Mobilization of patients in neurological Intensive Care Units of India: A survey

Abstract

Context:The rehabilitation needs of the patients in neurological Intensive Care Units (ICUs) vary from that of a medical ICU patient. Early mobilization is known to improve the various neurological outcomes in patients admitted to neurological ICUs, although little is known about the practice pattern among physiotherapists. The mobilization practice pattern may vary significantly than that of developed countries due to the reasons of differences in training of professionals, availability of equipment, and financial assistance by health insurance.Aim of the Study:To study the current mobilization practices by the physiotherapists in neurological ICUs of India.Subjects and Methods:A cross-sectional survey was conducted with a content validated questionnaire about the mobilization practices. Online questionnaire was distributed to physiotherapists working in neurological ICUs of India. Descriptive statistics were used.Results:Out of 185 e-mails sent, 82 physiotherapists completed the survey (survey response rate = 44%). Eighty participants (97.6%) mentioned that the patients received some form of mobilization during the day. The majority of the physiotherapists (58.5%), “always” provided bed mobility exercises to their patients when it was found appropriate for the patients. Many physiotherapists (41.5%) used tilt table “sometimes” to introduce orthostatism for their patients.Conclusion:Mobilization in various forms is being practiced in the neurological ICUs of India. However, fewer mobilization sessions are conducted on weekends and night hours in Indian Neurological ICUs.

Knowledge of physiotherapists working in adult ICU on contraindications to mobilization

“…These findings are in line with those found by Nozawa et al [27], when they determined this professional profile throughout Brazil. Different profiles were found in the studies by Bhat et al [28] and Hale et al [29]. The first conducted in India, showed that more than half of its respondents had just graduated; however, 34% said they had a master's degree, almost 18 times the number found in our study.…”

“…Neurological and/or motor deficits and/or musculoskeletal limitations that make mobilization impossible: they constitute contraindications in 3, paragraphs II, VI, VII, VIII, X and XII, which briefly state that the physiotherapist is responsible for evaluating, prescribing and carrying out the rehabilitation of critical patients but that the multidisciplinary team's assistance is essential for a differentiated assessment and safe mobilization [17,[28][29][30][31].…”

Combined Effect of Intercostal Stretch Technique and Perioral Stimulation Technique on Respiratory Rate and Saturation of Peripheral Oxygen Among ICU Patients

“…Independent t test was used to see the treatment effect between two groups for RR and SpO2. (16) IC stretch is performed actively by thoracic mobility exercises. Passively IC stretch can be performed by thoracic rotation, mid sternum rotation, lateral thoracic stretching, through thoracic mobility exercises as well as through manual stretching of IC spaces.…”

Benefícios Da Mobilização Precoce a Partir Do Uso Da Prancha Ortostática Em Pacientes Atendidos Em Unidade De Terapia Intensiva

“…As pesquisas feitas nos bancos de dados resultaram em 70 artigos, dos quais 68 foram excluídos de acordo com os critérios de exclusão pré-estabelecidos anteriormente, sendo selecionados e avaliados 2 artigos (BHAT et al, 2016;HASHIM et al, 2012;SIBINELLI et al, 2015). Estes estão apresentados no quadro 1 a seguir, em ordem alfabética: Os artigos apresentados neste estudo (HASHIM et al, 2012;SIBINELLI et al, 2015) não relataram mudanças em relação ao nível neurológico dos pacientes.…”