Evidence to Support Early ICU Rehabilitation

Brummel, N. E., Jackson, J. C., Girard, T. D., Pandharipande, P. p., Schiro, E., Work, B., Pun, B. T., Boehm, L., Gill, T. M., & Ely, E. W. (2012). A combined early cognitive and physical rehabilitation program for people who are critically ill: The activity and cognitive therapy in the intensive care unit (ACT-ICU) trial. Physical Therapy, 92(12), 1580–1592. https://doi.org/10.2522/ptj.20110414

• A protocol that evaluated usual physical rehabilitation with usual physical rehabilitation PLUS cognitive rehabilitation

• Includes safety screening tool to guide treatment

Engel, H. J., Needham, D. M., Morris, P. E., & Gropper, M. A. (2013). ICU early mobilization: From recommendation to implementation at three medical centers.Critical Care Medicine, 41, S69–S80. https://doi.org/10.1097/CCM.0b013e3182a240d5

• Includes daily mobility assessment and treatment algorithm

Hodgson, C. L., Stiller, K., Needham, D. M., Tipping, C. J., Harrold, M., Baldwin, C. E., Bradley, S., Berney, S., Caruana, L. R., Elliott, D., Green, M., Haines, K., Higgins, A. M., Kaukonen, K.-M., Leditschke, I. A., Nickels, M. R., Paratz, J., Patman, S., Skinner, E. H., … Webb, S. A. (2014). Expert consensus and recommendations on safety criteria for active mobilization of mechanically ventilated critically ill adults. Critical Care, 18(6), 658. https://doi.org/10.1186/s13054-014-0658-y

• Stoplight model with recommendations to guide which patients are appropriate for therapy

Hopkins, R. O., & Spuhler, V. J. (2009). Strategies for promoting early activity in critically ill mechanically ventilated patients. AACN Advanced Critical Care, 20(3), 13.

Linke, C. A., Chapman, L. B., Berger, L. J., Kelly, T. L., Korpela, C. A., & Petty, M. G. (2020). Early mobilization in the ICU: A collaborative, integrated approach. Critical Care Explorations, 2(4), e0090. https://doi.org/10.1097/CCE.0000000000000090 

• Includes algorithm to guide the evaluation of patients and their appropriateness for therapy

Knutsen, K., Solbakken, R., Gallagher, S., Müller, R. T., & Normann, B. (2024). Patients’ experiences with early rehabilitation in intensive care units: A qualitative study about aspects that influence their participation.Journal of Advanced Nursing, 80(5), 1984–1996. https://doi.org/10.1111/jan.15949

Mendez-Tellez, P. A., & Needham, D. M. (2012). Early physical rehabilitation in the ICU and ventilator liberation. Respiratory Care, 57(10), 1663–1669. https://doi.org/10.4187/respcare.01931

• Includes daily screening algorithm to evaluate appropriateness for therapy

Morris, P. E., Goad, A., Thompson, C., Taylor, K., Harry, B., Passmore, L., Ross, A., Anderson, L., Baker, S., Sanchez, M., Penley, L., Howard, A., Dixon, L., Leach, S., Small, R., Hite, R. D., & Haponik, E. (2008). Early intensive care unit mobility therapy in the treatment of acute respiratory failure. Critical Care Medicine, 36(8), 2238–2243. https://doi.org/10.1097/CCM.0b013e318180b90e

Nordon-Craft, A., Ohtake, P. J., Smith, J. M., Engel, H. J., Lowman, J. D., Moss, M., & Pastva, A. M. (2026). Next generation trial design for intensive care unit rehabilitation.Physical Therapy, 106(5), pzag036. https://doi.org/10.1093/ptj/pzag036

• A perspective piece on why RCT evidence hasn't translated well into routine ICU rehab practice (patient heterogeneity, inconsistent protocols), with proposed strategies for better-designed future trials — pairs well with your existing QI/implementation citations.

