title: Chest physiotherapy techniques in neurological intensive care units of India: A survey.
abstract: BACKGROUND
  Neurological intensive care units (ICUs) are a rapidly developing sub-specialty of neurosciences. Chest physiotherapy techniques are of great value in neurological ICUs in preventing, halting, or reversing the impairments caused due to neurological disorder and ICU stay. However, chest physiotherapy techniques should be modified to a greater extent in the neurological ICU as compared with general ICUs.
  
  
  OBJECTIVE
  The aim of this study is to obtain data on current chest physiotherapy practices in neurological ICUs of India.
  
  
  METHODS
  A tertiary care hospital in Karnataka, India, and cross-sectional survey.
  
  
  METHODS
  A questionnaire was formulated and content validated to assess the current chest physiotherapy practices in neurological ICUs of India. The questionnaire was constructed online and a link was distributed via E-mail to 185 physiotherapists working in neurological ICUs across India.
  
  
  METHODS
  Descriptive statistics.
  
  
  RESULTS
  The response rate was 44.3% (n = 82); 31% of the physiotherapists were specialized in cardiorespiratory physiotherapy and 30% were specialized in neurological physiotherapy. Clapping, vibration, postural drainage, aerosol therapy, humidification, and suctioning were used commonly used airway clearance (AC) techniques by the majority of physiotherapists. However, devices for AC techniques such as Flutter, Acapella, and standard positive expiratory pressure devices were used less frequently for AC. Techniques such as autogenic drainage and active cycle of breathing technique are also frequently used when appropriate for the patients. Lung expansion therapy techniques such as breathing exercises, incentive spirometry exercises, and positioning, proprioceptive neuromuscular facilitation of breathing are used by majority of physiotherapists.
  
  
  CONCLUSIONS
  Physiotherapists in this study were using conventional chest physiotherapy techniques more frequently in comparison to the devices available for AC.
authors.affiliation: Department of Physiotherapy, M. S. Ramaiah Medical College, Bengaluru, India.
authors.forename: Anup
authors.initials: A
authors.lastname: Bhat
authors.affiliation: School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India.
authors.forename: Kalyana
authors.initials: K
authors.lastname: Chakravarthy
authors.affiliation: School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India.
authors.forename: Bhamini K
authors.initials: BK
authors.lastname: Rao
keywords: Cardiorespiratory physiotherapy; India; critical care units; cross-sectional survey; neurological intensive care unit; online survey