ReviewBrazilian journal of physical therapy2026
ASSOBRAFIR clinical practice guidelines in intensive care physical therapy: Rehabilitation strategies in critically ill adults.
Review in Brazilian journal of physical therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEarly mobilization and respiratory muscle training strategies are widely used by physiotherapists to prevent, reduce impairment, and rehabilitate critically ill patients. Guidelines are required to respond to specific questions for physiotherapists in clinical practice.
objectiveTo provide evidence-based recommendations for rehabilitating intensive care unit (ICU) patients.
methodsThe Guideline International Network (GIN) and The Appraisal of Guidelines for Research & Evaluation (AGREE-II) recommendations and principles were followed. The guideline panel of specialists used the Grading of Recommendations Assessment Development and Evaluation (GRADE) approach to appraise evidence quality and formulate recommendations from four key questions on the rehabilitation of critically ill patients. Treatment effects were assessed using systematic reviews and meta-analyses.
resultsThe Guideline Panel recommends: 1. Structured and progressive early mobilization protocol over usual care (Strong recommendation [SR], Low to moderate certainty of evidence [LMCoE]) and 2. Inspiratory muscle training instead of usual care in mechanically ventilated adult patients undergoing difficult or prolonged weaning ([SR], Moderate certainty of evidence [MCoE]). The Guideline Panel suggests the following: 3. Against using passive mobilization alone compared with usual care in non-cooperative patients in the ICU (Conditional [CR], very low [VLCoE], and 4. Against inspiratory muscle training as a routine intervention compared with usual care ([CR] in mechanically ventilated adult patients under simple weaning, Low certainty of evidence [LCoE]).
conclusionThese guidelines can assist healthcare professionals in structuring respiratory muscle training and mobilization strategies in critically ill patients.
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