OVERVIEW OF PHYSIOTHERAPY, including exercise, positioning and multimodal techniques.
NICE GUIDELINE (2009) – Rehabilitation after critical illness

Bein T, Bischoff M, Brückner U et al (2015) S2e guideline: positioning and early mobilisation in prophylaxis or therapy of pulmonary disorders: Revision 2015: S2e guideline of the German Society of Anaesthesiology and Intensive Care Medicine (DGAI). Der Anaesthesist; 64:1-26. doi: 10.1007/s00101-015-0071-1.

Abelha FJ, Luis C, Veiga D et al (2013) Outcome and quality of life in patients with postoperative delirium during an ICU stay following major surgery. Critical Care; 201, 17:R257 doi:10.1186/cc13084
• exercise reduces the risk of postoperative delirium

Ahrens T, Kollef M, Stewart J et al (2004) Effect of kinetic therapy on pulmonary complications. Am J Crit Care, 13, 5, 376-82
• kinetic beds reduce the incidence of pneumonia

Amidei C (2013) Physiological responses to passive exercise in adults receiving mechanical ventilation. Am J Crit Care, 22(4):337-49

Arzu G (2012) Early mobilization of the critically ill patients: towards standardization. Crit Care Med, 40, 4, 1346-1347. doi: 10.1097/CCM.0b013e31823b8e44

Asher A (2013) Equipment used for safe mobilization of the ICU patient Crit Care Nurs Quarterly; 36(1):101-8

Ayasrah S (2016) Care-related pain in critically ill mechanically ventilated patients. Anaesth Int Care; 44(4):458-65
Bailey P, Thomsen GE, Spuhler VJ et al (2007) Early activity is feasible and safe in respiratory failure patients. Crit Care Med, 35, 139-45.

Baker C, L Mansfield (2008) Physical rehabilitation following critical illness. J Intens Care Soc, 9, 2, 166-9
• specific exercise programmes can influence weaning time and length of stay
• need for on-going rehabilitation post-discharge

Banasik J, Emerson R (2001) Effect of lateral positions on tissue oxygenation in the critically ill. Heart & Lung, 30, 4, 269-76
• lateral positioning of critically ill patients with hypoxemia or low cardiac output does not further endanger tissue oxygenation

Battle C, Lovett S, Hutchings H (2013) Chronic pain in survivors of critical illness: a retrospective analysis of incidence and risk factors. Crit Care, 17:R101
• the shoulder is the most commonly reported joint affected by post-ICU chronic pain (22%): all ICU staff need training on care of this vulnerable joint.

Beach, L.J., Fetterplace, K., Edbrooke, L., et al. 2017. Measurement of physical activity levels in the intensive care unit and functional outcomes: an observational study. J. Crit. Care. 40, 189-19

Bell HJ, Ramsaroop DM, Duffin J (2003) The respiratory effects of two modes of passive exercise. Eur J Appl Physiol, 88, 544-2

Berney S, Denehy L (2003) The effect of physiotherapy treatment on oxygen consumption and haemodynamics in patients who are critically ill. Austr J Physiother, 49, 99-105
• sensible physiotherapy does not upset metabolic or haemodynamic variables (unlike Hammon 1992 which rubbished physiotherapy by using silly techniques on unstable patients who did not need physiotherapy)

Beuret P et al (2002) Prone position as prevention of lung injury in comatose patients. Int Care Med, 28, 564-9
• RCT demonstrating benefit of daily 4-hour proning for patients with GCS of 9 or less

Bird SJ (2002) Critical illness myopathy and polyneuropathy Curr Neurol Neuroscience Reports 2002, 2, 527-533
• critical illness polyneuropathy is seen in up to one third of septic patients
• critical illness myopathy associated with corticosteroids and/or neuromuscular blocking agents

Bourdin G et al (2010) The feasibility of early physical activity in intensive care unit patients: a prospective observational one-center study. Respiratory Care, 55 (4): 400-7

Brown C (2013) Whither rehabilitation? A call to arms. J Intens Care Soc: 14(2):110-11

Burtin C, Clerck B, Robbeets C et al (2009) Early exercise in critically ill patients enhances short-term functional recovery. Crit Care Med, 37, 9, 2499-2505

