Mobility and Function

Patients experiencing critical illness often have extreme derangement of physiological function requiring admission to an intensive care unit (ICU). Within the ICU, there is an initial focus on aggressive life support, coupled with continuous monitoring and treatment for organ failure. While providing this care, management of the critically ill patient has traditionally involved supine or semi-recumbent positioning and bed rest, mechanical ventilation, analgesia and sedation but with historically little attention placed on long-term outcomes and in particular neuromuscular function. Consequently, survivors of critical illness often experience significant physical, psychological and cognitive morbidity, the effects of which can last for months to years after hospital (Herridge et al., N Engl J Med 364:1293–1304, 2011). Preventing or minimising the physical consequences of critical illness and supporting recovery from intensive care are, therefore, essential to improve patient outcomes. This has placed an increased focus on the importance of early rehabilitation during intensive care, followed by structured and comprehensive programmes of rehabilitation throughout the recovery period.