Motor physical therapy in hospitalized patients in an intensive care unit: a systematic review

Abstract

OBJECTIVE: To analyze the outcomes achieved by motor physical therapy in critically ill patients admitted to intensive care units. METHODS: A systematic literature review was performed, and clinical trials published between 2002 and 2011 were included in the study. The search involved the LILACS, SciELO, MedLine, EMBASE and Cochrane databases, using the keywords "intensive care unit", "physiotherapy", "physical therapy", "mobility", "mobilization" and "randomized controlled trials." Two researchers screened the articles independently and included works that addressed the effect of physical therapy on critically ill patients. RESULTS: From an initial analysis of 67 potentially relevant articles, only 8 met the selection criteria and addressed the outcomes of electrostimulation, cycle ergometry and kinesiotherapy techniques. The sample sizes ranged from 8 to 101 subjects, with mean ages between 52 and 79 years. All patients were undergoing invasive mechanical ventilation. Among the analyzed articles, 6 reported significant benefits of motor physical therapy, such as improvement in peripheral muscle strength, respiratory capacity and functionality, in critically ill patients. CONCLUSION: With this systematic review, it is possible to conclude that motor physical therapy is a feasible and safe therapy for critically ill patients and can minimize the deleterious effects of prolonged immobilization. Approaches involving electrostimulation, cycle ergometry and kinesiotherapy showed positive responses in patients under intensive care. Available evidence regarding the impact of motor physical therapy on length of stay in intensive care units and on mortality is still scarce, and further study in this area is warranted.