Royal Hospital, Muscat, Oman Adult ICU — Public Awareness
Physiotherapy in ICU
Physiotherapy in AICU supports breathing, movement, and recovery at every stage of critical illness — whether the patient is sedated, on a ventilator, or breathing independently. Care is always provided in coordination with the ICU medical team and based on the patient's stability.

Phases of Physiotherapy Care

1

Patient Intubated & Sedated

Patient on a breathing machine and not awake

Goals: Protect lungs · Maintain mobility · Prevent weakness · Prepare for recovery

Breathing & Lung Care

  • Positioning to improve oxygen levels
  • Chest physiotherapy to help remove secretions
  • Supporting prone positioning when medically required

Movement & Prevention

  • Passive range of motion exercises
  • Joint positioning to prevent stiffness
  • Preventing muscle shortening and weakness
  • Reducing risk of pressure injuries
2

Intubated but Not Fully Sedated

Patient may open eyes or follow simple commands

Goals: Improve lung expansion · Rebuild strength · Support ventilator weaning

Breathing Support

  • Breathing pattern training if responsive
  • Gentle breathing exercises
  • Secretion clearance techniques

Early Mobilization (If Stable)

  • Sitting up in bed
  • Dangling legs at bedside
  • Standing with assistance
  • Transferring to a chair

Early safe mobilization in ICU is supported by international critical care guidelines, including recommendations from the Society of Critical Care Medicine.

3

After Extubation

Breathing tube removed — a critical recovery phase

Goals: Restore breathing · Regain strength · Prevent re-intubation · Prepare for ICU transfer

Breathing Rehabilitation

  • Deep breathing exercises
  • Incentive breathing devices if prescribed
  • Cough training
  • Airway clearance support

Functional Recovery

  • Bed mobility training
  • Sitting balance
  • Standing practice
  • Walking with assistance
4

Not Intubated but Critically Ill

Some patients may never require a ventilator

Goals: Optimise oxygen · Manage secretions · Maintain strength · Prevent deconditioning

Physiotherapy focuses on

  • Oxygen optimisation positioning
  • Secretion management
  • Strength maintenance
  • Endurance training as tolerated
  • Preventing deconditioning

What Patients & Families Can Expect

Our commitment to you

  • Care provided only when medically safe
  • Continuous monitoring during every treatment session
  • Clear communication with family at all stages
  • Gentle, structured, goal-based rehabilitation
  • Full collaboration with the ICU medical and nursing team
Please remember: Recovery in ICU is often gradual. Progress may be slow but every small step is meaningful and celebrated by our team.

How Families Can Help

📋

Provide Background Information

  • Previous mobility level
  • Occupation and hobbies
  • Exercise habits
  • Any joint or spine problems
💪

Encourage Participation

  • Motivate during exercises when awake
  • Offer reassurance and calm presence
  • Celebrate small improvements
❤️

Emotional Support

  • Anxiety can affect breathing and recovery
  • Calm reassurance helps reduce stress
  • Your presence matters greatly
⚠️

Follow Safety Guidance

  • Do not mobilise patient without staff present
  • Follow all positioning instructions
  • Always ask before assisting
Important message for families: Physiotherapy in ICU is not just exercise. It is a structured medical intervention designed to protect the lungs, preserve strength, and support long-term recovery — even when the patient appears unconscious.