title: Safety of physical therapy interventions in critically ill patients: a single-center prospective evaluation of 1110 intensive care unit admissions.
abstract: OBJECTIVE
  Critical illness survivors commonly have impaired physical functioning. Physical therapy interventions delivered in the intensive care unit can reduce these impairments, but the safety of such interventions within routine clinical practice requires greater investigation.
  
  
  METHODS
  We conducted a prospective observational study of routine physical therapy from July 2009 through December 2011 in the Johns Hopkins Hospital Medical Intensive Care Unit in Baltimore, MD. The incidence of 12 types of physiological abnormalities and potential safety events associated with physical therapy were monitored and evaluated for any additional treatment, cost, or length of stay.
  
  
  RESULTS
  Of 1787 admissions of at least 24 hours, 1110 (62%) participated in 5267 physical therapy sessions conducted by 10 different physical therapists on 4580 patient-days. A total of 34 (0.6%) sessions had a physiological abnormality or potential safety event, with the most common being arrhythmia (10 occurrences, 0.2%) and mean arterial pressure greater than 140 mm Hg (8 occurrences; 0.2%) and less than 55 mm Hg (5 occurrences; 0.1%). Only 4 occurrences (0.1%) required minimal additional treatment or cost, without additional length of stay.
  
  
  CONCLUSIONS
  In this large, single-center study, routine care physical therapy interventions were safe for critically ill patients.
authors: Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Division of Pulmonary and Critical Care Medicine, Thammasat University, Pathum Thani, Thailand.
authors: Thiti
authors: T
authors: Sricharoenchai
authors: Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
authors: Ann M
authors: AM
authors: Parker
authors: Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Physical Medicine and Rehabilitation, Johns Hopkins Hospital, Baltimore, MD.
authors: Jennifer M
authors: JM
authors: Zanni
authors: Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
authors: Archana
authors: A
authors: Nelliot
authors: Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
authors: Victor D
authors: VD
authors: Dinglas
authors: Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: dale.needham@jhmi.edu.
authors: Dale M
authors: DM
authors: Needham
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000209:etiology; D015142:Baltimore; D016638:Critical Illness / Q000534:rehabilitation*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities / Q000009:adverse effects* / Q000706:statistics & numerical data; D011446:Prospective Studies; D012449:Safety
keywords: Critical illness; Intensive care unit; Physical therapy modalities; Rehabilitation; Safety