Olkowski, B. F., Devine, M. A., Slotnick, L. E., Veznedaroglu, E., Liebman, K. M., Arcaro, M. L., & Binning, M. J. (2013). Safety and feasibility of an early mobilization program for patients with aneurysmal subarachnoid hemorrhage. Physical Therapy, 93(2), 208–215. https://doi.org/10.2522/ptj.20110334

• Safety and feasibility data for early mobility in SAH patients (aneurysmal); includes MAP ≥80 and neurological stability criteria specific to this population

Peigne, V., Somme, D., Guérot, E., Lenain, E., Chatellier, G., Fagon, J.-Y., & Saint-Jean, O. (2016). Treatment intensity, age and outcome in medical ICU patients: Results of a French administrative database. Annals of Intensive Care, 6(1), 7. https://doi.org/10.1186/s13613-016-0107-y

Rawal, H., & Bakhru, R. N. (2024). Early mobilization in the ICU. CHEST Critical Care, 2(1), 100038. https://doi.org/10.1016/j.chstcc.2023.100038

• Update to the Hodgson et al (2014) article

Tang, J., Yu, P., Luo, L., Bian, H., Dong, C., & Zhang, T. (2025). Application of the occupational therapy program based on PEO model in elderly patients with mechanical ventilation in ICU: Study protocol for a randomized controlled trial.Trials, 27(1), 24. https://doi.org/10.1186/s13063-025-09335-2

Abbate, C., Trimarchi, P. D., Basile, I., Mazzucchi, A., & Devalle, G. (2014). Sensory stimulation for patients with disorders of consciousness: From stimulation to rehabilitation. Frontiers in Human Neuroscience, 8. https://doi.org/10.3389/fnhum.2014.00616

Aubinet, C., Gillet, A., & Regnier, A. (2025). Disorders of consciousness, language and communication following severe brain injury. Psychologica Belgica, 65(1), 169–188. https://doi.org/10.5334/pb.1381

Bodien, Y. G., Barra, A., Temkin, N. R., Barber, J., Foreman, B., Vassar, M., Robertson, C., Taylor, S. R., Markowitz, A. J., Manley, G. T., Giacino, J. T., Edlow, B. L., Badjatia, N., Duhaime, A.-C., Ferguson, A. R., Gaudette, E., Gopinath, S., Keene, C. D., McCrea, M., … Zafonte, R. (2021). Diagnosing level of consciousness: The limits of the Glasgow Coma Scale total score.Journal of Neurotrauma, 38(23), 3295–3305. https://doi.org/10.1089/neu.2021.0199

Bodien, Y. G., Vora, I., Barra, A., Chiang, K., Chatelle, C., Goostrey, K., Martens, G., Malone, C., Mello, J., Parlman, K., Ranford, J., Sterling, A., Waters, A. B., Hirschberg, R., Katz, D. I., Mazwi, N., Ni, P., Velmahos, G., Waak, K., … Giacino, J. T. (2023). Feasibility and validity of the Coma Recovery Scale‐Revised for accelerated standardized testing: A practical assessment tool for detecting consciousness in the intensive care unit. Annals of Neurology, 94(5), 919–924. https://doi.org/10.1002/ana.26740

Boltzmann, M., Schmidt, S. B., Gutenbrunner, C., Krauss, J. K., Stangel, M., Höglinger, G. U., Wallesch, C.-W., & Rollnik, J. D. (2021). The influence of the CRS-R score on functional outcome in patients with severe brain injury receiving early rehabilitation. BMC Neurology, 21(1), 44. https://doi.org/10.1186/s12883-021-02063-5

Giacino, J. T., Whyte, J., Nakase-Richardson, R., Katz, D. I., Arciniegas, D. B., Blum, S., Day, K., Greenwald, B. D., Hammond, F. M., Pape, T. B., Rosenbaum, A., Seel, R. T., Weintraub, A., Yablon, S., Zafonte, R. D., & Zasler, N. (2020). Minimum competency recommendations for programs that provide rehabilitation services for persons with disorders of consciousness. Archives of Physical Medicine and Rehabilitation, 101(6), 1072–1089. https://doi.org/10.1016/j.apmr.2020.01.013

Giacino, J. T., Katz, D. I., Schiff, N. D., Whyte, J., Ashman, E. J., Ashwal, S., Barbano, R., Hammond, F. M., Laureys, S., Ling, G. S. F., Nakase-Richardson, R., Seel, R. T., Yablon, S., Getchius, T. S. D., Gronseth, G. S., & Armstrong, M. J. (2018). Practice guideline update recommendations summary: Disorders of consciousness. Neurology, 91(10), 450–460. https://doi.org/10.1212/WNL.0000000000005926

Golden, K., Bodien, Y. G., & Giacino, J. T. (2024). Disorders of consciousness: Classification and taxonomy. Physical Medicine and Rehabilitation Clinics of North America, 35(1), 15–33. https://doi.org/10.1016/j.pmr.2023.06.011

