Resource type: Article

Physiotherapy on the ward

What does a physiotherapist do on the ward?

Physiotherapy has a very important role in recovery and rehabilitation after Intensive Care. The physiotherapist works very closely with all the other members of the ward staff to make sure that you are recovered enough to cope at home. The two main things that the physiotherapist can help with are breathing exercises and mobility (eg walking).

Why might I need to see a physiotherapist after Intensive Care?

Some patients still require oxygen therapy following transfer to the ward or are at risk of developing a chest infection due to weak breathing muscles and a weak cough. The physiotherapist can help with breathing exercises and with improving your ability to cough.

Patients are often immobile (lying still) for much of their time in Intensive Care, sometimes resulting in general stiffness or painful joints, especially in the knees and shoulders. They can also lose muscle due to the severity of their illness, resulting in general weakness. This can mean that patients may struggle to move without help or can become tired or short of breath when beginning to gently move around (e.g. being helped to sit on the edge of the bed, out in a chair or taking short walks). All of these problems can be more severe for patients who have spent longer in Intensive Care.

When should I expect to see a physiotherapist?

Patients who came into Intensive Care after surgery (or after complications during surgery) tend to be followed up on the general wards by the physiotherapists from Intensive Care. Patients tell us that they find this very helpful, because they prefer to be seen by someone who they know and trust, and who knows what they've been through in Intensive Care.

Patients who ended up in Intensive Care following a non-surgical problem will normally be referred to a new team of physiotherapists. The Intensive Care physiotherapists will give this new team a detailed handover on your illness, your progress and the types of things you will need help with.

You should expect to see a physiotherapist within the first few days after transfer to the general ward. How often patients are seen by a physiotherapist varies widely, depending on how much and what kind of help they need.

What is involved in physiotherapy assessments and exercises?

The physiotherapist will assess your chest, your breathing pattern and your ability to cough and to clear any phlegm. They also need to see if you are able to move independently in bed, if you have been out of bed, how much assistance you require, and how safely and how far you are able to walk.

The physiotherapist will give you an exercise plan which will be tailored to your individual needs. The main aim will be to help you to be able to walk independently. If you have stairs at home, you will have to be able to climb a flight of stairs safely. Exercises will help to get any stiff joints moving and strengthen your muscles. Your exercise plan may include some of the following: practice moving like getting in and out of bed or in and out of a chair; balance exercises; marching on the spot and walking; stretches; using pedals; climbing stairs and advice on how to pace your exercise so that you're doing the right amount of exercise.

What can I do to help myself?

You might need help or supervision when you first start your exercise programme and walking. However there are usually exercises that you can do by yourself. Your physiotherapist will have assessed your ability and know what exercises you can do by yourself and those that you still need help with. Don't be afraid to ask the physiotherapist what you can start doing by yourself if they haven't already told you.

What is involved in being assessed for formal rehabilitation?

If you have spent a number of weeks in Intensive Care your muscles may be very weak which can really affect your ability to do normal things like getting in and out of bed and walking. If this is the case then you may be assessed for transfer to a rehabilitation hospital.

What kind of help can I get after I get home?

There are different physiotherapy services available in the community. Some services come into your home, for example, if you have stairs at home but at the time of discharge you are unable to climb the stairs you might temporarily live downstairs and a physiotherapist could come to your house to help with exercises to get you stronger so that you are able to climb the stairs. Other physiotherapy services provide out-patient services that you would visit.

Who can I contact if I need help?

If you think you need some additional help improving physically then speak to your physiotherapist before you leave hospital or visit your GP who should be able to advise you about physiotherapy services in your area. There are also links to physiotherapy services in the 'Getting back to normal' section.