PICS is a collection of symptoms, limitations, and impairments that occur in people who have recently been treated in a hospital's intensive care unit (ICU). These impairments may be chronic, limiting your ability to fully participate in your normal activities after you leave the ICU.
If you have recently been discharged from the intensive care unit, you may benefit from the services of a physical therapist to help you fully recover and return to your previous level of work and recreational activity.
The global health pandemic caused by the COVID-19 virus has resulted in an increase in the number of people who may require ICU care. As these individuals recover from the virus and are released from the hospital, they may require extensive healthcare services and resources to fully recover.
A significant number of people may be diagnosed with PICS and require long-term rehabilitation. Physical therapy could be an important part of the rehabilitation and recovery process for people with PICS.
Understanding the symptoms of PICS can assist you in determining if you have it. A post-intensive care syndrome is a group of symptoms that you may or may not have. Physical impairments, cognitive impairments, and mental/emotional impairments are common symptoms.
If you have PICS, you may have significant physical impairments that make functional mobility difficult.
Following ICU treatment, a significant number of people with PICS have difficulty returning to full functional status. Many people do not return to their previous level of employment, and some people require extensive rehabilitation to return to independent driving and community engagement.
Cognitive impairment may also be present following an intensive care unit stay. Attention, memory, and concentration issues may be present. According to one study, roughly half of the survivors of acute respiratory distress syndrome (ARDS) have some form of cognitive impairment, which can last for two years or more after they leave the hospital.
Some people who survive a critical illness and an ICU stay have significant mental impairments. This may include depression, anxiety, and post-traumatic stress disorder symptoms.
While mental health care may be outside of your physical therapist's scope of practice, he or she may ask you about your feelings to screen for any mental health impairment. If you show signs of a problem, you will be referred to an appropriate provider.
An initial evaluation is your first session with a physical therapist for PICS. During this appointment, your PT will interview you and go over your current treatment plan.
Prepare to answer specific questions about your length of stay in the hospital, your functional status prior to admission, and whether or not you were ventilated. Your PT will inquire about any previous rehab services you have received, as well as review your medical history.
Your physical therapist will conduct an initial evaluation following the interview. He or she will take a variety of measurements to look for specific impairments that may be limiting your functional mobility.
During physical therapy, your primary tool should be exercised. Your physical therapist will work with you to improve your strength, balance, mobility, and function. If you have PICS, consult your doctor or physical therapist before beginning any exercise program.
If you are receiving PICS services in a rehab hospital, your PT may collaborate with an occupational therapist. Your PT and OT may collaborate to improve standing and walking while performing daily activities such as brushing your teeth or hair.
If you are receiving PICS PT at home, your therapist may be limited in the exercises that you can do. Don't worry; home care PTs are resourceful and can collaborate with you to provide challenging activities and exercises to help you improve your mobility.
PICS outpatient physical therapy may include the use of exercise machines to improve strength and endurance. Balance tools such as a BOSU ball or a BAPS board can be used to improve balance and proprioception. To improve respiratory and aerobic endurance, stationary bikes, upper-body bikes, or treadmills may be available.
