Recovery From Critical Illness: Physical Rehabilitation for PICS

Presented by Patricia J. Ohtake, James Smith, and Hallie Zeleznik

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Video Runtime: 60 Minutes; Learning Assessment Time: 48 Minutes

Post-intensive care syndrome (PICS) was described by the Society of Critical Care Medicine in 2012 to increase awareness of the problems that survivors of critical illness face following hospital discharge. People with PICS respond differently to rehabilitation interventions than other people with similar problems and activity limitations. However, interventions targeted to improve their functioning can be successful. This course will briefly review PICS, describe evidence-based rehabilitation strategies for the problems associated with PICS, and provide strategies for engaging in an interprofessional team approach to manage a patient with PICS. Those providing posthospitalization services, such as nursing, rehabilitation, social work, nutrition, and primary care, will learn strategies for fostering recovery from PICS.

Meet your instructors

Patricia J. Ohtake

Patricia J. Ohtake, PT, PhD, is the assistant vice president for interprofessional education in the Office of the Vice President for Health Sciences and associate professor in the physical therapy program at the University at Buffalo. Dr. Ohtake’s research focuses on acute and critical care rehabilitation, including…

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James Smith

James Smith, PT, DPT, is a professor of physical therapy at Utica College. Prior to that, much of his career had been in hospital-based practice. His service to the profession included president, Education Committee chair, Nominating Committee chair, and Clinical Practice Guidelines Committee chair in APTA-Acute Care;…

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Hallie Zeleznik

Hallie Zeleznik, PT, DPT, is the director of strategic initiatives and professional development for UPMC Centers for Rehab Services in Pittsburgh, Pennsylvania. She is a board-certified neurologic clinical specialist. She previously held the positions of assistant director of the outpatient neurologic/vestibular program for…

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Chapters & learning objectives

Overview of PICS and the Associated Impairments, Activity Limitations, and Participation Restrictions

1. Overview of PICS and the Associated Impairments, Activity Limitations, and Participation Restrictions

This chapter will provide an introduction to PICS and the scope of the syndrome. The chapter will address the physical, cognitive, and/or mental health problems associated with PICS. The long-term effects on the patient, the family, and health care utilization will be reviewed.

Interventions to Improve Physical Functioning in People With PICS

2. Interventions to Improve Physical Functioning in People With PICS

This chapter will focus on designing interventions for physical impairments, activity limitations, and participation restrictions. An evidence-based framework is applied to rehabilitation strategies to address the diverse problems associated with PICS, including the need for compensatory interventions and task-specific training, and the importance of titrating intensity for effective restorative interventions.

Interprofessional Communication and Collaboration to Optimize Outcomes for People With PICS

3. Interprofessional Communication and Collaboration to Optimize Outcomes for People With PICS

This chapter will address the value of early recognition and services for PICS, and concerns about the elevated risk for developing new, chronic medical conditions. It will also review strategic communication and collaboration with the interprofessional team to optimize outcomes for people with PICS. The value of community-based services and programs will be reviewed.

Importance of Family in the Management of PICS

4. Importance of Family in the Management of PICS

Critical illness is often a family crisis accompanied by family members frequently experiencing financial toxicity and problems with mental and physical health. This chapter will describe strategies for patient and family education as an integral component in the process of recovering after critical illness.