Rehabilitation in Intensive Care Unit

According to the clinical classification of the World Health Organization, COVID-19; It
manifests itself in a wide spectrum, ranging from mild illness, Pneumonia, Severe pneumonia,
Acute respiratory distress syndrome (ARDS), to Sepsis and septic shock, resulting in death.
In the presence of acute respiratory failure, a decrease in lung compliance leads to
increased respiratory work, impaired blood oxygenation, and rapid and superficial breathing
patterns. In this case, minimizing inspiratory effort and maximizing the mechanical
efficiency of breathing is the most important approach of treatment. In these clinical
conditions, the strength of the respiratory muscles may also be reduced.

The challenge of COVID-19 requires a multidisciplinary approach. Rehabilitative intervention
should be a part of the treatment pathway from the early stages of the disease. There is an
urgent need to build information based on the most effective non-pharmacological measures to
ensure the earliest discharge and best recovery after complex COVID-19 infection. Multimodal
rehabilitation at all stages of the disease should be part of a holistic medical approach,
but there is still no consensus on the timing and type of intervention.

Early physiotherapy in early-onset acute respiratory distress syndrome in the ICU is a
critical therapeutic tool to reduce the complications of immobilization in critical diseases
such as myopathy, neuropathy and ventilator dependence. Benefits include improved residual
respiration, musculoskeletal system, neurological and psychological function; It prevents
re-hospitalizations in the medium and long term, improves health status and improves the
perceived quality of life after discharge. In an acute setting, interventions can also
motivate active recipients to participate in rehabilitation pathways and improve adherence to
treatment after discharge.

Serious cases of COVID-19 are associated with the consequences of respiratory support and
rehabilitation needs related to prolonged immobility and bed rest. These can include:

Impaired lung function;

- physical impairment and muscle weakness; Delirium and other cognitive disorders;
Impaired swallowing and communication; and

- Mental health disorders and psychosocial support needs. Based on this information, we
aimed to investigate whether respiratory rehabilitation, positioning, normal joint
movement exercises and early mobilization are effective in the treatment of Covid-19.