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 - Journal Article
KW - Male
KW - Netherlands
KW - Physical Therapy Modalities
KW - Practice Guidelines as Topic
KW - Research Support, Non-U.S. Gov't
KW - Review
KW - Treatment Outcome
UR - https://pure.hva.nl/ws/files/5750471/suppl_appendix.pdf
U2 - https://doi.org/10.1177/0269215514567156
DO - https://doi.org/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 -