Rehabilitation Therapies in the Intensive Care Unit (ICU)

Sinai Rehab ICURehabilitation therapists working on the ICU are specifically trained to treat patients with complex medical issues resulting from a stroke, spinal cord injury, trauma, surgery or other complicated conditions. The frequency and type of rehabilitation treatment offered is wholly dependent on patients’ medical status and ability to participate. Therapists are part of a multidisciplinary group in the ICU that includes medical, surgical, cardiac and neurological teams, consisting of physicians, nurses, critical care technicians, respiratory therapists, and social work case managers. ICU patients may require mechanical ventilation to assist with breathing and close monitoring, due to critical illness.

As ordered by a physician, a physical therapist (PT) can begin early mobility with the patient to help avoid complications associated with excessive bedrest. Activities range from exercises in bed to supervised walking, depending on current status. Specialized equipment is available to assist with mobility such as hoyer lifts, sliding boards, tilt table, specialty chairs, beds and cushions, and assistive devices.

Consults by an occupational therapist (OT) may address activities of daily living (ADLs), splinting to improve hand functioning, and the creation of exercise programs for overall health. In addition, OTs can assess for changes in vision, cognition, safety awareness, and aid in ICU delirium prevention. Adaptive equipment and compensatory strategies to assist the patient in performing ADLs may also be recommended by the therapist.

A speech language pathologist (SLP) may be consulted for assessment and early treatment of communication, cognitive, and swallowing difficulties (dysphagia). The dysphagia assessment will determine the safest form of nutrition and hydration for a patient. An SLP is especially helpful to patients who have suffered a stroke, had a tracheostomy or are ventilator dependent.

Upon a patient’s discharge from the ICU, the treating rehabilitation therapists will make recommendations for the next level of care and any durable medical equipment needed for home. Helping a patient achieve their maximal functioning is the primary goal of rehabilitation therapy.