With the increasing survival rates of critically ill patients, patients with long-term sequelae post-discharge from the intensive care unit (ICU) and their living conditions have become apparent. Physical and cognitive impairments and psychological disturbances persisting after ICU discharge are barriers to reintegration and long-term prognosis of ICU survivors. Under these circumstances, the “Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit (PAD Guidelines)” were revised to address patient-centered management of pain, restlessness, and delirium, including patient distress and stress during the ICU treatment, as well as early mobilization and rehabilitation in the ICU. The PAD guidelines were subsequently revised into PADIS guidelines with additional issues related to immobility and sleep disruption, and advances in analgesia and sedation management have dramatically increased the use of early rehabilitation in the ICU, resulting in shorter ventilation periods and improved activities of daily living. Physical therapists play a diverse role in the ICU. They focus on several tasks, including: 1) improving physical function through exercise therapy, early mobilization, and complication prevention, 2) planning and coordinating specific exercise programs, 3) assessing patients, 4) monitoring exercise sessions, and 5) providing feedback on their effectiveness. To realize life plans that have been left unfulfilled after recovering from a serious illness, it is important to carefully listen to how patients live their lives, support their recovery of physical functions, and implement countermeasures against various complications in cooperation with multiple professions, which will lead to a brighter long-term prognosis post-discharge. With the continuously increasing elderly population, established treatment strategies for post-ICU syndrome have not yet been identified. In the future, detailed physical therapy tailored based on the characteristics of the elderly people and focusing on long-term prognosis will be required.
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