Changes in physiotherapy practices in Chilean intensive care units during the COVID-19 pandemic: A longitudinal nationwide survey

Background

COVID-19 impacted ICUs and physiotherapy services; however, its impact on physiotherapy teams remains unclear. This study examines changes in staffing, organization, and interventions in Chilean adult ICUs during the first pandemic year.

Methods

A nationwide online survey was conducted at four time points: pre-pandemic (before March 2020, T1), beginning (July 2020, T2), mid-year (October 2020, T3), and one-year pandemic (March 2021, T4). ICU representatives reported data on bed capacity, staffing, workload, specialized training, and interventions.

Results

Eighty-four ICU sites completed all four surveys. Median ICU beds increased from 10 (6–15) at T1 to 30 (12–44) at T2, decreased to 15 (11–27) at T3, and then increased to 24 (14–54) at T4 (p < 0.001). Bed-to-physiotherapist ratio decreased from 8 (6–10) at T1 to 6 (6–8) at T2, during daytime/weekend shift (p = 0.049), while 24/7 coverage increased from 64% to 88% (p < 0.001). At T4, 30% of sites reported specialized physiotherapists. High-flow oxygen and ventilator-related interventions were reported in ≥96% of sites at T4 (p < 0.001). In-bed mobilization remained highly reported (96–100%), and in-bed cycling increased from 20% at T1 to 32% at T4 (p = 0.013). Among team-based interventions, prone positioning assistance increased from 83% at T1 to 99% at T4 (p < 0.001) and in-person shift handover and intra-hospital patient transportation also increased (p < 0.001).

Conclusions

Chilean ICUs reported significant changes in their physiotherapy practices during COVID-19, with tripled bed capacity, doubled staffing, and advanced interventions. These findings underscore the need for strategic staffing planning, education, and standardized protocols for future crises.