From Strict Bedrest to Early Mobilization: A History of Physiotherapy in the Intensive Care Unit

Crit Care Clin. 2023 Jul;39(3):479-502. doi: 10.1016/j.ccc.2023.01.003. Epub 2023 Feb 26.

Abstract

Critically ill patients are at risk of post-intensive care syndrome, including physical, cognitive, and psychological sequelae. Physiotherapists are rehabilitation experts who focus on restoring strength, physical function, and exercise capacity. Critical care has evolved from a culture of deep sedation and bed rest to one of awakening and early mobility; physiotherapeutic interventions have developed to address patients' rehabilitation needs. Physiotherapists are assuming more prominent roles in clinical and research leadership, with opportunities for wider interdisciplinary collaboration. This paper reviews the evolution of critical care from a rehabilitation perspective, highlights relevant research milestones, and proposes future opportunities for improving survivorship outcomes.

Keywords: Clinical trials; Early mobility; Intensive care units; Mechanical ventilation; Physical therapy; Physiotherapy; Post-intensive care syndrome; Rehabilitation.

Publication types

  • Review

MeSH terms

  • Bed Rest*
  • Critical Care
  • Critical Illness / rehabilitation
  • Early Ambulation*
  • Humans
  • Intensive Care Units
  • Physical Therapy Modalities