Intensive Care Medicine

, Volume 34, Issue 7, pp 1188–1199 | Cite as

Physiotherapy for adult patients with critical illness: recommendations of the European Respiratory Society and European Society of Intensive Care Medicine Task Force on Physiotherapy for Critically Ill Patients

  • R. Gosselink
  • J. Bott
  • M. Johnson
  • E. Dean
  • S. Nava
  • M. Norrenberg
  • B. Schönhofer
  • K. Stiller
  • H. van de Leur
  • J. L. Vincent
ESICM Statement

Abstract

The Task Force reviewed and discussed the available literature on the effectiveness of physiotherapy for acute and chronic critically ill adult patients. Evidence from randomized controlled trials or meta-analyses was limited and most of the recommendations were level C (evidence from uncontrolled or nonrandomized trials, or from observational studies) and D (expert opinion). However, the following evidence-based targets for physiotherapy were identified: deconditioning, impaired airway clearance, atelectasis, intubation avoidance, and weaning failure. Discrepancies and lack of data on the efficacy of physiotherapy in clinical trials support the need to identify guidelines for physiotherapy assessments, in particular to identify patient characteristics that enable treatments to be prescribed and modified on an individual basis. There is a need to standardize pathways for clinical decision-making and education, to define the professional profile of physiotherapists, and increase the awareness of the benefits of prevention and treatment of immobility and deconditioning for critically ill adult patients.

Supplementary material

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Electronic Supplementary Material (DOC 390K)

References

  1. 1.
    Ackerman MH, Mick DJ (1998) Instillation of normal saline before suctioning in patients with pulmonary infections: a prospective randomized controlled trial. Am J Crit Care 7:261–266PubMedGoogle Scholar
  2. 2.
    Aguilo R, Togores B, Salvador P, Rubi M, Barbe F, Agust A (1997) Non-invasive ventilatory support after lung resectional surgery. Chest 112:117–121PubMedGoogle Scholar
  3. 3.
    Aldrich TK, Karpel JP, Uhrlass RM, Sparapani MA, Eramo D, Ferranti R (1989) Weaning from mechanical ventilation: adjunctive use of inspiratory muscle resistive training. Crit Care Med 17:143–147PubMedGoogle Scholar
  4. 4.
    Anonymous (1992) AARC clinical practice guideline. Nasotracheal suctioning. American Association for Respiratory Care (update 2004). Respir Care 37:1176–1179Google Scholar
  5. 5.
    Bach JR, Saporito LR (1996) Criteria for extubation and tracheostomy tube removal for patients with ventilatory failure. A different approach to weaning. Chest 110:1566–1571PubMedGoogle Scholar
  6. 6.
    Bailey P, Thomsen GE, Spuhler VJ, Blair R, Jewkes J, Bezdjian L, Veale K, Rodriquez L, Hopkins RO (2007) Early activity is feasible and safe in respiratory failure patients. Crit Care Med 35:139–145PubMedGoogle Scholar
  7. 7.
    Berney S, Denehy L (2002) A comparison of the effects of manual and ventilator hyperinflation on static lung compliance and sputum production in intubated and ventilated intensive care patients. Physiother Res Int 7:100–108PubMedGoogle Scholar
  8. 8.
    Berney S, Denehy L, Pretto J (2004) Head-down tilt and manual hyperinflation enhance sputum clearance in patients who are intubated and ventilated. Aust J Physiother 50:9–14PubMedGoogle Scholar
  9. 9.
    Blackwood B (1999) Normal saline instillation with endotracheal suctioning: primum non nocere (first do no harm). J Adv Nurs 29:928–934PubMedGoogle Scholar
  10. 10.
    Bott J, Carroll MP, Conway JH, Keilty SE, Ward EM, Brown AM, Paul EA, Elliot MW, Godfrey RC, Wedzicha JA, Moxham J (1993) Randomised controlled trial of nasal ventilation in acute ventilatory failure due to chronic obstructive airways disease. Lancet 341:1555–1557PubMedGoogle Scholar
  11. 11.
