Current Physical Therapy Practice in the Intensive Care Unit in Saudi Arabia: A Multiple Centre Cross-Sectional Survey

Abstract

Background: Early mobilization of patients in the intensive care unit (ICU) is associated with positive health benefits. The available literature does not provide insights into the current status of physical therapy practice in the ICU in the Kingdom of Saudi Arabia (KSA). To determine the current standard of ICU physical therapy practice, attitude, and barriers, an online survey was administered to KSA physiotherapists (PTs) working in the hospitals. Methods: A total of 124 PTs volunteered to participate, and the questionnaire consisted of closed-ended questions with regard to their experiences, qualifications, barriers, and most frequently encountered case scenarios in the ICU. Results: The most commonly referred cases were traumatic paraplegia (n=111, 89%) and stroke (n=102, 82.3%) compared to congestive road traffic accidents (n=20, 16.1%) and pulmonary infections (n=7, 5.6%). The preferred treatment of choice among PTs was chest physiotherapy (n=102, 82.2%) and positioning (n=73, 58.8%), whereas functional electrical stimulation (n=12, 9.6%) was the least preferred choice of physical therapy, irrespective of the condition. The perceived barriers in ICU physical therapy management was low confidence in managing cases (n=89, 71.7%), followed by inadequate training (n=53, 42.7%), and the least mentioned barrier was a communication gap among the critical care team members (n=8, 6.4%). Conclusion: PTs reported significant variation in the choice of treatment for different clinical case scenarios in the ICU. Several facilitators and barriers to physical therapy management should be taken into account to improve ICU recovery. Among the most important barriers are low confidence and inadequate training and strategies needed to overcome these barriers.