Research supports the provision of physical therapy intervention and early mobilization in the management of patients with critical illness. However, the translation of care from that of well-controlled research protocols to routine practice can be challenging and requires further study. Discussions in the critical care and physical therapy communities, as well as in published literature, are investigating factors related to early mobilization such as transforming culture in the intensive care unit, encouraging interprofessional collaboration, coordinating sedation interruption with mobility sessions, and determining the rehabilitation modalities that will most significantly improve patient outcomes. Some variables, however, need to be investigated and addressed specifically by the physical therapy profession. These include assessing and increasing physical therapist competence managing patients with critical illness both in entry-level educational programs and clinical settings, determining and providing an adequate number of physical therapists for a given intensive care unit, evaluating methods of prioritization of patients in the acute care setting, and adding to the body of research to support specific functional outcome measures to be used with patients in the intensive care unit. Additionally, as persistent weakness and functional limitations can exist long after the critical illness itself has resolved, there is a need for increased awareness and involvement of physical therapists in all settings of practice, including outpatient clinics. The purpose of this paper is to explore the issues that the physical therapy profession needs to address as the rehabilitation management of the patient with critical illness evolves.
Source: http://ptjournal.apta.org/cgi/content/short/ptj.20110445v1?rss=1
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