    Burtin C, Clerckx B, Robbeets C, Gall S, Pillen R, Leclercq H, Caluwé K, Lommers B, Wilmer A, Troosters T, Ferdinande P, Gosselink R (2006) Effectiveness of early exercise in critically ill patients: preliminary results. Intensive Care Med 32:109Google Scholar
  12. 12.
    Capdevila XJ, Perrigault PF, Perey PJ, Roustan JP, d’Athis F (1995) Occlusion pressure and its ratio to maximum inspiratory pressure are useful predictors for successful extubation following T-piece weaning trial. Chest 108:482–489PubMedGoogle Scholar
  13. 13.
    Carson SS, Bach PB (2002) The epidemiology and costs of chronic critical illness. Crit Care Clin 18:461–476PubMedGoogle Scholar
  14. 14.
    Chang A, Paratz J, Rollston J (2002) Ventilatory effects of neurophysiological facilitation and passive movement in patients with neurological injury. Aust J Physiother 48:305–310PubMedGoogle Scholar
  15. 15.
    Chang AT, Boots R, Hodges PW, Paratz J (2004) Standing with assistance of a tilt table in intensive care: a survey of Australian physiotherapy practice. Aust J Physiother 50:51–54PubMedGoogle Scholar
  16. 16.
    Chiang LL, Wang LY, Wu CP, Wu HD, Wu YT (2006) Effects of physical training on functional status in patients with prolonged mechanical ventilation. Phys Ther 86:1271–1281PubMedGoogle Scholar
  17. 17.
    Combes A, Costa MA, Trouillet JL, Baudot J, Mokhtari M, Gibert C, Chastre J (2003) Morbidity, mortality, and quality-of-life outcomes of patients requiring > or = 14 days of mechanical ventilation. Crit Care Med 31:1373–1381PubMedGoogle Scholar
  18. 18.
    Confalonieri M, Potena A, Carbone G, Porta RD, Tolley EA, Umberto MG (1999) Acute respiratory failure in patients with severe community-acquired pneumonia. A prospective randomized evaluation of noninvasive ventilation. Am J Respir Crit Care Med 160:1585–1591PubMedGoogle Scholar
  19. 19.
    Copnell B, Fergusson D (1995) Endotracheal suctioning: time-worn ritual or timely intervention? Am J Crit Care 4:100–105PubMedGoogle Scholar
  20. 20.
    Corrado A, Roussos C, Ambrosino N, Confalonieri M, Cuvelier A, Elliott M, Ferrer M, Gorini M, Gurkan O, Muir JF, Quareni L, Robert D, Rodenstein D, Rossi A, Schoenhofer B, Simonds AK, Strom K, Torres A, Zakynthinos S (2002) Respiratory intermediate care units: a European survey. Eur Respir J 20:1343–1350PubMedGoogle Scholar
  21. 21.
    De Jonghe B, Bastuji-Garin S, Sharshar T, Outin H, Brochard L (2004) Does ICU-acquired paresis lengthen weaning from mechanical ventilation? Intensive Care Med 30:1117–1121PubMedGoogle Scholar
  22. 22.
    Dean E (1997) Oxygen transport deficits in systemic disease and implications for physical therapy. Phys Ther 77:187–202PubMedGoogle Scholar
  23. 23.
    Dean E, Ross J (1992) Discordance between cardiopulmonary physiology and physical therapy. Toward a rational basis for practice. Chest 101:1694–1698PubMedGoogle Scholar
  24. 24.
    Dehaven CB Jr., Hurst JM, Branson RD (1985) Postextubation hypoxemia treated with a continuous positive airway pressure mask. Crit Care Med 13:46–48PubMedGoogle Scholar
  25. 25.
    Dodek P, Keenan S, Cook D, Heyland D, Jacka M, Hand L, Muscedere J, Foster D, Mehta N, Hall R, Brun-Buisson C (2004) Evidence-based clinical practice guideline for the prevention of ventilator-associated pneumonia. Ann Intern Med 141:305–313PubMedGoogle Scholar
  26. 26.
