Rehabilitation for People With Critical Illness: Taking the Next Steps

Abstract

Due to the omission of several references, the original, published editorial has been replaced by this corrected version. This special series on rehabilitation for people with critical illness (published in 2 issues—December 2012 and February 2013) presents recent advances in managing critical illness across the continuum of care, from the intensive care unit (ICU) to the community setting. The series also raises awareness of the essential role that physical therapists and rehabilitation and critical care professionals play in this growing patient population. The articles in this issue showcase important research conducted by established authors in the field, including physical therapists from across the United States and from Australia. In February 2013, articles will highlight innovative quality improvement initiatives, discuss key considerations for the profession, illustrate educational strategies, and describe novel cases. Improvements in managing the care of patients with critical illness have resulted in an increasing number of survivors.1 However, survivors of critical illness often experience “post–intensive care syndrome,”2 with long-lasting physical impairments, including muscle weakness and decreased functional ability3 and neuropsychiatric dysfunction.4 These consequences of critical illness often lead to decreased quality of life.5,6 Early intervention by physical therapists and other rehabilitation and critical care professionals is feasible and safe for patients in respiratory,7 medical,8 and surgical9 ICUs. Moreover, early rehabilitation in the ICU is associated with many short-term benefits, including decreased duration of mechanical ventilation, shorter ICU and hospital lengths of stay, shorter duration of delirium, and improved functional outcomes.8,10–12 Throughout a 1-year follow-up, early rehabilitation during the ICU stay also is associated with decreased hospital readmission and mortality rates.13 With this growing body of evidence, interest in early rehabilitation in the ICU is rapidly increasing, likely resulting in significant change from …