Effects of 24-hours/day versus business hours physical therapy intervention in adult intensive care unit patients: a systematic review

Abstract

Background: Some evidence suggests that higher doses of mobilization could have benefits on functional status. However, the impact of increasing the availability of Physical Therapist in the intensive care unit to provide critical care for these conditions is unclear. Objective: to determine the effect of physical therapy 24-hour/7days on the length of stay, index of respiratory system infection, days of mechanical ventilation, mortality and quality of life, in adult patients admitted to an intensive care unit. Methods and design: The databases EMBASE, MEDLINE, PUBMED, and reference lists of previous reviews were searched for clinical trials and observational studies, without restriction on language or publication date. Four reviewers independently screened articles for eligibility, and included studies were appraised using the ROBINS-I risk of bias tool for non-randomised studies. Results: 4509 records were screened. Two prospective cohorts were included in the review. Both studies reported significant improvements in length of intensive care unit stay and days of mechanical ventilation, while the index of respiratory system infection and mortality had unclear improvement. No studies reported quality of life in patients. Conclusion: There was insufficient robust data to conclude that increasing availability of physical therapy beyond business hours could shorten the length of ICU stay and days of mechanical ventilation. Further studies are required to increase certainty about the effectiveness of Physical Therapist intervention 24-hours/7 days in intensive care unit.