Gurin, L., Evangelist, M., Laverty, P., Hanley, K., Corcoran, J., Herbsman, J., Im, B., Frontera, J., Flanagan, S., Galetta, S., & Lewis, A. (2022). Early neurorehabilitation and recovery from disorders of consciousness after severe COVID-19.Neurocritical Care, 36(2), 357–371. https://doi.org/10.1007/s12028-021-01359-1

Keech, K., & Asiello, J. (2024). Conscious care: A proposed model to improve interprofessional care of patients with disorders of consciousness in the acute hospital setting. Brain Injury, 38(13), 1125–1132. https://doi.org/10.1080/02699052.2024.2376767

Keech, K., Schnakers, C., Murtaugh, B., O’Brien, K.; Slomine, B., Briand, M.-M., Formisano, R., Thibaut, A., Estraneo, A., Noé, E., Gosseries, O., & da Conceição Teixeira, L. (2025). Optimizing neurobehavioral assessment for patients with disorders of consciousness: Proposal of a comprehensive pre-assessment checklist for clinicians. Brain Sciences, 15(71). https://doi.org/10.3390/brainsci15010071

Marino, M. H., Koffer, J., & Nalla, S. (2023). Update on disorders of consciousness.Current Physical Medicine and Rehabilitation Reports, 11(1), 62–73. https://doi.org/10.1007/s40141-023-00384-9

Murtaugh, B., & Shapiro Rosenbaum, A. (2023). Clinical application of recommendations for neurobehavioral assessment in disorders of consciousness: An interdisciplinary approach.Frontiers in Human Neuroscience, 17, Article 1129466. https://doi.org/10.3389/fnhum.2023.1129466

O’Brien, K., Zhang, B., Anderl, E., & Kothari, S. (2023). Special considerations in behavioral assessments for disorders of consciousness. Physical Medicine and Rehabilitation Clinics of North America, 1–16. https://doi.org/10.1016/j.pmr.2023.07.007

Padilla, R., & Domina, A. (2016). Effectiveness of sensory stimulation to improve arousal and alertness of people in a coma or persistent vegetative state after traumatic brain injury: A systematic review. The American Journal of Occupational Therapy, 70(3), 7003180030p1-7003180030p8. https://doi.org/10.5014/ajot.2016.021022

Peterson, A., Young, M. J., & Fins, J. J. (2022). Ethics and the 2018 practice guideline on disorders of consciousness. Neurology, 98(17), 712–718. https://doi.org/10.1212/WNL.0000000000200301

Seel, R. T., Douglas, J., Dennison, A. C., Heaner, S., Farris, K., & Rogers, C. (2013). Specialized early treatment for persons with disorders of consciousness: Program components and outcomes.Archives of Physical Medicine and Rehabilitation, 94(10), 1908–1923. https://doi.org/10.1016/j.apmr.2012.11.052

Zheng, R.-Z., Qi, Z.-X., Wang, Z., Xu, Z.-Y., Wu, X.-H., & Mao, Y. (2023). Clinical decision on disorders of consciousness after acquired brain injury: Stepping forward.Neuroscience Bulletin, 39(1), 138–162. https://doi.org/10.1007/s12264-022-00909-7

Capo-Lugo, C. E., Askew, R. L., Muldoon, K., Maas, M., Liotta, E., Prabhakaran, S., & Naidech, A. (2020). Longer time before acute rehabilitation therapy worsens disability after intracerebral hemorrhage. Archives of Physical Medicine and Rehabilitation, 101(5), 870–876. https://doi.org/10.1016/j.apmr.2019.11.006

Corcoran, J. R., Herbsman, J. M., Bushnik, T., Van Lew, S., Stolfi, A., Parkin, K., McKenzie, A., Hall, G. W., Joseph, W., Whiteson, J., & Flanagan, S. R. (2017). Early rehabilitation in the medical and surgical intensive care units for patients with and without mechanical ventilation: An interprofessional performance improvement project. PM&R, 9(2), 113–119. https://doi.org/10.1016/j.pmrj.2016.06.015

Hernandez, S., Kittelty, K., & Hodgson, C. L. (2021). Rehabilitating the neurological patient in the ICU: What is important?Current Opinion in Critical Care, 27(2). https://doi.org/10.1097/MCC.0000000000000804

Hiser, S. L., Casey, K., Nydahl, P., Hodgson, C. L., & Needham, D. M. (2025). Intensive care unit acquired weakness and physical rehabilitation in the ICU.BMJ, 388, e077292. https://doi.org/10.1136/bmj-2023-077292

• Comprehensive review covering ICUAW definition, diagnosis, epidemiology, pathophysiology, and management — useful as a single foundational citation for why rehab matters, with an explicit summary of current research gaps.