    Eisner MD, Thompson T, Hudson LD, Luce JM, Hayden D, Schoenfeld D, Matthay MA (2001) Efficacy of low tidal volume ventilation in patients with different clinical risk factors for acute lung injury and the acute respiratory distress syndrome. Am J Respir Crit Care Med 164:231–236PubMedGoogle Scholar
  27. 27.
    Ely EW, Baker AM, Dunagan DP, Burke HL, Smith AC, Kelly PT, Johnson MM, Browder RW, Bowton DL, Haponik EF (1996) Effect on the duration of mechanical ventilation of identifying patients capable of breathing spontaneously. N Engl J Med 335:1864–1869PubMedGoogle Scholar
  28. 28.
    Esteban A, Alia I, Ibanez J, Benito S, Tobin MJ (1994) Modes of mechanical ventilation and weaning. A national survey of Spanish hospitals. The Spanish Lung Failure Collaborative Group. Chest 106:1188–1193PubMedGoogle Scholar
  29. 29.
    Fletcher SN, Kennedy DD, Ghosh IR, Misra VP, Kiff K, Coakley JH, Hinds CJ (2003) Persistent neuromuscular and neurophysiologic abnormalities in long-term survivors of prolonged critical illness. Crit Care Med 31:1012–1016PubMedGoogle Scholar
  30. 30.
    Fontaine DK (1994) Nonpharmacologic management of patient distress during mechanical ventilation. Crit Care Clin 10:695–708PubMedGoogle Scholar
  31. 31.
    Gayan-Ramirez G, Decramer M (2002) Effects of mechanical ventilation on diaphragm function and biology. Eur Respir J 20:1579–1586PubMedGoogle Scholar
  32. 32.
    Gayan-Ramirez G, Testelmans D, Maes K, Racz GZ, Cadot P, Zador E, Wuytack F, Decramer M (2005) Intermittent spontaneous breathing protects the rat diaphragm from mechanical ventilation effects. Crit Care Med 33:2804–2809PubMedGoogle Scholar
  33. 33.
    Gibson JNA, Smith K, Rennie MJ (1988) Prevention of disuse muscle atrophy by means of electrical stimulation: maintenance of protein synthesis. Lancet 2(8614):767–769PubMedGoogle Scholar
  34. 34.
    Goldman JM, Rose LS, Williams SJ, Silver JR, Denison DM (1986) Effect of abdominal binders on breathing in tetraplegic patients. Thorax 41:940–945PubMedGoogle Scholar
  35. 35.
    Gomez-Merino E, Sancho J, Marin J, Servera E, Blasco ML, Belda FJ, Castro C, Bach JR (2002) Mechanical insufflation-exsufflation: pressure, volume, and flow relationships and the adequacy of the manufacturer’s guidelines. Am J Phys Med Rehabil 81:579–583PubMedGoogle Scholar
  36. 36.
    Greenbaum DM, Millen JE, Eross B, Snyder JV, Grenvik A, Safar P (1976) Continuous positive airway pressure without tracheal intubation in spontaneously breathing patients. Chest 69:615–620PubMedGoogle Scholar
  37. 37.
    Gregg RW, Friedman BC, Williams JF, McGrath BJ, Zimmerman JE (1990) Continuous positive airway pressure by face mask in Pneumocystis carinii pneumonia. Crit Care Med 18:21–24PubMedGoogle Scholar
  38. 38.
    Griffiths RD, Palmer A, Helliwell T, Maclennan P, Macmillan RR (1995) Effect of passive stretching on the wasting of muscle in the critically ill. Nutrition 11:428–432PubMedGoogle Scholar
  39. 39.
    Grill E, Quittan M, Huber EO, Boldt C, Stucki G (2005) Identification of relevant ICF categories by health professionals in the acute hospital. Disabil Rehabil 27:437–445PubMedGoogle Scholar
  40. 40.
