Move it or lose it? A survey of the aims of treatment when using passive movements in intensive care

Abstract

Objectives: To identify the aims of treatment when physiotherapists use passive movements (PMs) for ventilated and sedated patients on intensive care in the UK.

Method: Postal questionnaires distributed to senior physiotherapists working within all National Health Service (NHS) trusts with open level 3 ICU beds. Open questionnaire items surveyed the aims of using PMs in different clinical areas (neurology, cardiology, orthopaedics/trauma, general surgery, medicine, other).

Results: The vast majority of respondents stated that the aim of using PMs was to maintain joint range of movement (ROM) in ventilated and sedated patients across all clinical areas. Respondents also identified additional uses of PMs for neurological patients.

Conclusion: There appears to be a high level of consensus amongst physiotherapists that PMs influence joint range and that there will be a loss of range if PMs are not carried out. Currently this is not supported by empirical evidence. Therefore, future research should investigate the actual physiological effects of PMs and the clinical reasoning underpinning their use in critically ill patients.