Hodgson, C. L., Ayre, E., Broadley, T., Burry, L., Casey, K., Dale, C., ... Herridge, M. S. (2026). Standard of care for rehabilitation in critical illness.Intensive Care Medicine, 52(6), 1269–1283. https://doi.org/10.1007/s00134-026-08427-0

• A 2026 synthesis defining current international standard-of-care recommendations across the full rehab continuum (ICU → ward → community), including physical, psychological, and cognitive rehab. Strong citation if you want to point to "current guidelines" rather than older individual studies.

Jenkins, A. S., Isha, S., Hanson, A. J., Kunze, K. L., Johnson, P. W., Sura, L., Cornelius, P. J., Hightower, J., Heise, K. J., Davis, O., Satashia, P. H., Hasan, M. M., Esterov, D., Worsowicz, G. M., & Sanghavi, D. K. (2023). Rehabilitation in the intensive care unit: How amount of physical and occupational therapy impacts patients’ functionality and length of hospital stay. PM&R: The Journal of Injury, Function and Rehabilitation. https://doi.org/10.1002/pmrj.13116

• Large retrospective cohort (6,628 patients) showing a dose-response relationship: every additional 10 minutes/day of PT-OT was associated with better mobility scores and 1.2 fewer hospital days

Kumble, S., Zink, E. K., Burch, M., Deluzio, S., Stevens, R. D., & Bahouth, M. N. (2017). Physiological effects of early incremental mobilization of a patient with acute intracerebral and intraventricular hemorrhage requiring dual external ventricular drainage.Neurocritical Care, 27(1), 115–119. https://doi.org/10.1007/s12028-017-0376-9

Liu, K., Tronstad, O., Flaws, D., Churchill, L., Jones, A. Y. M., Nakamura, K., & Fraser, J. F. (2024). From bedside to recovery: Exercise therapy for prevention of post-intensive care syndrome. Journal of Intensive Care, 12(1), 11. https://doi.org/10.1186/s40560-024-00724-4

Moyer, M. T., Hinkle, J. L., & Mendez, J. D. (2021). An integrative review: Early mobilization of patients with external ventriculostomy drains in the neurological intensive care unit.Journal of Neuroscience Nursing, 53(5), 220–224. https://doi.org/10.1097/JNN.0000000000000609

Patel, B. K., Wolfe, K. S., Patel, S. B., Dugan, K. C., Esbrook, C. L., Pawlik, A. J., Stulberg, M., Kemple, C., Teele, M., Zeleny, E., Hedeker, D., Pohlman, A. S., Arora, V. M., Hall, J. B., & Kress, J. P. (2023). Effect of early mobilisation on long-term cognitive impairment in critical illness in the USA: A randomised controlled trial.The Lancet Respiratory Medicine, 11(6), 563–572. https://doi.org/10.1016/S2213-2600(22)00489-1

Yataco, R. A., Arnold, S. M., Brown, S. M., David Freeman, W., Carmen Cononie, C., Heckman, M. G., Partridge, L. W., Stucky, C. M., Mellon, L. N., Birst, J. L., Daron, K. L., Zapata-Cooper, M. H., & Schudlich, D. M. (2019). Early progressive mobilization of patients with external ventricular drains: Safety and feasibility.Neurocritical Care, 30(2), 414–420. https://doi.org/10.1007/s12028-018-0632-7

Young, B., Moyer, M., Pino, W., Kung, D., Zager, E., & Kumar, M. A. (2019). Safety and feasibility of early mobilization in patients with subarachnoid hemorrhage and external ventricular drain.Neurocritical Care, 31(1), 88–96. https://doi.org/10.1007/s12028-019-00670-2

Álvarez, E. A., Garrido, M. A., Tobar, E. A., Prieto, S. A., Vergara, S. O., Briceño, C. D., & González, F. J. (2017). Occupational therapy for delirium management in elderly patients without mechanical ventilation in an intensive care unit: A pilot randomized clinical trial. Journal of Critical Care, 37, 85–90. https://doi.org/10.1016/j.jcrc.2016.09.002

Barbieri Bombarda, T., Lanza, A. L., Valente Santos, C. A., & Vitale Torkomian Joaquim, R. H. (2016). The occupational therapy in adult intensive care unit (ICU) and team perceptions. Cadernos de Terapia Ocupacional Da UFSCar, 24(4), 827–835. https://doi.org/10.4322/0104-4931.ctoRE0861

