Physical therapy in the intensive care unit: A cross-sectional study of three Asian countries

Physical therapy in the intensive care unit: A cross-sectional study of three Asian countries

Physical therapy (PT) is beneficial for critically ill patients, but the extent of its application in the intensive care unit (ICU) differs between countries. Here, we compared the extent of PT intervention in the ICU in Japan, the Philippines, and Taiwan by evaluating the sociodemographic and ICU-r...

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Bibliographic Details
Published in:PloS one Vol. 18; no. 11; p. e0289876
Main Authors: Viloria, Mary Audrey Domingo, Lee, Shin-Da, Takahashi, Tetsuya, Cheng, Yu-Jung
Format: Journal Article
Language:English
Published: San Francisco Public Library of Science 09-11-2023
Public Library of Science (PLoS)
Subjects:
Breathing exercises
Care and treatment
Comparative analysis
Cross-sectional studies
Health care disparities
Hospital patients
Hospitals
Informed consent
Intensive care
Intensive care units
Intervention
Medicine and Health Sciences
Patients
Pediatrics
People and Places
Physical therapists
Physical therapy
Physical therapy services
Physiology
Research and Analysis Methods
Services
Social networks
Sociodemographics
Surveys
Therapeutics, Physiological
Training
Variance analysis
Ventilators
Workplaces
Japan
Philippines
Taiwan
India
United States > US
Sri Lanka
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Summary:Physical therapy (PT) is beneficial for critically ill patients, but the extent of its application in the intensive care unit (ICU) differs between countries. Here, we compared the extent of PT intervention in the ICU in Japan, the Philippines, and Taiwan by evaluating the sociodemographic and ICU-related profiles of ICU physical therapists. In this cross-sectional study, a semistructured nationwide online survey was distributed to ICU physical therapists in the three countries. We analyzed the responses of 164 physical therapists from Japan, Philippines, and Taiwan. Significant differences were observed between the countries in all sociodemographic variables and the following ICU-related profiles of physical therapists: ICU work experience, duration of the ICU posting, number of hours per day spent in the ICU, on-call ICU PT service engagement, source of ICU patient referral, therapist-patient ratio, and ICU-related PT training participation (p < 0.05). Medical, surgical, and neurologic ICUs were the most common ICU workplaces of the ICU physical therapists, but only surgical and neurologic ICUs exhibited significant differences between the countries (p < 0.05). Standard PT techniques in the ICU were passive and active-assisted range of motion, positioning, and breathing exercises but were implemented with significantly different frequencies between the countries (p < 0.05). The most common challenge faced in ICU PT service delivery by respondents from all three countries was lack of training prior to ICU duty, and lack of training was even bigger challenge in Japan than in other two countries after adjustment of age, highest educational attainment, and work experience. The differences in the health-care system between Japan, the Philippines, and Taiwan were related to differences in the compliance with internationally recommended PT practice standards in the ICU, differences in the type of PT intervention prioritized, and the challenges encountered in ICU PT service delivery.
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Competing Interests: The authors have declared that no competing interests exist.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0289876