Rehabilitation in the Intensive Care Unit: How Amount of Physical and Occupational Therapy Impacts Patients' Functionality and Length of Hospital Stay

Abstract

AbstractIntroductionPatients in the Intensive Care Unit (ICU) often experience extended periods of immobility. Following hospital discharge, many face impaired mobility and never return to baseline functionality. While the benefits of physical and occupational rehabilitation are well established in non‐ICU patients, a paucity of work describes effective practices to alleviate ICU‐related declines in mobility.ObjectiveThis study aims to build upon prior work and provide a larger analysis assessing how rehabilitation with physical and occupational therapy (PT‐OT) during ICU stays impacts patients' mobility, self‐care, and length of hospital stay.DesignRetrospective cohort study.SettingInpatient intensive care unit.Participants6628 adult patients who received physical rehabilitation across multiple sites (Arizona, Florida, Minnesota, and Wisconsin) of a single institution between January 2018 and December 2021.InterventionsNot applicable.Main Outcome MeasuresDescriptive statistics, linear regression models, and gradient boosting machine (GBM) methods were used to examine the relationship between the amount of PT‐OT received and outcomes of length of hospital stay (LOS), AM‐PAC Daily Activity and Basic Mobility scores.ResultsThe 6628 patients who met inclusion criteria received an average (median) of 23 (range: 1, 89) minutes of PT‐OT minutes per day. Regression analyses showed each additional 10‐minutes of PT‐OT per day was associated with a 1.03% (95% CI: 0.41–1.66, p < 0.001) higher final Basic Mobility score, a 1.82% (95% CI: 1.30%–2.34%, p < 0.001) higher final Daily Activity score, and a 1.19‐day (95% CI: −1.28 to −1.09, p < 0.001) lower hospital length of stay. One‐dimensional partial dependence plots revealed an exponential decrease in predicted length of stay as minutes of PT‐OT received increased.ConclusionOur study indicates that higher rehabilitation minutes in patients in the ICU may reduce the length of stay and improve patients' functional outcomes at discharge. The benefits of rehabilitation increased with increasing amounts of time of therapy received.This article is protected by copyright. All rights reserved.