Chang A, Paratz J, Rollston J (2002) Ventilatory effects of neurophysiological facilitation and passive movement in patients with neurological injury. Austr J Physiother, 48, 305-9
• neurophysiological facilitation improves minute volume and SpO2 in neurological patients

Chen YH, Tsai YH, Wu YK (2004) Exercise reconditioning in the rehabilitation for prolonged ventilator dependent patients. Eur Respir J, 24: Suppl. 48, 662s

Chiang LL, Wang LY, Wu CP, Wu HD, Wu YT (2006) Effects of physical training on functional status in patients with prolonged mechanical ventilation. Phys Ther, 86, 9 1271-1281
• 6-week physical training program may improve limb strength, ventilator-free time and functional outcomes

Choi J, Tasota FJ, Hoffman AL (2008) Mobility interventions to improve outcomes in patients undergoing prolonged mechanical ventilation: a review of the literature. Biol Res Nurs, 10, 21-33

Chung MS, Huang CC, Yeh SL et al (2016) The effectiveness of pulmonary rehabilitation for critical-care ventilator patients: a systematic review. Hu Li Za Zhi; 63(3):94-104. doi: 10.6224/JN.63.3.94

Clark DE, Lowman JD, Griffin et al (2013) Effectiveness of an early mobilization protocol in a trauma and burns intensive care unit: a retrospective cohort study. Phys Ther; 93(2):186-196. doi: 10.2522/ptj.20110417

Clavet H, Hébert PC, Fergusson D (2008) Joint contracture following prolonged stay in the intensive care unit. Can Med Ass J, 178, 6, 691–7
• 39% of ICU patients staying for 2/52 or more acquired joint contractures, often in more than 1 joint; these were sufficient to impair function and persistent until discharge home

Clini E, Ambrosino N (2005) Early physiotherapy in the respiratory intensive care unit. Respir Med, 99 (9), 1096-1104.
• review of evidence-based effectiveness of weaning practices and physiotherapy

Cohen D (1996) Modulating effects of propofol on metabolic and cardio-pulmonary responses to stressful ICU procedures. Crit Care Med, 24,612-17.
• propofol given 2 minutes before PT reduces the excess VO2 and VCO2 of treatment

Connolly B, O'Neill B, Salisbury L et al (2016) Physical rehabilitation interventions for adult patients during critical illness: an overview of systematic reviews. Thorax; 71:881-890 doi:10.1136/thoraxjnl-2015-208273

Corner EJ, Brett SJ (2014) Early identification of patients at risk of long-term critical illness-associated physical disability: is it possible? Crit Care, 18:629
• bed rest and other risk factors for ICU weakness and disability

Cuthbertson BH, Hull AM (2007) A pragmatic randomized controlled trial of intensive care follow up programmes in improving longer-term outcomes. BMC Health Serv Res, 7, 116

Denehy L, Lanphere J, Needham DM (2017) Ten reasons why ICU patients should be mobilized early. Intensive Care Med; 43(1):86-90

Denehy L, de Morton NA, Skinner E (2013) A Physical Function Test for use in the intensive care unit: validity, responsiveness, and predictive utility of the physical function ICU test (scored). Phys Ther, 93(12):1636-1645. doi:10.2522/ptj.20120310

Dingle M (2003) Role of dangling when moving from supine to standing position. Br J Nurs, 12, 346-50
• cardiovascular adjustments to standing from supine: physiology, risks, technique

Drolet A, DeJuilio P, Harkless S et al (2012) Move to improve: the feasibility of using an early mobility protocol to increase ambulation in the intensive and intermediate care settings. Phys Ther, 93, 2, 197-207. doi:10.2522/ptj.20110400

Fan E (2012) Critical illness neuromyopathy and the role of physical therapy and rehabilitation in critically ill patients. Respir Care, 57, 6, 933-4

Farhan H et al (2016) Acquired muscle weakness in the surgical intensive care unit: nosology, epidemiology, diagnosis, and prevention. Anesthesiology; 124(1):207-234
• early rehabilitation helps prevent myopathy

Fischer A, Spiegl M, Altmann K et al (2016) Muscle mass, strength and functional outcomes in critically ill patients after cardiothoracic surgery: does neuromuscular electrical stimulation help? The Catastim 2 randomized controlled trial. Crit Care, 20 :30

