THE ROLE OF THE PHYSICAL THERAPIST IN THE INTENSIVE CARE UNIT FOR PATIENTS WITH STROKE

Abstract

Purpose. To investigate and substantiate the pivotal role of the physical therapist in the intensive care unit (ICU) for patients with acute stroke, as well as to highlight the strategies and benefits of early rehabilitation intervention aimed at improving functional outcomes and reducing long-term disability.Materials. This study is an analytical literature review based on high-quality clinical trials, systematic reviews, meta-analyses, and clinical guidelines published between 2010 and 2025. The search wasconducted in leading scientific databases (PubMed, Scopus, Web of Science, Cochrane Library, GoogleScholar) using keywords such as “stroke”, “intensive care unit”, “physical therapy”, “early mobilization”.Source selection followed strict inclusion/exclusion criteria, with an emphasis on evidence and timeliness.Results. The review revealed that early physical therapy in the ICU significantly improves functional outcomes in stroke patients. Specifically, a statistically significant reduction in NIHSS scores was observedeven at discharge from the ICU (average reduction of 1-2 points), indicating faster regression of neuro-logical deficit. Long-term functional benefits are confirmed by a statistically significant improvement in functional independence as measured by the modified Rankin Scale (mRS) (an increase in the proportion of patients achieving mRS ≤ 2 by 15–20%) and higher scores on the Barthel Index at ICU discharge. Earlyactive and passive movements also contribute to accelerated recovery of motor function.In addition to functional recovery, early physical therapy is crucial for reducing the incidence of secondarycomplications. Data indicate a reduction in the frequency of pneumonia by up to 30%, pressure ulcers by up to 40%, and contractures by up to 50%. The risk of thromboembolic complications is also reduced by 20%. These findings underscore the preventive role of the physical therapist. Furthermore, the implementation of early physical therapy demonstrates a reduction in the average length of stay in the ICU by 1–2 days, leading to optimized healthcare resource utilization and reduced treatment costs. The effectiveness of these interventions depends on the integration of the physical therapist into the multidisciplinary team, ensuring timely assessment, individualized program development, complication prevention, and family education.Conclusions. Early physical therapy, initiated in the intensive care unit under the guidance of a qualified physical therapist, is a safe, effective, and cost-efficient strategy for managing patients with acute stroke.It not only enhances neurological and functional indicators but also significantly reduces the incidence of severe complications and shortens hospital stay, which is of substantial importance for the Ukrainian healthcare system.