Physiotherapy led early rehabilitation of the patient with critical illness

Thomas, Amanda

doi:10.1179/1743288x10y.0000000022

Cited by 17 publications

(16 citation statements)

References 40 publications

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“…Improving function has been shown to reduce dependency and promote earlier weaning, which in turn decreases hospital length of stay and increases quality of life [42-44]. With a reduction in hospital length of stay, along with increased function and fewer patient complications, physiotherapy treatment is highly cost-effective, reducing both the burden on acute care services and future health care service use [45,46]. Further, because treatment prevents critical weakness and increases functional ability [45,47,48] patients are less likely to be discharged to a care facility and are more likely to return to their home.…”

Section: Results: Key Findings By Service Areasmentioning

confidence: 99%

The challenge of obtaining information necessary for multi-criteria decision analysis implementation: the case of physiotherapy services in Canada

Dionne

Mitton

MacDonald

et al. 2013

Cost Eff Resour Alloc

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BackgroundAs fiscal constraints dominate health policy discussions across Canada and globally, priority-setting exercises are becoming more common to guide the difficult choices that must be made. In this context, it becomes highly desirable to have accurate estimates of the value of specific health care interventions.Economic evaluation is a well-accepted method to estimate the value of health care interventions. However, economic evaluation has significant limitations, which have lead to an increase in the use of Multi-Criteria Decision Analysis (MCDA). One key concern with MCDA is the availability of the information necessary for implementation. In the Fall 2011, the Canadian Physiotherapy Association embarked on a project aimed at providing a valuation of physiotherapy services that is both evidence-based and relevant to resource allocation decisions. The framework selected for this project was MCDA. We report on how we addressed the challenge of obtaining some of the information necessary for MCDA implementation.MethodsMCDA criteria were selected and areas of physiotherapy practices were identified. The building up of the necessary information base was a three step process. First, there was a literature review for each practice area, on each criterion. The next step was to conduct interviews with experts in each of the practice areas to critique the results of the literature review and to fill in gaps where there was no or insufficient literature. Finally, the results of the individual interviews were validated by a national committee to ensure consistency across all practice areas and that a national level perspective is applied.ResultsDespite a lack of research evidence on many of the considerations relevant to the estimation of the value of physiotherapy services (the criteria), sufficient information was obtained to facilitate MCDA implementation at the local level.ConclusionsThe results of this research project serve two purposes: 1) a method to obtain information necessary to implement MCDA is described, and 2) the results in terms of information on the benefits provided by each of the twelve areas of physiotherapy practice can be used by decision-makers as a starting point in the implementation of MCDA at the local level.

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Section: Results: Key Findings By Service Areasmentioning

confidence: 99%

The challenge of obtaining information necessary for multi-criteria decision analysis implementation: the case of physiotherapy services in Canada

Dionne

Mitton

MacDonald

et al. 2013

Cost Eff Resour Alloc

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“…Early PT in patients with surgery-associated critical illness may have significant impact on physical and functional outcomes in addition to decreasing length of ICU stay and its associated resource implications. The potential for early PT should therefore be assessed immediately upon surgical ICU admission in all patients and continue throughout the acute admission [17]. …”

Section: Reviewmentioning

confidence: 99%

Peri-operative physiotherapy

Makhabah¹,

Martino²,

Ambrosino

2013

Multidiscip Respir Med

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Postoperative pulmonary complications (PPC) are a major cause of morbidity, mortality, prolonged hospital stay, and increased cost of care. Physiotherapy (PT) programs in post-surgical and critical area patients are aimed to reduce the risks of PPC due to long-term bed-rest, to improve the patient’s quality of life and residual function, and to avoid new hospitalizations. At this purpose, PT programs apply advanced cost-effective therapeutic modalities to decrease complications and patient’s ventilator-dependency. Strategies to reduce PPC include monitoring and reduction of risk factors, improving preoperative status, patient education, smoking cessation, intra-operative and postoperative pulmonary care. Different PT techniques, as a part of the comprehensive management of patients undergoing cardiac, upper abdominal, and thoracic surgery, may prevent and treat PPC such as secretion retention, atelectasis, and pneumonia.

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“…This study aims to quantify the acute exercise response to early passive and active activities in order to inform exercise prescription when designing rehabilitation programmes for the critically ill. Critical care survival is often associated with a poor functional outcome [1], with recent investigations presenting the case for early rehabilitation in order to optimise functional recovery [2]. There, remains, however, a scarcity of research investigating the immediate response to exercise and subsequent exercise prescription, in the acute phase following critical illness.…”

Section: Introductionmentioning

confidence: 99%