Title:Impact of Physiotherapy on Functional Status and Length of Stay of
Patients Admitted to Intensive Care Unit
Volume: 18
Issue: 4
Author(s): Amrutha Hosakote Mahesh, Renukadevi Mahadevan*Chaya Sindaghatta Krishnarao
Affiliation:
- JSS College of Physiotherapy, Mysore, Karnataka, India
Keywords:
Physiotherapy, ICU, length of stay, early mobilization, functional status assessment, chelsea critical care physical assessment tool (CPAx).
Abstract:
Background: Early mobilization of patients with critical illness reduces the consequences
of extended periods of bed rest and improves self-care functions and quality of life. Early mobilization
for mechanically ventilated patients in any ICU prevents patients from a spiral of progressive
complications, leading to either nursing home placement or persistent critical illness. Early mobilization
of ICU patients has been associated with improved muscle strength and functional independence,
a shorter duration of delirium, mechanical ventilation, and ICU length of stay.
Objective: This study was undertaken to assess the impact of physiotherapy management and early
mobilization on Functional Status and Length of Stay in patients admitted to the Intensive Care
Unit.
Methods: An observational study was conducted at a tertiary care university teaching hospital in
Mysore, South India, among patients admitted to medical and surgical intensive care units. The patients
were assessed, and the patient’s baseline characteristics were recorded. The study subjects
were divided into two groups, the intervention and the control groups. There were 71 patients in the
intervention group and 67 patients control group. Subjects in the intervention group underwent
physiotherapy management and early mobilization. Subjects in the control group did not undergo
physiotherapy management and early mobilization. Physiotherapy intervention was given 2-3
times/day, and the outcome measures were the length of stay in ICU and assessment of physical
morbidity using the Chelsea Critical Care Physical Assessment Tool (CPAx).
Results: The results showed that subjects in the intervention group were weaned from the ventilator
support (3.86±3.4 and 5.59±4.3, p = 0.005) and oxygen support (5.23±0.99 and 7.48±2.0, p = 0.000)
much earlier than the subjects in the control group. The length of ICU stay was significantly less in
the intervention group than in the control group (7.71±3.70 days and 11.64±4.8 days with a p-value,
p = 0.000). respectively
Conclusion: This study demonstrated that implementation of physiotherapy intervention and early
mobilization in critically ill patients undergoing treatment in intensive care unit resulted in early
weaning from ventilator support and supplemental oxygen therapy, with improvement in functional
status leading to reduced length of ICU stays compared to the patients who were not given physiotherapy
intervention and early mobilization.