Gagnon MM, Rukstele CD (2013) Making strides in preventing ICU-acquired weakness: involving family in early progressive mobility. Crit Care Nurs Quarterly, 36, 1, 141 – 147

Genc A (2012) Respiratory and hemodynamic responses to mobilization of critically ill obese patients. Cardiopulm Phys Ther J; 23(1):14-18

Gerovasili V (2009) Short-term systemic effect of electrical muscle stimulation in critically ill patients. Chest, 136, 1249-56

Gosselink R, Bott J, Johnson M, et al (2008) Physiotherapy for adult patients with critical illness: recommendations of the ERS and European Society of Intensive Care Medicine task force on physiotherapy for critically ill patients. Int Care Med, 34, 7, 1188-99
• evidence-based problems that respond to physiotherapy are: deconditioning, impaired airway clearance, atelectasis, intubation avoidance, and weaning failure

Graf J (2003) Health-related quality of life before, 1 month after, and 9 months after intensive care in medical patients. Crit Care Med, 31, 2163-9
• useful outcome measures independent of severity of illness

Grap MJ, Munro CL, Wetzel PA et al (2016) Backrest elevation and tissue interface pressure by anatomical location during mechanical ventilation. Am J Crit Care; 25(3):e56-63. doi: 10.4037/ajcc2016317.
• backrest elevation less than 30° is recommended to reduce pressure ulcers, but positions greater than 30° are recommended to reduce ventilator-associated pneumonia

Guo S, Zappetti D (2016) Is there an ideal site for central venous catheterization? Cardiopulm Phys Ther J; 26(1):44–45. doi: 10.1097/CPM.0000000000000138
• re. siting of central line for mobilization: subclavian vein results in less infection and DVT, but is associated with more mechanical complications than femoral or jugular veins.

Hanneman SK, Gusick GM, Shannan K et al (2015) Manual vs automated lateral rotation to reduce preventable pulmonary complications in ventilator patients. Am J Crit Care; 24:24-32; doi: 10.4037/ajcc2015171
• automated turning shows modestly improved benefits compared to manual turning

Harrold M, Salisbury L, Webb S et al (2015) Early mobilisation in intensive care units in Australia and Scotland: a prospective, observational cohort study examining mobilisation practises and barriers. Critical Care; 19:336

Heyland DK, Stapleton RD, Mourtzakis M et al (2016) Combining nutrition and exercise to optimize survival and recovery from critical illness: conceptual and methodological issues.
Clin Nutr; 35(5):1196-206. doi: 10.1016/j.clnu.2015.07.003

Hicky J (2006) Manually ventilating & suctioning in-line with a SensorMedics 3100B high frequency oscillatory ventilator bench test. AARC Conference, Texas
• method for manual hyperinflation and suction without losing airway pressure with HFO

Hiner C (2010) Clinicians’ perception of head-of-bed elevation. Am J Crit Care, 19, 2, 164-7
• between treatment sessions, the head of the bed should be elevated 30° to 45° to prevent ventilator-associated pneumonia.

Hodgson CL, Stiller K, Needham DM et al (2016) Expert consensus and recommendations on safety criteria for active mobilization of mechanically ventilated critically ill adults. Crit Care; 18(6):658. doi: 10.1186/s13054-014-0658-y.

Hopkins RO, Mitchell L, Thomsen GE et al (2016) Implementing a mobility program to minimize post-intensive care syndrome. AACN Adv Crit Care; 27(2):187-203. doi: 10.4037/aacnacc2016244

Horiuchi K (1997) Insights into the increased oxygen demand during chest physiotherapy. Crit Care Med, 25, 1347-51
• increase in physiologic activity produced by chest physiotherapy is secondary to both exercise-like and stress-like responses

Ikeda S et al (2003) Repetitive stretch induces c-fos and myogenin mRNA within several hours in skeletal muscle removed from rats. Arch Phys Med Rehab, 84, 419-23
• mechanical repetitive stretch stimulates growth (in rats at least)

Jackson JC, Ely EW, Morey M et al (2012) Cognitive and physical rehabilitation of intensive care unit survivors: Results of the RETURN randomized controlled pilot investigation. Crit Care Med, 40, 4, 1088–1097. doi: 10.1097/CCM.0b013e3182373115

