Physiotherapy practice with mechanically ventilated spinal cord injury patients in the intensive care unit (ICU): A qualitative study of physiotherapists’ experiences and perspectives

ObjectiveTo explore physiotherapists' experiences with and perspectives on providing care to acute mechanically ventilated spinal cord injury patients in intensive care units to better understand physiotherapy practice with this patient population.DesignQualitative descriptive study.SettingLevel 1 intensive care units in hospitals across Ontario.ParticipantsEleven physiotherapists working in level 1 intensive care units who had experience treating at least one mechanically ventilated spinal cord injury patients within the year prior to recruitment.MethodsSemistructured interviews were conducted with participants. Interviews lasted approximately 60 minutes, were transcribed verbatim and anonymised. Interview transcripts were analyzed using an inductive thematic analysis approach.ResultsThree overarching themes with several subthemes were identified: (1) spinal cord injury care provision is improved by physiotherapist presence and collaboration with patients' circle of care in the intensive care unit; (2) increased access to resources, specialized education and training could address challenges in physiotherapist treatments and assessments; and (3) physiotherapist involvement in acute spinal cord injury patients' care can optimize safety.ConclusionsOur findings suggest that integrating physiotherapist into intensive care unit spinal cord injury care may support early mobilization and improved patient outcomes. Physiotherapist presence enhanced interprofessional collaboration and communication. Physiotherapists faced challenges such as training gaps and limited autonomy, but informal mentorship improved physiotherapist integration. This qualitative study of 11 intensive care unit physiotherapists from one region suggests that greater physiotherapist involvement may improve care processes and warrants larger multisite studies.