Three-Fourths of ICU Physical Therapists Report Use of Assistive Equipment and Technology in Practice: Results of an International Survey

Abstract

Introduction: Patients surviving critical illness develop persistent functional mobility impairments that significantly impact their quality of life. Early rehabilitation interventions in the intensive care unit (ICU) may mitigate the sequelae of critical illness. However, implementation of such interventions is very low in clinical practice. Assistive rehabilitation equipment and technology, such as tilt beds and cycle ergometers, provide physical therapists (PTs) with strategies to complement functional mobility interventions. Purpose: To determine PTs' self-reported use of assistive rehabilitation equipment and technology in their clinical practices in the ICU and to describe the rationale for their use. Methods: An online survey (Qualtrics), with closed- and open-ended questions, was distributed to PTs working in the ICU, via e-mail through the Academy of Acute Care Physical Therapy “PTinICU” e-mail listserv and the online ICU Recovery Network and Twitter. Descriptive statistics were used to assess frequency and rationale for the use of specific equipment and technology. Results: PTs (n = 206, mean age 39.6 ± 9.7 years, 82% female) completed the survey (81% in the United States and 19% from 12 countries outside of the United States). Respondents (153/206, 74%) reported using at least one type of equipment or technology. The most commonly used were hospital tilt beds and tilt tables (n = 106, 51%), mobilization chairs (n = 80, 39%), standing frames (n= 66, 32%), cycle ergometers (n = 63, 31%), and exercise platforms (n = 36, 17%). The most common rationale for use was as a bridge to functional mobility (response ranging from 17% to 44% depending on the technology). The most common reason for not using equipment or technology was limited or no access (71%, 37/53). PTs from outside the United States (vs US-based PTs) reported greater use of equipment or technology (n = 206, 92% vs 70%, P = .001). Conclusions: Approximately 75% of PTs completing this survey report use of assistive rehabilitation equipment and technology in their ICU clinical practice, emphasizing the need for further research to understand the clinical approaches for use and the efficacy of such technology.