Clinical investigation of the reasons for interrupting physiotherapy sessions in the intensive care unit: A retrospective observational study

Physiotherapy interventions in intensive care are individualized and planned according to the clinical condition of the patients, and the interventions may sometimes be interrupted depending on the clinical response of the patient. This study aims to systematically identify the clinical conditions that cause interruption of physiotherapy sessions in intensive care units (ICUs). This study was planned as a retrospective observational study. Data regarding the patients' demographic information and clinical conditions were obtained from the hospital information technology management system. Also, data on physiotherapy interventions (type of exercises, reason for interruption) were obtained through the Physiotherapy and Rehabilitation Follow-up Form, which is routinely used to systematically document physiotherapy evaluations and interventions in the ICU. According to our results, the patients had a mean age of 63.7 ± 18 years, with an average ICU stay of 9.3 ± 11.7 days. The mean systolic and diastolic blood pressures were 121.8 ± 17.6 and 67.8 ± 11.5 mm Hg, respectively. Respiratory assessments revealed a mean respiratory rate of 25.8 ± 7.6 breaths per minute and an oxygen saturation of 93.9 ± 3.5%. Reasons for session interruption were classified under 4 main headings: hemodynamic disorders, respiratory problems, clinical symptoms and other reasons. Of the 985 physiotherapy sessions performed in the ICU for 1 year, 79 (8%) were terminated for various reasons. The reasons for interruption were hemodynamic changes (11.4%), respiratory problems (16.4%), clinical symptoms (41.8%), and other reasons such as cooperation problems (30.4%). The most common reason for interruption of physiotherapy sessions was clinical symptoms, followed by problems with cooperation, respiratory and hemodynamic changes. Our findings indicate that most interruptions during physiotherapy sessions were due to temporary and manageable reasons, suggesting that physiotherapy interventions in intensive care can be performed safely under appropriate conditions. In clinical perspectives, these insights can guide clinicians in identifying optimal timing for physiotherapy interventions and adapting treatment plans to minimize interruptions, thereby enhancing the continuity and effectiveness of care.