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


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.


Intensive Care Unit Intensive Care Unit Patient Continuous Passive Motion Inhalation Injury Inspiratory Muscle Training 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

134_2008_1026_MOESM1_ESM.doc (390 kb)
Electronic Supplementary Material (DOC 390K)


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© Springer-Verlag 2008

Authors and Affiliations

  • R. Gosselink
    • 1
    Email author
  • 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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