Early Physical Rehabilitation in the ICU: A Review for the Neurohospitalist

Research output: Contribution to journalReview article

Abstract

Advances in critical care have resulted in improved intensive care unit (ICU) mortality. However, improved ICU survival has resulted in a growing number of ICU survivors living with long-term sequelae of critical illness, such as impaired physical function and quality of life (QOL). In addition to critical illness, prolonged bed rest and immobility may lead to severe physical deconditioning and loss of muscle mass and muscle weakness. ICU-acquired weakness is associated with increased duration of mechanical ventilation and weaning, longer ICU and hospital stay, and increased mortality. These physical impairments may last for years after ICU discharge. Early Physical Medicine and Rehabilitation (PM&R) interventions in the ICU may attenuate or prevent the weakness and physical impairments occurring during critical illness. This article reviews the evidence regarding safety, feasibility, barriers, and benefits of early PM&R interventions in ICU patients and discusses the limited existing data on early PM&R in the neurological ICU and future directions for early PM&R in the ICU.

Original languageEnglish (US)
Pages (from-to)96-105
Number of pages10
JournalThe Neurohospitalist
Volume2
Issue number3
DOIs
StatePublished - 2012

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Keywords

  • bed rest
  • deconditioning
  • early ICU rehabilitation
  • early Neuro-ICU rehabilitation
  • feasibility
  • immobility
  • muscle weakness
  • outcomes
  • safety

ASJC Scopus subject areas

  • Clinical Neurology

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