Physiotherapy in the intensive care unit: an evidence-based, expert driven, practical statement and rehabilitation recommendations

Juultje Sommers; Raoul HH Engelbert; Daniela Dettling-Ihnenfeldt; Rik Gosselink; Peter E Spronk; Frans Nollet; Marike van der Schaaf

doi:10.1177/0269215514567156

Physiotherapy in the intensive care unit: an evidence-based, expert driven, practical statement and rehabilitation recommendations

Juultje Sommers, Raoul HH Engelbert, Daniela Dettling-Ihnenfeldt, Rik Gosselink, Peter E Spronk, Frans Nollet, Marike van der Schaaf

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Abstract

OBJECTIVE: To develop evidence-based recommendations for effective and safe diagnostic assessment and intervention strategies for the physiotherapy treatment of patients in intensive care units.

METHODS: We used the EBRO method, as recommended by the 'Dutch Evidence Based Guideline Development Platform' to develop an 'evidence statement for physiotherapy in the intensive care unit'. This method consists of the identification of clinically relevant questions, followed by a systematic literature search, and summary of the evidence with final recommendations being moderated by feedback from experts.

RESULTS: Three relevant clinical domains were identified by experts: criteria to initiate treatment; measures to assess patients; evidence for effectiveness of treatments. In a systematic literature search, 129 relevant studies were identified and assessed for methodological quality and classified according to the level of evidence. The final evidence statement consisted of recommendations on eight absolute and four relative contra-indications to mobilization; a core set of nine specific instruments to assess impairments and activity restrictions; and six passive and four active effective interventions, with advice on (a) physiological measures to observe during treatment (with stopping criteria) and (b) what to record after the treatment.

CONCLUSIONS: These recommendations form a protocol for treating people in an intensive care unit, based on best available evidence in mid-2014.

Original language	English
Pages (from-to)	1051-1063
Number of pages	13
Journal	Clinical Rehabilitation
Volume	29
Issue number	11
DOIs	https://doi.org/10.1177/0269215514567156
Publication status	Published - 2015

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@article{0e8147f61af348689c41878b0a7345c8,

title = "Physiotherapy in the intensive care unit: an evidence-based, expert driven, practical statement and rehabilitation recommendations",

abstract = "OBJECTIVE: To develop evidence-based recommendations for effective and safe diagnostic assessment and intervention strategies for the physiotherapy treatment of patients in intensive care units.METHODS: We used the EBRO method, as recommended by the 'Dutch Evidence Based Guideline Development Platform' to develop an 'evidence statement for physiotherapy in the intensive care unit'. This method consists of the identification of clinically relevant questions, followed by a systematic literature search, and summary of the evidence with final recommendations being moderated by feedback from experts.RESULTS: Three relevant clinical domains were identified by experts: criteria to initiate treatment; measures to assess patients; evidence for effectiveness of treatments. In a systematic literature search, 129 relevant studies were identified and assessed for methodological quality and classified according to the level of evidence. The final evidence statement consisted of recommendations on eight absolute and four relative contra-indications to mobilization; a core set of nine specific instruments to assess impairments and activity restrictions; and six passive and four active effective interventions, with advice on (a) physiological measures to observe during treatment (with stopping criteria) and (b) what to record after the treatment.CONCLUSIONS: These recommendations form a protocol for treating people in an intensive care unit, based on best available evidence in mid-2014.",

keywords = "Evidence-Based Medicine, Female, Humans, Intensive Care Units, Male, Netherlands, Physical Therapy Modalities, Practice Guidelines as Topic, Treatment Outcome, Journal Article, Research Support, Non-U.S. Gov't, Review",

author = "Juultje Sommers and Engelbert, {Raoul HH} and Daniela Dettling-Ihnenfeldt and Rik Gosselink and Spronk, {Peter E} and Frans Nollet and {van der Schaaf}, Marike",

note = "With supplementary file.",

year = "2015",

doi = "10.1177/0269215514567156",

language = "English",

volume = "29",

pages = "1051--1063",

journal = "Clinical Rehabilitation",

issn = "0269-2155",

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number = "11",

}

TY - JOUR

T1 - Physiotherapy in the intensive care unit: an evidence-based, expert driven, practical statement and rehabilitation recommendations

AU - Sommers, Juultje

AU - Engelbert, Raoul HH

AU - Dettling-Ihnenfeldt, Daniela

AU - Gosselink, Rik

AU - Spronk, Peter E

AU - Nollet, Frans

AU - van der Schaaf, Marike

N1 - With supplementary file.

PY - 2015

Y1 - 2015

N2 - OBJECTIVE: To develop evidence-based recommendations for effective and safe diagnostic assessment and intervention strategies for the physiotherapy treatment of patients in intensive care units.METHODS: We used the EBRO method, as recommended by the 'Dutch Evidence Based Guideline Development Platform' to develop an 'evidence statement for physiotherapy in the intensive care unit'. This method consists of the identification of clinically relevant questions, followed by a systematic literature search, and summary of the evidence with final recommendations being moderated by feedback from experts.RESULTS: Three relevant clinical domains were identified by experts: criteria to initiate treatment; measures to assess patients; evidence for effectiveness of treatments. In a systematic literature search, 129 relevant studies were identified and assessed for methodological quality and classified according to the level of evidence. The final evidence statement consisted of recommendations on eight absolute and four relative contra-indications to mobilization; a core set of nine specific instruments to assess impairments and activity restrictions; and six passive and four active effective interventions, with advice on (a) physiological measures to observe during treatment (with stopping criteria) and (b) what to record after the treatment.CONCLUSIONS: These recommendations form a protocol for treating people in an intensive care unit, based on best available evidence in mid-2014.

AB - OBJECTIVE: To develop evidence-based recommendations for effective and safe diagnostic assessment and intervention strategies for the physiotherapy treatment of patients in intensive care units.METHODS: We used the EBRO method, as recommended by the 'Dutch Evidence Based Guideline Development Platform' to develop an 'evidence statement for physiotherapy in the intensive care unit'. This method consists of the identification of clinically relevant questions, followed by a systematic literature search, and summary of the evidence with final recommendations being moderated by feedback from experts.RESULTS: Three relevant clinical domains were identified by experts: criteria to initiate treatment; measures to assess patients; evidence for effectiveness of treatments. In a systematic literature search, 129 relevant studies were identified and assessed for methodological quality and classified according to the level of evidence. The final evidence statement consisted of recommendations on eight absolute and four relative contra-indications to mobilization; a core set of nine specific instruments to assess impairments and activity restrictions; and six passive and four active effective interventions, with advice on (a) physiological measures to observe during treatment (with stopping criteria) and (b) what to record after the treatment.CONCLUSIONS: These recommendations form a protocol for treating people in an intensive care unit, based on best available evidence in mid-2014.

KW - Evidence-Based Medicine

KW - Female

KW - Humans

KW - Intensive Care Units

KW - Male

KW - Netherlands

KW - Physical Therapy Modalities

KW - Practice Guidelines as Topic

KW - Treatment Outcome

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

KW - Review

U2 - 10.1177/0269215514567156

DO - 10.1177/0269215514567156

M3 - Article

C2 - 25681407

SN - 0269-2155

VL - 29

SP - 1051

EP - 1063

JO - Clinical Rehabilitation

JF - Clinical Rehabilitation

IS - 11

ER -

Physiotherapy in the intensive care unit: an evidence-based, expert driven, practical statement and rehabilitation recommendations

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