    Hall JB, Wood LD (1987) Liberation of the patient from mechanical ventilation. JAMA 257:1621–1628PubMedGoogle Scholar
  41. 41.
    Herridge MS, Cheung AM, Tansey CM, Matte-Martyn A, Diaz-Granados N, Al Saidi F, Cooper AB, Guest CB, Mazer CD, Mehta S, Stewart TE, Barr A, Cook D, Slutsky AS (2003) One-year outcomes in survivors of the acute respiratory distress syndrome. N Engl J Med 348:683–693PubMedGoogle Scholar
  42. 42.
    Hinderer SR, Dixon K (2001) Physiologic and clinical monitoring of spastic hypertonia. Phys Med Rehabil Clin N Am 12:733–746PubMedGoogle Scholar
  43. 43.
    Hodgson C, Ntoumenopoulos G, Dawson H, Paratz J (2007) The Mapleson C circuit clears more secretions than the Laerdal circuit during manual hyperinflation in mechanically-ventilated patients: a randomised cross-over trial. Aust J Physiother 53:33–38PubMedGoogle Scholar
  44. 44.
    Holliday JE, Hyers TM (1990) The reduction of weaning time from mechanical ventilation using tidal volume and relaxation biofeedback. Am Rev Respir Dis 141:1214–1220PubMedGoogle Scholar
  45. 45.
    Ibanez J, Raurich JM, Abizanda R, Claramonte R, Ibanez P, Bergada J (1981) The effect of lateral positions on gas exchange in patients with unilateral lung disease during mechanical ventilation. Intensive Care Med 7:231–234PubMedGoogle Scholar
  46. 46.
    Jenkins SC, Soutar SA, Moxham J (1988) The effects of posture on lung volumes in normal subjects and in patients pre- and post-coronary artery surgery. Physiotherapy 74:492–496Google Scholar
  47. 47.
    Jones AYM, Hutchinson RC, Oh TE (1992) Chest physiotherapy practice in intensive care units in Australia, the UK and Hong Kong. Physiother Theory Pract 8:39–47Google Scholar
  48. 48.
    Jones C, Macmillan RR, Griffiths RD (1994) Providing psychological support for patients after critical illness. Clin Intensive Care 5:176–179PubMedGoogle Scholar
  49. 49.
    Jones C, Skirrow P, Griffiths RD, Humphris GH, Ingleby S, Eddleston J, Waldmann C, Gager M (2003) Rehabilitation after critical illness: a randomized, controlled trial. Crit Care Med 31:2456–2461PubMedGoogle Scholar
  50. 50.
    King J, Crowe J (1998) Mobilization practices in Canadian critical care units. Physiother Can 50:206–211Google Scholar
  51. 51.
    Kollef MH, Shapiro SD, Silver P, St.John RE, Prentice D, Sauer S, Ahrens TS, Shannon W, Baker-Clinkscale D (1997) A randomized, controled trial of protocol-directed versus physician-directed weaning from mechanical ventilation. Crit Care Med 25:567–574PubMedGoogle Scholar
  52. 52.
    Kraemer WJ, Adams K, Cafarelli E, Dudley GA, Dooly C, Feigenbaum MS, Fleck SJ, Franklin B, Fry AC, Hoffman JR, Newton RU, Potteiger J, Stone MH, Ratamess NA, Triplett-McBride T (2002) American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Med Sci Sports Exerc 34:364–380PubMedGoogle Scholar
  53. 53.
    Kramer N, Meyer TJ, Meharg J, Cece RD, Hill NS (1995) Randomized, prospective trial of noninvasive positive pressure ventilation in acute respiratory failure. Am J Respir Crit Care Med 151:1799–1806PubMedGoogle Scholar
  54. 54.
    Krishnan JA, Moore D, Robeson C, Rand CS, Fessler HE (2004) A prospective, controlled trial of a protocol-based strategy to discontinue mechanical ventilation. Am J Respir Crit Care Med 169:673–678PubMedGoogle Scholar
  55. 55.
