To map the patient’s outcome measures of intensive care unit physiotherapy interventions in studies published between 2004 and 2023.
We conducted a systematic mapping review of original studies published between 2004 and 2023 in five databases (i.e. Web of Science’s core collection, CINAHL, MEDLINE via EBSCO Host, PubMed, and PEDro) without a language restriction. Our search had two facets: “physical therapy” and “intensive care unit”. The screening and data extraction process was conducted in three phases using Covidence. First, all titles and abstract were screened. Secondly, all full-text articles were checked against pre-stablished selection criteria. Thirdly, data on the author, year, country of origin, study design, description of the physiotherapy intervention, and outcome measures used were extracted. Two reviewers conducted each phase separately, with a third reviewer arbitrating disagreements. For the analysis phase, the physiotherapy intervention was classified as physical rehabilitation, chest physiotherapy, ventilatory management, or combined therapy. Identified outcome measures were classified using the Williamson/Clarke taxonomy (revised), which has 38 domains organised in five core areas: death, physiological or clinical, life impact, resource use, and adverse events. The data on physiotherapy intervention and outcome measures was mapped to identify measurement gaps and trends over time.
Our search found 5593 records, of which 506 were included. United States (97 [17%]), Brazil (86 [15%]), and Australia (52 [9%]), were the countries with the highest number of studies. Most publications were in English (473 [93%]). Most studies were observational (311 [61%]) instead of experimental (195 [39%]). Between 2004 and 2006, most studies (10 [48%]), focused on chest physiotherapy, but from 2010, most studies focused on the effects of physical rehabilitation (462 [67%]). We identified 3495 outcome measures. Physiological or clinical outcomes were reported the most (1332 [38%]), followed by life impact (1291 [37%]), resource use (534 [15%]), adverse events (242 [7%]) and death (96 [3%]). For all interventions, the categories with the highest number of outcomes measures were “respiratory, thoracic, and mediastinal outcomes” and “delivery of care”, which represent over 40% of all outcome measures. "Emotional functioning/well-being"(1 [0%]), “Perceived health status"(1 [0%])”, "Global quality of life""(17 [0%]), and "Cognitive functioning" "(56 [2%]) were the least reported outcome measures.
This evidence map shows that studies on physical rehabilitation have steadily increased since 2010. Studies measuring life impact outcomes are still scarce. However, there has been an increase in the number of studies reporting physical functioning and delivery of care.
Although there has been a steady increase in the number of studies assessing the effect of physical rehabilitation in the intensive care unit, outcomes that are relevant to patients are still seldom measured. Future research should adhere to established core outcome sets so the effect of interventions can be captured consistently and the evidence base for physiotherapist interventions can be improved.
Outcome Measure
Physical Therapy Modalities