Jones C, Eddleston J, McCairn A et al (2015) Improving rehabilitation after critical illness through outpatient physiotherapy classes and essential amino acid supplement: A randomized controlled trial. J Crit Care; 30(5):901–907. doi:

Jones AYM, Dean E (2004) Body position change and its effect on hemodynamic and metabolic status. Heart & Lung, 33, 5, 281-90
• HR, BP, and VO2 highest in sitting compared with lying, and lowest in left-side-lying (in normals)

Josaleen D et al (2013) Mobilization of ventilated older adults. J Geriatr Phys Ther; 36(4):162-168. doi: 10.1519/JPT.0b013e31828836e7

Kasper C (2002) Skeletal muscle damage and recovery. AACN Clinical Issues, 13, 3, 237-47
• disuse atrophy of muscle begins within 4 hours of the start of bed rest; strenuous exercise of atrophic muscle can lead to muscle damage

Kemper (1992) The effect of increasing mechanical ventilation during physiotherapy. Respir Care, 37, 1313
• oxygen consumption increases by an average 40% during PT

Koo KKY, Choong K, Cook DJ et al (2016) Early mobilization of critically ill adults: a survey of knowledge, perceptions and practices of Canadian physicians and physiotherapists. CMAJ Open; 4(3):E448-E454. doi: 10.9778/cmajo.20160021.

Kortebein P (2009) Rehabilitation for hospital-associated deconditioning. Am J Phys Med Rehab. 88, 1, 66-77
• deconditioning, even in younger patients, can have a prolonged effect on functional abilities
• for older patients, functional decline increases risk of institutionalisation and death
• inpatient rehabilitation is effective for improving function

Krause MW et al (2000) Postural drainage in intubated patients with acute lobar atelectasis. South African J Physiother, 56, 3, 29-32

Kress JP (2009) Clinical trials of early mobilization of critically ill patients. Crit Care Med, 37, 10, S442-S447

Krishnagopalan S et al (2002) Body positioning of intensive care patients. Crit Care Med, 30(11), 2588-92

Kwan WS, Yang CNA, Poon YH, Lau HW (2013) Initiation of an early mobilisation programme in intensive care units—A preliminary report. Hong Kong Physiother J, 31(2):105-106

Lewis M (2003) Intensive Care Unit rehabilitation within the UK. Physiotherapy, 89, 531-8
• rehab programmes in UK ICU’s

Lewis RM (2001) Airway clearance techniques for the patient with an artificial airway. Respir Care, 7, 808-817
• literature review, with emphasis on infection control

Loram L, de Charmoy S (2002) The cardiopulmonary effect of passive movement. SA Journal Physiother, 58, 27-32
• positive effect of PMs on ventilation, PMs are OK with head injured patients

Lowman JD, Kirk TK, Clark DE (2012) Physical therapy management of a patient on portable extracorporeal membrane oxygenation as a bridge to lung transplantation: a case report. Cardiopulmon Phys Ther J, 23, 1, 30-35

Mase K, Tagami M, Imura S et al (2016) Regional lung volume differences between the side-lying and semi-prone positions. J Physical Ther Science; 28(3):1020-1025. doi: 10.1589/jpts.28.1020
. in right-side-lying, rolling the patient forward into semi-prone increases basal lung volume

Malkoç M, Karadibak D, Yücel Y (2009) The effect of physiotherapy on ventilatory dependency and the length of stay in an intensive care unit. Int J Rehab Res, 32, 85–88

Martin U, Hincapie L, Nimchuk M (2005) Impact of whole-body rehabilitation in patients receiving chronic mechanical ventilation. Crit Care Med. 33, 10, 2259-65

McWilliams DJ, Pantelides KP (2008) Does physiotherapy led early mobilization aaffect length of stay in ICU? ACPRC Journal, 40, 5-9
• rehab reduces ICU length of stay by an average 5 days

McWilliams DJ, Atkinson D, Carter A, Foëx BA, Benington S, Conway DH (2009) Feasibility and impact of a structured, exercise-based rehabilitation programme for intensive care survivors. Physiother Theory Pract, 25, 8, 566-71
• rehab increases exercise capacity, reduces anxiety and depression

