Home and Community-Based Physical Therapist Management of Adults With Post–Intensive Care Syndrome. Issue 7 (13th April 2020)

• Record Type: Journal Article
• Authors: Smith, James M; Lee, Alan C; Zeleznik, Hallie; Coffey Scott, Jacqueline P; Fatima, Arooj; Needham, Dale M; Ohtake, Patricia J
• Is Part Of: Physical therapy. Volume 100:Issue 7(2020)
• Page Start: 1062
• Page End: 1073
• Publication Date: 2020-04-13
• Subjects: Critical Illness -- Ambulatory Care -- Outpatients -- Post-Intensive Care Syndrome; Physical therapy -- Periodicals; Physical therapy; Physical Therapy Modalities; Rehabilitation; Physical and Rehabilitation Medicine; Periodicals; 615.8205
• DOI: 10.1093/ptj/pzaa059
• Languages: English
• ISSNs: 0031-9023

Abstract

Abstract: More than 4 million adults survive a stay in the intensive care unit each year, with many experiencing new or worsening physical disability, mental health problems, and/or cognitive impairments, known as post-intensive care syndrome (PICS). Given the prevalence and magnitude of physical impairments after critical illness, many survivors, including those recovering from COVID-19, could benefit from physical therapist services after hospital discharge. However, due to the relatively recent recognition and characterization of PICS, there may be limited awareness and understanding of PICS among physical therapists practicing in home health care and community-based settings. This lack of awareness may lead to inappropriate and/or inadequate rehabilitation service provision. While this perspective article provides information relevant to all physical therapists, it is aimed toward those providing rehabilitation services outside of the acute and postacute inpatient settings. This article reports the prevalence and clinical presentation of PICS and provides recommendations for physical examination and outcomes measures, plan of care, and intervention strategies. The importance of providing patient and family education, coordinating community resources including referring to other health care team members, and community-based rehabilitation service options is emphasized. Finally, this perspective article discusses current challenges for optimizing outcomes for people with PICS and suggests future directions for research and practice.