Physical Therapy Department, Utica College, 1600 Burrstone Road, Utica, NY 13502 (USA).
Department of Physical Therapy, Mount St Mary's University, Los Angeles, California.
Phys Ther. 2020 Jul 19;100(7):1062-1073. doi: 10.1093/ptj/pzaa059.
More than 4 million adults survive a stay in the intensive care unit each year, with many experiencing new or worsening physical disability, mental health problems, and/or cognitive impairments, known as post-intensive care syndrome (PICS). Given the prevalence and magnitude of physical impairments after critical illness, many survivors, including those recovering from COVID-19, could benefit from physical therapist services after hospital discharge. However, due to the relatively recent recognition and characterization of PICS, there may be limited awareness and understanding of PICS among physical therapists practicing in home health care and community-based settings. This lack of awareness may lead to inappropriate and/or inadequate rehabilitation service provision. While this perspective article provides information relevant to all physical therapists, it is aimed toward those providing rehabilitation services outside of the acute and postacute inpatient settings. This article reports the prevalence and clinical presentation of PICS and provides recommendations for physical examination and outcomes measures, plan of care, and intervention strategies. The importance of providing patient and family education, coordinating community resources including referring to other health care team members, and community-based rehabilitation service options is emphasized. Finally, this perspective article discusses current challenges for optimizing outcomes for people with PICS and suggests future directions for research and practice.
每年有超过 400 万成年人在重症监护病房接受治疗后幸存下来，其中许多人经历新的或恶化的身体残疾、心理健康问题和/或认知障碍，称为重症监护后综合征（PICS）。鉴于危重病后身体损伤的普遍性和严重程度，许多幸存者，包括从 COVID-19 中康复的幸存者，在出院后可能需要物理治疗师的服务。然而，由于 PICS 的相对较新的认识和特征，在家庭保健和社区环境中执业的物理治疗师可能对 PICS 的认识和理解有限。这种缺乏认识可能导致康复服务的提供不适当和/或不足。虽然本文提供了与所有物理治疗师相关的信息，但它针对的是在急性和急性后住院环境之外提供康复服务的治疗师。本文报告了 PICS 的患病率和临床表现，并为体格检查和结果测量、护理计划和干预策略提供了建议。强调了提供患者和家庭教育、协调社区资源（包括转介给其他医疗保健团队成员）以及社区康复服务选择的重要性。最后，本文讨论了优化 PICS 患者治疗效果的当前挑战，并提出了未来研究和实践的方向。