    Kwan MW, Ha KW (2002) Splinting programme for patients with burnt hand. Hand Surg 7:231–241PubMedGoogle Scholar
  56. 56.
    Laghi F, Cattapan SE, Jubran A, Parthasarathy S, Warshawsky P, Choi YS, Tobin MJ (2003) Is weaning failure caused by low-frequency fatigue of the diaphragm? Am J Respir Crit Care Med 167:120–127PubMedGoogle Scholar
  57. 57.
    Langou RA, Wolfson S, Olson EG, Cohen LS (1977) Effects of orthostatic postural changes on myocardial oxygen demands. Am J Cardiol 39:418–421PubMedGoogle Scholar
  58. 58.
    Lindgren S, Almgren B, Hogman M, Lethvall S, Houltz E, Lundin S, Stenqvist O (2004) Effectiveness and side effects of closed and open suctioning: an experimental evaluation. Intensive Care Med 30:1630–1637PubMedGoogle Scholar
  59. 59.
    Lorente L, Lecuona M, Martin MM, Garcia C, Mora ML, Sierra A (2005) Ventilator-associated pneumonia using a closed versus an open tracheal suction system. Crit Care Med 33:115–119PubMedGoogle Scholar
  60. 60.
    Mackenzie CF, Shin B (1985) Cardiorespiratory function before and after chest physiotherapy in mechanically ventilated patients with post-traumatic respiratory failure. Crit Care Med 13:483–486PubMedGoogle Scholar
  61. 61.
    Mancinelli-Van Atta J, Beck SL (1992) Preventing hypoxemia and hemodynamic compromise related to endotracheal suctioning. Am J Crit Care 1:62–79PubMedGoogle Scholar
  62. 62.
    Marini JJ, Pierson DJ, Hudson LD (1979) Acute lobar atelectasis: a prospective comparison of fiberoptic bronchoscopy and respiratory therapy. Am Rev Respir Dis 119:971–978PubMedGoogle Scholar
  63. 63.
    Marini JJ, Smith TC, Lamb V (1986) Estimation of inspiratory muscle strength in mechanically ventilated patients: the measurement of maximal inspiratory pressure. J Crit Care 1:32–38Google Scholar
  64. 64.
    Martin AD, Davenport PD, Franceschi AC, Harman E (2002) Use of inspiratory muscle strength training to facilitate ventilator weaning: a series of 10 consecutive patients. Chest 122:192–196PubMedGoogle Scholar
  65. 65.
    Martin D, Davenport PW, Gonzalez-Rothi J, Baz M, Banner J, Caruso L, Layon J, Gabrielli A (2006) Inspiratory muscle strength training improves outcome in failure to wean patients. p 369sGoogle Scholar
  66. 66.
    Martin UJ, Hincapie L, Nimchuk M, Gaughan J, Criner GJ (2005) Impact of whole-body rehabilitation in patients receiving chronic mechanical ventilation. Crit Care Med 33:2259–2265PubMedGoogle Scholar
  67. 67.
    Masip J, Roque M, Sanchez B, Fernandez R, Subirana M, Exposito JA (2005) Noninvasive ventilation in acute cardiogenic pulmonary edema: systematic review and meta-analysis. JAMA 294:3124–3130PubMedGoogle Scholar
  68. 68.
    Maxwell L, Ellis E (1998) Secretion clearance by manual hyperinflation: possible mechanisms. Physiother Theory Pract 14:189–197Google Scholar
  69. 69.
    Milberg JA, Davis DR, Steinberg KP, Hudson LD (1995) Improved survival of patients with acute respiratory distress syndrome (ARDS): 1983–1993. JAMA 273:306–309PubMedGoogle Scholar
  70. 70.
    Montuclard L, Garrouste-Org, Timsit JF, Misset B, De Jonghe B, Carlet J (2000) Outcome, functional autonomy, and quality of life of elderly patients with a long-term intensive care unit stay. Crit Care Med 28:3389–3395PubMedGoogle Scholar
  71. 71.
