ABSTRACT

Background: Patients with various life-threatening conditions are admitted to intensive care units. There is growing evidence that early physiotherapy intervention in critically-ill intensive care patients is feasible and safe and can result in improvement of patient outcomes.

Aim of the study: This study was aimed at investigating the effects of passive exercises, positioning and chest physiotherapy on respiratory and haemodynamic parameters in critically-ill patients admitted to the Intensive Care Unit (ICU) of the Obafemi Awolowo University Teaching Hospitals (OAUTH), Ile-Ife, Nigeria.

Method: Ten critically-ill patients admitted to the ICU of OAUTH Ile-Ife and referred for physiotherapy, from January to March 2016, were included in this single group pretest-posttest experimental study. They received physiotherapy for a total of 82 sessions at the average of 45 minutes per session. Six of the patients had severe head injury and were unconscious (GCS=4/15 to 7/15) on referral. Two patients had abdominal surgery while two had haemorrhagic stroke. Following the recommendations of Sommers et al, (2015), patients received passive exercises to the limbs, passive cycling (modified), electrical muscle stimulation (EMS), and chest physiotherapy while mobilization (sitting) on bed was included with increasing level of consciousness with at least eye opening to pain. All patients were haemodynamically stable with vital signs within normal limits for critically-ill patients without orthopaedic or neurological contraindications. We hypothesized that patients’ pre-treatment parameters (Systolic Blood Pressure, SBP; Diastolic Blood Pressure, SBP; percutaneous oxygen saturation, SPO₂; Respiratory rate, RR; Pulse rate, PR) would significantly improve after the intervention.

Results: There was significant improvement (p>0.05) between participants’ pre- and post-treatment SpO₂. No significant difference (p>0.05) was found between pre- and post-treatment values of SBP, DBP, MAP, RR and PR while significant correlation was found between all the pre-and post-treatment values (p<0.05) for all the parameters.

Conclusion and recommendation: The selected physiotherapy interventions had no adverse effects on the haemodynamic and respiratory parameters of critically-ill patients. Physiotherapy intervention within recommended dosage is feasible and safe for this category of patients.

Key words: physiotherapy, critically-ill patients, haemodynamic parameters, respiratory parameters.