Early mobilization of critically ill patients with mechanical ventilation is an advanced physical therapy practice. It requires specialized knowledge and skills in specific areas such as cardiovascular and pulmonary anatomy and pathophysiology, mechanical ventilation, and evaluation of the oxygen delivery system through hemodynamic monitoring. Comprehensive knowledge and skills in these areas will affect the clinical decision-making process and treatment prescription for such complex patients. Implementation of an early physical therapy program for selected mechanical ventilation patients with a focus on early mobility and walking is essential to minimize functional decline. The use of an interdisciplinary approach is essential to obtain successful results. Physical therapists are an integral member of the interdisciplinary team caring for a patient in the Intensive Care Unit (ICU) and are uniquely qualified to design and implement treatment plans to improve function. Physiotherapists must be competent, confident, and use sound clinical thinking skills when faced with the challenges of patient care in the ICU. This article includes the rationale for an early mobility and gait program, the knowledge required for safe and effective treatment, and treatment approaches that will optimize the function of these patients.
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