    Morris PE (2007) Early mobility of the ICU patient. Crit Care Clin 23:1–116PubMedGoogle Scholar
  72. 72.
    Moser DK, Chung ML, McKinley S, Riegel B, An K, Cherrington CC, Blakely W, Biddle M, Frazier SK, Garvin BJ (2003) Critical care nursing practice regarding patient anxiety assessment and management. Intensive Crit Care Nurs 19:276–288PubMedGoogle Scholar
  73. 73.
    Nava S (1998) Rehabilitation of patients admitted to a respiratory intensive care unit. Arch Phys Med Rehabil 79:849–854PubMedGoogle Scholar
  74. 74.
    Nava S, Ambrosino N, Clini E, Prato M, Orlando G, Vitacca M, Brigada P, Fracchia C, Rubini F (1998) Noninvasive mechanical ventilation in the weaning of patients with respiratory failure due to chronic obstructive pulmonary disease. A randomized, controlled trial. Ann Intern Med 128:721–728PubMedGoogle Scholar
  75. 75.
    Nava S, Gregoretti C, Fanfulla F, Squadrone E, Grassi M, Carlucci A, Beltrame F, Navalesi P (2005) Noninvasive ventilation to prevent respiratory failure after extubation in high-risk patients. Crit Care Med 33:2465–2470PubMedGoogle Scholar
  76. 76.
    Nelson BJ, Weinert CR, Bury CL, Marinelli WA, Gross CR (2000) Intensive care unit drug use and subsequent quality of life in acute lung injury patients. Crit Care Med 28:3626–3630PubMedGoogle Scholar
  77. 77.
    Norrenberg M, Vincent JL (2000) A profile of European intensive care unit physiotherapists. European Society of Intensive Care Medicine. Intensive Care Med 26:988–994PubMedGoogle Scholar
  78. 78.
    Paratz J, Burns Y (1993) The effect of respiratory physiotherapy on intracranial pressure, mean arterial pressure, cerebral perfusion pressure and end tidal carbon dioxide in ventilated neurosurgical patients. Physiother Theory Pract 9:3–11Google Scholar
  79. 79.
    Partsch H (2002) Bed rest versus ambulation in the initial treatment of patients with proximal deep vein thrombosis. Curr Opin Pulm Med 8:389–393PubMedGoogle Scholar
  80. 80.
    Plant PK, Owen JL, Parrott S, Elliott MW (2003) Cost effectiveness of ward based non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease: economic analysis of randomised controlled trial. BMJ 326:956PubMedGoogle Scholar
  81. 81.
    Polkey MI, Moxham J (2001) Clinical aspects of respiratory muscle dysfunction in the critically ill. Chest 119:926–939PubMedGoogle Scholar
  82. 82.
    Porta R, Vitacca M, Gile LS, Clini E, Bianchi L, Zanotti E, Ambrosino N (2005) Supported arm training in patients recently weaned from mechanical ventilation. Chest 128:2511–2520PubMedGoogle Scholar
  83. 83.
    Ram FS, Lightowler JV, Wedzicha JA (2003) Non-invasive positive pressure ventilation for treatment of respiratory failure due to exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev CD004104Google Scholar
  84. 84.
    Redfern J, Ellis E, Holmes W (2001) The use of a pressure manometer enhances student physiotherapists’ performance during manual hyperinflation. Aust J Physiother 47:121–131PubMedGoogle Scholar
  85. 85.
    Richard R, Ward RS (2005) Splinting strategies and controversies. J Burn Care Rehabil 26:392–396PubMedGoogle Scholar
  86. 86.
    Richards K, Nagel C, Markie M, Elwell J, Barone C (2003) Use of complementary and alternative therapies to promote sleep in critically ill patients. Crit Care Nurs Clin North Am 15:329–340PubMedGoogle Scholar
  87. 87.
    Richards KC (1994) Sleep promotion in the critical care unit. AACN Clin Issues Crit Care Nurs 5:152–158PubMedGoogle Scholar
  88. 88.
