An investigation of the use of passive movements in intensive care by UK physiotherapists.

The purpose of this study was to investigate the current use of passive movements (PMs) by National Health Service (NHS) physiotherapists working with sedated and ventilated patients in critical care settings. DESIGN: Postal questionnaire. SETTING: All open NHS critical/intensive care units in England, Northern Ireland, Scotland and Wales. PARTICIPANTS: Physiotherapists working in UK NHS critical/intensive care units. RESULTS: Questionnaires were posted to 246 physiotherapists working in intensive care units; 165 (67%) were returned. One hundred and fifty-two respondents routinely treated ventilated and sedated patients, of which 151 (99%) reported utilising PMs. They were used most commonly (>70%) in patients admitted to critical care with medical, neurological or surgical problems. Respondents reported using a median of five repetitions of PMs once daily, and the majority of respondents took joints to the end of range (>78%). Joints most commonly treated included the shoulder, hip, knee, elbow and ankle. Heart rate and blood pressure were monitored by over 84% of respondents during treatment.

Whilst there is little empirical evidence to underpin the use of PMs, this study found that PMs were used regularly by 99% of respondents working in NHS critical care settings. Further work is now needed to evaluate the immediate and long-term effects of PMs in critically ill patients to inform and develop future practice.

Stockley RC, Hughes J, Morrison J, Rooney J. An investigation of the use of passive movements in intensive care by UK physiotherapists. Physiotherapy. 2010 Sep;96(3):228-233

Models of Foot Function

A short online course with podiatrist Kevin Bruce Lee Herrington which reviews the different models of foot function and clinically relevant tests for the ankle foot complex.