, 2017 who had been hospitalized for more than 7 days and had acute physiology and chronic health evaluation II (APACHE II) > 8 were enrolled, and they were divided into treatment group and control group according to random number table method...
June 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Elizabeth L Capell, Claire J Tipping, Carol L Hodgson
BACKGROUND: Early mobilisation in the intensive care unit (ICU) has been consistently reported as feasible and safe with minimal adverse events; however, invasive mechanical ventilation patients are rarely actively mobilised. An expert consensus group developed and published recommendations using a traffic light system on safety criteria to promote active mobilisation of invasive mechanical ventilation patients. OBJECTIVES: The aim of this study was to determine whether, in clinical practice, the safety consensus recommendations resulted in (1) increased early mobilisation in patients assessed as appropriate to mobilise based on the risk classification and (2) early mobilisation without adverse events...
July 10, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Ianthe Boden, Kate Sullivan, Claire Hackett, Brooke Winzer, Rebecca Lane, Melissa McKinnon, Iain Robertson
Background: Postoperative complications and delayed physical recovery are significant problems following emergency abdominal surgery. Physiotherapy aims to aid recovery and prevent complications in the acute phase after surgery and is commonplace in most first-world hospitals. Despite ubiquitous service provision, no well-designed, adequately powered, parallel-group, randomised controlled trial has investigated the effect of physiotherapy on the incidence of respiratory complications, paralytic ileus, rate of physical recovery, ongoing need for formal sub-acute rehabilitation, hospital length of stay, health-related quality of life, and mortality following emergency abdominal surgery...
2018: World Journal of Emergency Surgery: WJES
Mary I Thurber, Mark Greenberg, Dawn Weiss, Lynn Richardson, Andrew Stallard, Nadine Lamberski
A female western lowland gorilla (Gorilla gorilla gorilla) infant was delivered by cesarean section (C-section) to an 18-year-old primiparous dam after prolonged labor. The infant required resuscitation at birth and was hospitalized for management of pneumonia and associated respiratory distress secondary to the aspiration of meconium-stained amniotic fluid. The infant received nine days of intensive care with respiratory support, antibiotics, intravenous fluid therapy, anti-inflammatory drugs, bronchodilators, and chest physiotherapy...
July 4, 2018: Zoo Biology
Monica R Perracini, Morten Tange Kristensen, Caitriona Cunningham, Cathie Sherrington
Physiotherapy can play a vital role in the pathway of care of people after fragility fracture and includes interventions of early mobilisation and prescription of structured exercise programmes for maximising functional recovery and reducing the risk of falls and further fractures. Although the optimal nature of physiotherapist interventions after hip and vertebral fracture requires further investigation in large-scale trials, evidence supports the prescription of high-intensity and extended exercise interventions...
August 2018: Injury
R Goñi-Viguria, E Yoldi-Arzoz, L Casajús-Sola, T Aquerreta-Larraya, P Fernández-Sangil, E Guzmán-Unamuno, B M Moyano-Berardo
INTRODUCTION AND AIMS: Patients in intensive care unit are susceptible to complications due to different causes (underlying disease, immobilisation, infection risk…) The current main intervention in order to prevent these complications is respiratory physiotherapy, a common practice for nurses on a daily basis. Therefore, we decided to carry out this bibliographic review to describe the most efficient respiratory physiotherapy methods for the prevention and treatment of lung complications in patients in intensive care, taking into account the differences between intubated and non-intubated patients...
June 14, 2018: Enfermería Intensiva
M Weigeldt, M Paul, S Schulz-Drost, M D Schmittner
The management of anesthesia plays a central role in the treatment of thoracic trauma, both in the initial phase when safeguarding the difficult airway and in the intensive care unit. A rapid transfer to a trauma center should be considered in order to recognize and treat organ dysfunction in time. Development of atelectasis, pneumonia and acute lung failure are common pulmonary complications. Non-invasive ventilation combined with physiotherapy and respiratory training can help to minimize these pulmonary complications...
August 2018: Der Unfallchirurg
W Schmelling, J N Poulsen, L Christrup, P Gazerani
Aims A fast-track based surgical treatment reduces morbidity and hospital stay by providing early mobilization. Sufficient postoperative pain management is mandatory for early mobilization and optimal utilization of rehabilitation measures. Insufficient postoperative pain management is however a widespread problem. Lack of knowledge about pain and pain treatment among health care professionals and general community has been considered as a major potential contributor in insufficient pain management. It has been suggested that severe postoperative pain might imply a potential risk of developing chronic pain...
December 29, 2017: Scandinavian Journal of Pain
Kylie Hill, Vinicius Cavalheri, Sunita Mathur, Marc Roig, Tania Janaudis-Ferreira, Priscila Robles, Thomas E Dolmage, Roger Goldstein
BACKGROUND: In people with chronic obstructive pulmonary disease (COPD), the use of neuromuscular electrostimulation (NMES) either alone, or together with conventional exercise training, might improve the condition of the peripheral muscles, increase exercise capacity and functional performance, reduce symptoms and improve health-related quality of life (HRQoL). OBJECTIVES: To determine the effects of NMES, applied in isolation or concurrently with conventional exercise training to one or more peripheral muscles, on peripheral muscle force and endurance, muscle size, exercise capacity, functional performance, symptoms, HRQoL and adverse events in people with COPD...
May 29, 2018: Cochrane Database of Systematic Reviews
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