McWilliams D, Weblin J, Atkins G et al (2015) Enhancing rehabilitation of mechanically ventilated patients in the intensive care unit: A quality improvement project. J Crit Care, 30(1):13-18
• ICU rehab reduces time on mechanical ventilation and length of stay in the ICU and in hospital

McWilliams, D., Atkins, G., Hodson, J. et al. 2017. The Sara Combilizer® as an early mobilisation aid for critically ill patients: a prospective before and after study. Aust Crit Care. 30(4),189-195. doi: 10.1016/j.aucc.2016.09.001

McWilliams DJ, Benington S, Atkinson D (2016) Outpatient-based physical rehabilitation for survivors of prolonged critical illness: A randomized controlled trial. Physiother Theory Pract; 32(3):179-90. doi: 10.3109/09593985.2015.1137663

Merbitz NH, Westie K, Dammeyer JA et al (2016) After critical care: Challenges in the transition to inpatient rehabilitation. Rehabil Psychol; 61(2):186-200. doi: 10.1037/rep0000072

Merriweather J, Smith T, Walsh T (2014) Nutritional rehabilitation after ICU - does it happen: a qualitative interview and observational study. J Clin Nurs; 23(5) 654-662

Morris PE, Goad A, Thompson C et al (2008) Early intensive care unit mobility therapy in the treatment of acute respiratory failure. Crit Care Med, 36, 8, 2238-43

Munshi, L., Kobayashi, T., DeBacker, J. et al. 2017. Intensive care physiotherapy during extracorporeal membrane oxygenation for acute respiratory distress syndrome. Ann Am Thorac Soc.14(2),246-253. doi: 10.1513/AnnalsATS.201606-484OC

Nava S (1998) Rehabilitation of patients in a respiratory ICU. Arch.Phys.Med.Rehab, 79, 849-54
• early rehabilitation shows improved lung function, reduced SOB and increased exercise tolerance

Needham DM, Davidson J, Cohen H (2012) Improving long-term outcomes after discharge from intensive care unit: Report from a stakeholders' conference. Crit Care Med, 40, 2, 502-9

Ntoumenopoulos G (2008) Mucus on the move: embed it or expel it--the patient, the clinician, and now the ventilator. Respir Care, 53, 10, 1276-9.

Ohtake, P.J. 2017. Impairments, activity limitations and participation restrictions experienced in the first year following a critical illness: protocol for a systematic review. BMJ Open. 7(1):e013847

Page VJ, Casarin A (2014) Missing link or not, mobilise against delirium. Crit Care; 18:105. doi: 0.1186/cc13712

Parker AM et al (2013) Early rehabilitation in the intensive care unit: preventing impairment of physical and mental health. Curr Phys Med Rehab Rep; 1(4):307-314

Parry SM, Huang M, Needham DM (2017) Evaluating physical functioning in critical care: considerations for clinical practice and research. Critical Care; 21:249

Parry, S.M., 2017. Factors influencing physical activity and rehabilitation in survivors of critical illness: a systematic review of quantitative and qualitative studies. Int Care Med. 43(4),531-542

Patman S, Sanderson D and Blackmore M (2001) Physiotherapy following cardiac surgery: Is it necessary during the intubation period? Austr J Physiother, 47, 7-16
• following routine, uncomplicated cardiac surgery, physiotherapy in the post-operative intubation period does not improve outcomes

Pattanshetty RB, Gaude GS (2010) Effect of multimodality chest physiotherapy in prevention of ventilator-associated pneumonia: A randomized clinical trial. Indian J Crit Care Med, 14(2):70-6
• ventilator-associated pneumonia may be reduced by twice-daily positioning, manual hyperinflation, vibrations and suction.

