For critically ill, leaving the ICU is just the beginning


Patients who are discharged from the ICU can experience significant losses of physical, mental and cognitive abilities. This group of problems is called post-intensive care syndrome (PICS). It’s a serious issue that’s now recognized as a public health burden.

The effects of PICS are wide-reaching. Physical declines can lead to serious difficulty completing basic daily tasks like getting to the bathroom, preparing a meal, or walking to the mailbox. Fifty percent of ICU survivors still have limitations in daily activities 1 year later, showing how serious and long-lasting this problem is.

Mental health issues are common for ICU survivors. They show significant rates of depression, anxiety and PTSD. These conditions have a real impact on the quality of life after leaving the ICU.

ICU survivors also commonly show declines in cognitive abilities. Seventy-seven percent have cognitive impairments at 3 months post-discharge and 71% have impairments 1 year out. Cognitive issues can take the form of poor memory, slower thinking, difficulty making decisions, or difficulty concentrating.

For COVID-19 survivors the road to recovery can be far from over even after the worst symptoms have subsided. It’s important to be proactive and speak to your medical team about how you can continue to manage remaining symptoms and seek treatment whenever possible. Mental health issues such as depression or severe cognitive deficits may be managed by a mental health professional. 

The physical impairments of weakness, immobility, and decreased endurance can be treated by a physical therapist.

Depending on the extent and severity of any cardiac injury sustained during the acute phase of COVID-19 you may need to engage in rehabilitation only under the direct supervision of a cardiologist.

A doctor of physical therapy will take a thorough history and request any medical records and labs to best understand the severity of your case. Vitals including heart rate, blood pressure, oxygen saturation, and respiration rate will be monitored throughout rehabilitation sessions. In addition, your doctor of physical therapy will monitor your rate of perceived exertion (RPE) as this is a good indicator and correlates with how intensely the prescribed exercise is taxing your cardiovascular system. 

Other neurological deficits such as impaired balance and gait can be addressed with balance retraining. In addition, any disuse muscle atrophy can be targeted with carefully graded and monitored exercise.

While PICS isn’t totally preventable, recognizing the losses that remain after discharge from the ICU is an important step. Involving physical therapists and other rehab professionals early helps combat the effects of PICS and allows patients to return to higher quality lives.

ProFysio Physical Therapy provides outpatient physical therapy services in Aberdeen, Old Bridge, East Brunswick and Edison. Visit to learn more. Click “request an appointment” to schedule.