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在重症监护室借助倾斜台站立:澳大利亚物理治疗实践调查

Standing with assistance of a tilt table in intensive care: a survey of Australian physiotherapy practice.

作者信息

Chang Angela T, Boots Robert, Hodges Paul W, Paratz Jennifer

机构信息

School of Physiotherapy, University of Queensland, Brisbane, QLD, 4072, Australia.

出版信息

Aust J Physiother. 2004;50(1):51-4. doi: 10.1016/s0004-9514(14)60249-x.

Abstract

Although tilt tables are used by physiotherapists to reintroduce patients to the vertical position, no quantitative evidence is available regarding their use within intensive care units (ICUs) of Australian hospitals. The purpose of this study was to evaluate the use of tilt tables in physiotherapy management of patients in ICUs across Australia. Ninety-nine physiotherapists working in Australian public ICUs were contacted via mail and asked to complete a questionnaire regarding their use of tilt tables in practice. Reasons for the use of the tilt table, contraindications, commonly used adjuncts, monitoring, and outcome measures were also investigated. Eighty-six questionnaires were returned (87% response). The tilt table was used by 58 physiotherapists (67.4%). The most common reasons for inclusion of tilt table treatment were to: facilitate weight bearing (94.8% of those who tilt); prevent muscle contractures (86%); improve lower limb strength (81%); and increase arousal (70%). The tilt table was most frequently applied to patients with neurological conditions (63.8%) and during long-term ICU stay (43.1%). Techniques often combined with tilt table treatment included upper limb exercises (93.1%) and breathing exercises (86.2%). Standing with assistance of the tilt table is used by the majority of physiotherapists working in Australian ICUs. A moderate level of agreement is demonstrated by physiotherapists regarding indications to commence tilt table treatment and adjunct modalities combined with standing with assistance of the tilt table.

摘要

尽管物理治疗师会使用倾斜床让患者重新适应垂直姿势,但对于澳大利亚医院重症监护病房(ICU)使用倾斜床的情况,尚无定量证据。本研究的目的是评估倾斜床在澳大利亚各ICU患者物理治疗管理中的应用。通过邮件联系了在澳大利亚公立ICU工作的99名物理治疗师,要求他们填写一份关于在实际工作中使用倾斜床情况的问卷。还调查了使用倾斜床的原因、禁忌症、常用辅助手段、监测情况及结果指标。共返回86份问卷(回复率87%)。58名物理治疗师(67.4%)使用了倾斜床。纳入倾斜床治疗的最常见原因是:促进负重(倾斜患者中的94.8%);预防肌肉挛缩(86%);增强下肢力量(81%);以及提高觉醒程度(70%)。倾斜床最常用于患有神经系统疾病的患者(63.8%)以及长期入住ICU的患者(43.1%)。常与倾斜床治疗相结合的技术包括上肢运动(93.1%)和呼吸运动(86.2%)。在澳大利亚ICU工作的大多数物理治疗师会使用在倾斜床辅助下站立的方法。物理治疗师在开始倾斜床治疗的适应症以及与倾斜床辅助站立相结合的辅助方式方面表现出中等程度的一致性。

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