Puckree T et al (2002) Does intercostal stretch alter breathing pattern and respiratory muscle activity in conscious adults? Physiotherapy, 88, 89-97
• intercostal stretch alters the pattern of breathing

Puthucheary Z, Montgomery H, Moxham J, et al. Structure to function: muscle failure in critically ill patients. J Physiol 2010;588:4641–8

Puthucheary Z, Harridge S, Hart N. Skeletal muscle dysfunction in critical care: wasting, weakness and rehabilitation strategies. Crit Care Med 2010;38(Suppl):S676–82

Reames CD, Price DM, King EA et al (2016) Mobilizing patients along the continuum of critical care. Dimens Crit Care Nurs; 35(1):10-5. doi: 10.1097/DCC.0000000000000151

Reper P, van Looy K (2013) Chest physiotherapy using intrapulmonary percussive ventilation to treat persistent atelectasis in hypoxic patients after smoke inhalation.
Burns; 39(1):192-3. doi: 10.1016/j.burns.2012.04.015

Rydingsward JE, Horkan CM, Mogensen KM et al (2016) Functional status in ICU survivors and out of hospital outcomes: a cohort study. Crit Care Med; 44(5):869-79. doi: 10.1097/CCM.0000000000001627

Rukstele CD, Gagnon MM (2013) Making strides in preventing ICU weakness. Crit Care Nurs Quarterly; 36(1):141-7
• family involvement in early mobility has shown adherence increase from 66% to 94%

Salisbury LG, Merriweather JL, Walsh TS (2010) Rehabilitation after critical illness: could a ward-based generic rehabilitation assistant promote recovery? Nurs Crit Care, 15, 2, 57-65

Schandl A, Bottai M, Holdar U et al (2014) Early prediction of new-onset physical disability after intensive care unit stay: a preliminary instrument. Crit Care;18:455. doi: 10.1186/s13054-014-0455-7

Schellekens W, van Hees H, Doorduin J et al (2016) Strategies to optimize respiratory muscle function in ICU patients. Crit Care; 20:103
• prevention of respiratory muscle dysfunction and strategies to improve respiratory muscle function

Schmidt UH, Knecht L, MacIntyre NR et al (2016) Should early mobilization be routine in mechanically ventilated patients? Respir Care; 61(6):867-875.

Shannan K, Hamlin SK, Hanneman NS et al (2015) Hemodynamic changes with manual and automated lateral turning in patients receiving mechanical ventilation. Am J Crit Care; 24:131-140; doi:10.4037/ajcc2015782
• lateral turning can cause haemodynamic instability, sometimes prolonged

Shelly, A. G., Prabhu, N. S., Jirange, P. et al. 2017. Quality of life improves with individualized home-based exercises in critical care survivors. Indian J, Crit. Care Medicine. 21(2), 89–93. doi.org/10.4103/ijccm.IJCCM_433_16

Simonis G, Steiding K, Schaefer K et al (2012) A prospective, randomized trial of continuous lateral rotation ("kinetic therapy") in patients with cardiogenic shock. Clin Res Cardiol; 101(12):955-62. doi: 10.1007/s00392-012-0484-7

Skinner EH, Haines KJ, Berney S et al (2015) Usual care physiotherapy during acute hospitalization in subjects admitted to the ICU: an observational cohort study. Respir Care; 60(10):1476-85. doi: 10.4187/respcare.04064

Sottile PD, Nordon-Craft A, Malone D et al (2015) Physical therapist treatment of patients in the neurological intensive care unit: description of practice. Phys Ther; 95(7):1006-14. doi: 10.2522/ptj.20140112 

Stiller K (2000) Physiotherapy in intensive care. Chest, 118, 1801-13
• flawed references in this article lead to inaccurate conclusions about physiotherapy

Stiller K (2007) Safety issues that should be considered when mobilizing critically ill patients. Crit Care Clin, 23, 1, 35-53

Stiller K (2013) Physiotherapy in intensive care: an updated systematic review. Chest; 144(3):825-847. doi:10.1378/chest.12-2930

Stockley RC, Hughes J, Morrison J, Rooney J (2010) An investigation of the use of passive movements in intensive care by UK physiotherapists. Physiotherapy, 96, 3, 228-33
• most physiotherapists do passive movements.

