This study aims to assess the functional status and physiotherapy workload of TBI patients during their ICU rehabilitation, to optimize physiotherapy interventions to the specific characteristics and needs of each patient.
This retrospective observational study included patients over 18 years old admitted to the Trauma ICU between february 2022 and april 2024, diagnosed with TBI and requiring invasive mechanical ventilation (IMV). Data were collected from the internal database. Patient functional levels were assessed using the IMS (Intensive Mobility Scale), while physiotherapy workload was documented based on the number of personnel assisting during sessions: 1 person (25% assistance), 2 persons (50%), 3 persons (75%), or 4 persons (100%). TBI severity was classified according to the Glasgow Coma Scale (GCS) at the time of the accident (GCS 3-8: severe; 9-12: moderate; 13-15: mild).
A total of 42 patients were included, with a mean age of 40.7 (SD ± 14.9) years, and the majority were male (85.7%). Upon admission, 40.5% had severe GCS scores. The most common injury mechanism was traffic accidents (50%). The median duration of IMV was 10 (IQR 4-14) days, and ICU stay was 15 (IQR 9-19) days. All patients achieved "Sitting Edge of Bed" within a median of 12 (IQR 6-16) days, with an IMS score of 3 points and 50% (IQR 50%-50%) assistance. Additionally, 71.4% of patients achieved the "Biped" position in a median of 11 (IQR 5-15) days, with an IMS score of 4 points and 50% (IQR 25%-75%) assistance. Half of the patients were able to walk within a median of 10 (IQR 6-17) days, with an IMS score of 7 points and 50% (IQR 25%-50%) assistance. A positive correlation was observed between GCS scores and both higher functional achievements (rho=0.4, p0.05) and physiotherapy workload (rho=0.4, p0.05).
TBI patients demonstrate high physiotherapy demands, with varying functional levels across individuals. ICU motor rehabilitation should involve at least two therapists to ensure optimal recovery times for TBI patients.
This study shows the importance of personalized physiotherapy for TBI patients in the ICU, recommending a minimum of two physiotherapists per session to optimize the rehabilitation process. Research shows that early intervention may improve functional outcomes and reduce ICU stay. Our results show that the severity of TBI significantly impacts physiotherapy workload and functional recovery, highlighting the need for early and individualized rehabilitation plans.
Traumatic Brain Injury
Intensive Care Unit
