Commencing rehabilitation in the ICU

Rehabilitation is an integral part of the management of patients in Intensive Care Units (ICUs). The most important aim in this area is to enhance the patient's overall functional capacity and to restore his/her respiratory and physical independence, thus decreasing the risks of bed-rest and associated complications. The evidence for applying a weaning protocol and physiotherapy techniques (postures, percussion/vibration, limb exercise, and active mobilization) in these patients has proved to be effective according to the application rationale of each process. However, to date, there are only strong recommendations concerning the evidence-based strategies to speed weaning from mechanical ventilation. Early physiotherapy may be effective in the ICU: nonetheless, most techniques need to be further studied in a wider population. In particular, evidence supporting physiotherapy interventions is limited as there are no studies examining the specific effects of interventions on long-term outcomes.