Stockton L (2009) Seating and pressure ulcers: clinical practice guideline. J Tissue Viability, 18, 4, 98-108
• recommendations for seating, especially useful for patients needing prolonged sitting, e.g. spinal injury

Talley CL, Wonnacott RO, Schuette JK et al (2013) Extending the benefits of early
mobility to critically ill patients undergoing continuous renal replacement therapy. Crit Care Nurs Quarterly; 36(1):89–100

TEAM Study (2015) Early mobilization and recovery in mechanically ventilated patients in the ICU: a bi-national, multi-centre, prospective cohort study. Crit Care; 19:81 doi:10.1186/s13054-015-0765-4
• more than 50% of patients discharged from the ICU have ICU-acquired weakness, less than a third had returned to their previous work at 6 months

Thelandersson A (2010) Cerebrovascular and systemic haemodynamic parameters during passive exercise. Adv Physiother, 12, 1, 58-63

Thomas PJ, Paratz JD, Lipman J (2007) Lateral positioning of ventilated intensive care patients: a study of oxygenation, respiratory mechanics, hemodynamics and adverse events. Heart Lung, 36, 4, 277-86

Thomas AJ, Wright K, Mill LM (2009) The incidence of physiotherapy and rehabilitation activities within a general intensive care unit. ACPRC Journal, 41, 3-8.

Tipping CJ (2016) The ICU Mobility Scale has construct and predictive validity and is responsive. a multicenter observational study. Ann Am Thorac Soc; 13(6):887-93. doi: 10.1513/AnnalsATS.201510-717OC

Tipping, C.J., Harrold. M., Holland, A. et al. 2017. The effects of active mobilisation and rehabilitation in ICU on mortality and function: a systematic review. Intensive Care Med. 43(2),171-183.

Topp R et al (2002) The effect of bed rest and potential of prehabilitation on patients in the intensive care unit. AACN Clin Issues, 13, 263-76
• the case for prehabilitaion before admission to the ICU

Unoki T (2004) Effects of expiratory rib cage compression combined with endotracheal suctioning on gas exchange in mechanically ventilated rabbits with induced atelectasis. Resp Care, 49, 896-901
• rib cage compression probably exacerbates atelectasis

Van Duijnhoven NTL (2010) Resistive exercise versus resistive vibration exercise to counteract vascular adaptations to bed rest. J Appl Physiol, 108, 28-33
• resistive vibration exercise shows a greater capacity to prevent the vascular effects of bed rest than resistive exercise

van Nieuwenhoven CA, Vandenbroucke-Grauls C, van Tiel FH et al (2006) Feasibility and effects of the semi-recumbent position to prevent ventilator- associated pneumonia: a randomised study, Critical Care Medicine, 34(2) p396-402

Verceles AC, Hager ER (2015) Use of accelerometry to monitor physical activity in critically ill subjects: a systematic review. Respir Care; 60(9):1330-1336

Vincent J-L, Shehabi Y, Walsh TS et al (2016) Comfort and patient-centred care without excessive sedation: the eCASH concept. Int Care Med; 42:962-971. doi: 10.1007/s00134-016-4297-4.
• early mobilisation helps prevent delirium

Whyte J (2013) Medical complications during inpatient rehabilitation among patients with traumatic disorders of consciousness. Arch Phys Med Rehabil, 94(10):1877-83

Williams SL (2009) Recovering from the psychological impact of intensive care: how constructing a story helps. Nurs Crit Care, 14, 6, 281-288

Williams N, Flynn M (2014) A review of the efficacy of neuromuscular electrical stimulation in critically ill patients. Physiother Theory Pract; 30(1):6–11

Wollersheim T (2017) Whole-body vibration to prevent intensive care unit-acquired weakness: safety, feasibility, and metabolic response. Crit Care; 21:9. doi:10.1186/s13054-016-1576-y

Wong WP, Paratz JD, Wilson K et al (2006) Hemodynamic and ventilatory effects of manual respiratory physiotherapy techniques of chest clapping, vibration, and shaking in an animal model. J Appl Physiol, 95, 991-8
• manual techniques do not usually cause significant haemodynamic effects

Zafiropoulos B, Alison JA, McCarren B (2004) Physiological responses to the early mobbilisation of the intubated, ventilated abdominal surgery patient. Austr J Physiother, 50, 95-100

ACPRC = Association of Chartered Physiotherapists in Respiratory Care
HR = heart rate
GCS = Glasgow coma scale
HFO = high frequency oscillation
PM = passive movement
PT = physiotherapy
RCT = randomized controlled trial
SpO2 = oxygen saturation by pulse oximetry
VO2 = oxygen consumption