Occupational Therapy in the Intensive Care Unit: A Retrospective Cohort Study

Importance Determining whether individualized occupational therapy (OT) can be feasibly and safely provided to intensive care unit (ICU) patients is essential. Objective The aim of this study is to investigate the feasibility and safety of providing individualized OT programs in the ICU based on functional assessment outcomes. Design This study was designed as a retrospective cohort study. Setting The study was conducted in the ICU of a tertiary university hospital. Participants Patients referred for ICU rehabilitation who met predefined ICU OT inclusion and exclusion criteria and initiated ICU OT between February 2021 and December 2023 were included. Intervention Based on functional evaluation, each patient′s individualized OT program was classified into cognitive training, functional and activities of daily living (ADLs) training, or a combination of cognitive training and functional and ADL training. Outcomes and Measures Feasibility was assessed based on eligibility, initiation and interruption rates, time to OT initiation, missed or deferred sessions, and adherence to the intervention framework. Safety was evaluated by whether OT sessions were discontinued or prescriptions were terminated owing to adverse events based on predefined criteria during OT delivery. Results Among 828 patients referred for ICU rehabilitation, 184 (22%) met eligibility criteria, and 158 patients initiated the ICU OT program. Among these, 55 patients (34.8%) completed all prescribed OT sessions, whereas 103 (65.2%) did not, yielding a program interruption rate of 65.2%. The median time from OT prescription to the first session was 1 day. No sessions were canceled owing to patient refusal, and only one session (0.15%) was deferred because of agitation. Only one adverse event (hypotension) occurred during OT delivery. Conclusion and Relevance Individualized ICU OT can be feasible and safe to be implemented for ICU patients who meet predefined eligibility criteria when interventions are guided by structured functional assessments and clearly defined criteria for treatment discontinuation or termination.