    Richards KC, Gibson R, Overton-McCoy AL (2000) Effects of massage in acute and critical care. AACN Clin Issues 11:77–96PubMedGoogle Scholar
  89. 89.
    Rocker GM, Mackenzie MG, Williams B, Logan PM (1999) Noninvasive positive pressure ventilation: successful outcome in patients with acute lung injury/ARDS. Chest 115:173–177PubMedGoogle Scholar
  90. 90.
    Roussos C (1985) Function and fatigue of respiratory muscles. Chest 88:124S–132SPubMedGoogle Scholar
  91. 91.
    Salter RB (1989) The biologic concept of continuous passive motion of synovial joints. The first 18 years of basic research and its clinical application. Clin Orthop Relat Res 242:12–25Google Scholar
  92. 92.
    Schwartz Cowley R, Swanson B, Chapman P, Mackay LE (1994) The role of rehabilitation in the intensive care unit. J Head Trauma Rehabil 9:32–42CrossRefGoogle Scholar
  93. 93.
    Sharp JT, Druz WS, Moisan T, Foster J, Machnach W (1980) Postural relief of dyspnea in severe chronic obstructive pulmonary disease. Am Rev Respir Dis 122:201–211PubMedGoogle Scholar
  94. 94.
    Sim J (1998) Interpersonal aspects of care: communication, counselling and health education. In: Pryor JA, Webber BA (eds) Physiotherapy for respiratory and cardiac problems. Churchill Livingstone, Edinburgh, pp 211–226Google Scholar
  95. 95.
    Singer M, Vermaat J, Hall G, Latter G, Patel M (1994) Hemodynamic effects of manual hyperinflation in critically ill mechanically ventilated patients. Chest 106:1182–1187PubMedGoogle Scholar
  96. 96.
    Sivasothy P, Brown L, Smith IE, Shneerson JM (2001) Effect of manually assisted cough and mechanical insufflation on cough flow of normal subjects, patients with chronic obstructive pulmonary disease (COPD), and patients with respiratory muscle weakness. Thorax 56:438–444PubMedGoogle Scholar
  97. 97.
    Squadrone V, Coha M, Cerutti E, Schellino MM, Biolino P, Occella P, Belloni G, Vilianis G, Fiore G, Cavallo F, Ranieri VM (2005) Continuous positive airway pressure for treatment of postoperative hypoxemia: a randomized controlled trial. JAMA 293:589–595PubMedGoogle Scholar
  98. 98.
    Stiller K (2000) Physiotherapy in intensive care. Towards an evidence based practice. Chest 118:1801–1813PubMedGoogle Scholar
  99. 99.
    Stiller K, Jenkins S, Grant R, Geake T, Taylor J, Hall B (1996) Acute lobar atelectasis: a comparisosn of five physiotherapy regimens. Physiother Theory Pract 12:197–209Google Scholar
  100. 100.
    Stiller K, Philips A (2003) Safety aspects of mobilising acutely ill patients. Physiother Theory Pract 19:239–257Google Scholar
  101. 101.
    Stoll C, Schelling G, Goetz AE, Kilger E, Bayer A, Kapfhammer HP, Rothenhausler HB, Kreuzer E, Reichart B, Peter K (2000) Health-related quality of life and post-traumatic stress disorder in patients after cardiac surgery and intensive care treatment. J Thorac Cardiovasc Surg 120:505–512PubMedGoogle Scholar
  102. 102.
    Stoller JK, Mascha EJ, Kester L, Haney D (1998) Randomized controlled trial of physician-directed versus respiratory therapy consult service-directed respiratory care to adult non-ICU inpatients. Am J Respir Crit Care Med 158:1068–1075PubMedGoogle Scholar
  103. 103.
    Thomas DC, Kreizman IJ, Melchiorre P, Ragnarsson KT (2002) Rehabilitation of the patient with chronic critical illness. Crit Care Clin 18:695–715PubMedGoogle Scholar
  104. 104.
