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VOLUME 18 , ISSUE 6 ( June, 2014 ) > List of Articles


Chest physiotherapy techniques in neurological intensive care units of India: A survey

Kalyana Chakravarthy, Anup Bhat, Bhamini Rao

Keywords : Cardiorespiratory physiotherapy, critical care units, cross-sectional survey, India, neurological intensive care unit, online survey

Citation Information : Chakravarthy K, Bhat A, Rao B. Chest physiotherapy techniques in neurological intensive care units of India: A survey. Indian J Crit Care Med 2014; 18 (6):363-368.

DOI: 10.4103/0972-5229.133890

License: CC BY-ND 3.0

Published Online: 01-01-2006

Copyright Statement:  Copyright © 2014; The Author(s).


Context: 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. Aim: The aim of this study is to obtain data on current chest physiotherapy practices in neurological ICUs of India. Settings and Design: A tertiary care hospital in Karnataka, India, and cross-sectional survey. Subjects and 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. Statistical Analysis Used: 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.

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  1. Howard RS, Kullmann DM, Hirsch NP. Admission to neurological intensive care: Who, when, and why? J Neurol Neurosurg Psychiatry 2003;74 Suppl 3:iii2-9.
  2. Lee K, Rincon F. Pulmonary complications in patients with severe brain injury. Crit Care Res Pract 2012;2012:207247.
  3. Bersten A, Soni N. Oh′s Intensive Care Manual. 6 th ed. Philadelphia: Butterworth Heinemann; 2009.
  4. Ersson U, Carlson H, Mellström A, Pontén U, Hedstrand U, Jakobsson S. Observations on intracranial dynamics during respiratory physiotherapy in unconscious neurosurgical patients. Acta Anaesthesiol Scand 1990;34:99-103.
  5. Olson DM, Thoyre SM, Bennett SN, Stoner JB, Graffagnino C. Effect of mechanical chest percussion on intracranial pressure: A pilot study. Am J Crit Care 2009;18:330-5.
  6. Harden B, Calls to the neurology/neurosurgical unit. In: Clapham L, editor. Emergency Physiotherapy. Philadelphia, USA: Elsevier; 2005. p. 172-83.
  7. Chaboyer W, Gass E, Foster M. Patterns of chest physiotherapy in Australian Intensive Care Units. J Crit Care 2004;19:145-51.
  8. Kumar JA, Maiya AG, Pereira D. Role of physiotherapists in intensive care units of India: A multicenter survey. Indian J Crit Care Med 2007;11:198-203.
  9. Stiller K. Physiotherapy in intensive care: An updated systematic review. Chest 2013;144:825-47.
  10. Norrenberg M, Vincent JL. A profile of European intensive care unit physiotherapists. European Society of Intensive Care Medicine. Intensive Care Med 2000;26:988-94.
  11. Hodgin KE, Nordon-Craft A, McFann KK, Mealer ML, Moss M. Physical therapy utilization in intensive care units: Results from a national survey. Crit Care Med 2009;37:561-6.
  12. Macmillan CS, Andrews PJ. Cerebrovenous oxygen saturation monitoring: Practical considerations and clinical relevance. Intensive Care Med 2000;26:1028-36.
  13. Yang M, Yan Y, Yin X, Wang BY, Wu T, Liu GJ, et al. Chest physiotherapy for pneumonia in adults. Cochrane Database Syst Rev 2013;2:CD006338.
  14. Garrubba M, Turner T, Grieveson C. Multidisciplinary care for tracheostomy patients: A systematic review. Crit Care 2009;13:R177.
  15. Dean E, Perme C. Intensive care management of individuals with secondary cardiovascular and pulmonary dysfunction. In: Frownfelter D, Dean E, editors. Cardiovascular and Pulmonary Physical Therapy: Evidence to Practice. St. Louis: Mosby, Elsevier; 2012. p. 577-80.
  16. Moodie L, Reeve J, Elkins M. Inspiratory muscle training increases inspiratory muscle strength in patients weaning from mechanical ventilation: A systematic review. J Physiother 2011;57:213-21.
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