Physical Rehabilitation following Critical Illness

Abstract

The effects of critical illness and associated significant periods of immobility often result in patients requiring lengthy periods of rehabilitation. Patients frequently have diminished cardiac and respiratory reserve, together with generally decreased muscle strength and endurance. Myopathies and neuropathies are sometimes evident, and patients are frequently unable to carry out simple functional tasks. Although the need for physical rehabilitation is well established, substantive evidence to guide rehabilitation services is lacking. Research has been conducted to establish safe commencement of mobilisation, and expert opinion is that there is a generally accepted hierarchy of mobilisation techniques. As well as progressively increasing mobility, there are also suggestions that specific exercise programmes can influence weaning time and length of stay. Post discharge, evidence suggests that there is a need for on-going rehabilitation, and early research shows encouraging results. However, many questions remain unanswered. More evidence is required in order to establish what the best practice is for acute rehabilitation and for rehabilitation as part of follow-up care.