    Topp R, Ditmyer M, King K, Doherty K, Hornyak J III (2002) The effect of bed rest and potential of prehabilitation on patients in the intensive care unit. AACN Clin Issues 13:263–276PubMedGoogle Scholar
  105. 105.
    Unoki T, Kawasaki Y, Mizutani T, Fujino Y, Yanagisawa Y, Ishimatsu S, Tamura F, Toyooka H (2005) Effects of expiratory rib-cage compression on oxygenation, ventilation, and airway-secretion removal in patients receiving mechanical ventilation. Respir Care 50:1430–1437PubMedGoogle Scholar
  106. 106.
    Van ’t Hul A, Gosselink R, Hollander P, Postmus P, Kwakkel G (2006) Training with inspiratory pressure support in patients with severe COPD. Eur Respir J 27:65–72PubMedGoogle Scholar
  107. 107.
    Walsh D (1991) Nocioceptive pathways – relevance to the physiotherapist. Physiotherapy 77:317–321CrossRefGoogle Scholar
  108. 108.
    Wenger NK (1982) Early ambulation: the physiologic basis revisited. Adv Cardio 31:138–141Google Scholar
  109. 109.
    Winkelman C, Higgins PA, Chen YJ, Levine AD (2007) Cytokines in chronically critically ill patients after activity and rest. Biol Res Nurs 8:261–271PubMedGoogle Scholar
  110. 110.
    Wood CJ (1998) Endotracheal suctioning: a literature review. Intensive Crit Care Nurs 14:124–136PubMedGoogle Scholar
  111. 111.
    Yang KL, Tobin MJ (1991) A prospective study of indexes predicting the outcome of trials of weaning from mechanical ventilation. N Engl J Med 234:1445–1450CrossRefGoogle Scholar
  112. 112.
    Yohannes AM, Connolly MJ (2003) Early mobilization with walking aids following hospital admission with acute exacerbation of chronic obstructive pulmonary disease. Clin Rehabil 17:465–471PubMedGoogle Scholar
  113. 113.
    Zafiropoulos B, Alison JA, McCarren B (2004) Physiological responses to the early mobilisation of the intubated, ventilated abdominal surgery patient. Aust J Physiother 50:95–100PubMedGoogle Scholar
  114. 114.
    Zanotti E, Felicetti G, Maini M, Fracchia C (2003) Peripheral muscle strength training in bed-bound patients with COPD receiving mechanical ventilation. Effect of electrical stimulation. Chest 124:292–296PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • R. Gosselink
    • 1
  • J. Bott
    • 2
  • M. Johnson
    • 3
  • E. Dean
    • 4
  • S. Nava
    • 5
  • M. Norrenberg
    • 6
  • B. Schönhofer
    • 7
  • K. Stiller
    • 8
  • H. van de Leur
    • 9
  • J. L. Vincent
    • 6
  1. 1.Respiratory Rehabilitation, Faculty of Kinesiology and Rehabilitation SciencesKatholieke Universiteit LeuvenLeuvenBelgium
  2. 2.Respiratory Care TeamSurrey Primary Care TrustChertseyUK
  3. 3.Physiotherapy DepartmentMeath and National Children’s HospitalDublinIreland
  4. 4.School of Rehabilitation SciencesUniversity of British ColumbiaVancouverCanada
  5. 5.Respiratory Intensive Care UnitFondazione S. Maugeri Istituto Scientifico di PaviaI.R.C.C.S. PaviaItaly
  6. 6.Department of Intensive CareErasme Hospital (Free University of Brussels)BrusselsBelgium
  7. 7.Abteilung Pneumologie und Internistische IntensivmedizinKlinikum Region Hannover, Krankenhaus Oststadt-HeidehausHannoverGermany
  8. 8.Physiotherapy DepartmentRoyal Adelaide HospitalAdelaideAustralia
  9. 9.Faculty for Health Studies, School of PhysiotherapyHanze University GroningenGroningenThe Netherlands

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