Boltzmann, M., Schmidt, S. B., Gutenbrunner, C., Krauss, J. K., Stangel, M., Höglinger, G. U., Wallesch, C.-W., & Rollnik, J. D. (2021). The influence of the CRS-R score on functional outcome in patients with severe brain injury receiving early rehabilitation. BMC Neurology, 21(1), 44. https://doi.org/10.1186/s12883-021-02063-5

Britton, L., Rosenwax, L., & McNamara, B. (2016). Occupational therapy in Australian acute hospitals: A modified practice. Australian Occupational Therapy Journal, 63(4), 257–265. https://doi.org/10.1111/1440-1630.12298

Costigan, F. A., Duffett, M., Harris, J. E., Baptiste, S., & Kho, M. E. (2019). Occupational therapy in the ICU: A scoping review of 221 documents. Critical Care Medicine, 47(12), e1014. https://doi.org/10.1097/CCM.0000000000003999

Dinglas, V. D., Colantuoni, E., Ciesla, N., Mendez-Tellez, P. A., Shanholtz, C., & Needham, D. M. (2013). Occupational therapy for patients with acute lung injury: Factors associated with time to first intervention in the intensive care unit. American Journal of Occupational Therapy, 67(3), 355–362. https://doi.org/10.5014/ajot.2013.007807

de Oliveira Coelho, P. S., do Valle, K., Pereira do Carmo, G., de Melo dos Santos, T. R., Santos Nascimento, J., & Bonadiu Pelosi, M. (2020). Systematization of procedures for the implementation of alternative and extended communication in a general ICU. Brazilian Journal of Occupational Therapy, 28(3), 829–854. https://doi.org/10.4322/2526-8910.ctoAO1930

Eyers, L., & Unsworth, C. (2005). Occupational therapy in acute hospitals: The effectiveness of a pilot program to maintain occupational performance in older clients. Australian Occupational Therapy Journal, 52(3), 218–224. https://doi.org/10.1111/j.1440-1630.2005.00498.x

George, S., Barrett, M., De Ionno, J., Fletcher, L., Choo, W. S., Rivas-Dominguez, S., Romanic, N., Lizarondo, L., & Stern, C. (2021). Experiences and effectiveness of occupational therapy interventions delivered in the acute setting: A mixed methods systematic review protocol. JBI Evidence Synthesis, 19(9), 2457–2463. https://doi.org/10.11124/JBIES-20-00407

Goodchild, K., Fleming, J., & Copley, J. A. (2023). Assessments of functional cognition used with patients following traumatic brain injury in acute care: A survey of Australian occupational therapists. Occupational Therapy In Health Care, 37(1), 145–163. https://doi.org/10.1080/07380577.2021.2020389

Gosset, A. T., Sklar, M. C., Delman, A. M., & Detsky, M. E. (2018). Patients’ primary activities prior to critical illness: How well do clinicians know them and how likely are patients to return to them? Critical Care, 22(1), 340. https://doi.org/10.1186/s13054-018-2283-7

Jenkins, A. S., Isha, S., Hanson, A. J., Kunze, K. L., Johnson, P. W., Sura, L., Cornelius, P. J., Hightower, J., Heise, K. J., Davis, O., Satashia, P. H., Hasan, M. M., Esterov, D., Worsowicz, G. M., & Sanghavi, D. K. (2023). Rehabilitation in the intensive care unit: How amount of physical and occupational therapy impacts patients’ functionality and length of hospital stay. PM&R: The Journal of Injury, Function and Rehabilitation. https://doi.org/10.1002/pmrj.13116

Kingston, G., Pain, T., Murphy, K., Bennett, M., & Watson, M. (2019). Perceptions of acute hospital occupational therapy services: Developing a new model of care for occupational therapy on acute medical wards. International Journal of Therapy and Rehabilitation, 26, 1–9. https://doi.org/10.12968/ijtr.2017.0047

Lockwood, K. J., Harding, K. E., Boyd, J. N., & Taylor, N. F. (2018). Reasons for readmission to hospital after hip fracture: Implications for occupational therapy. British Journal of Occupational Therapy, 81(5), 247–254. https://doi.org/10.1177/0308022618756000

Margetis, J. L., Wilcox, J., Thompson, C., & Mannion, N. (2021). Occupational therapy: Essential to critical care rehabilitation. The American Journal of Occupational Therapy, 75(2), 7502170010. https://doi.org/10.5014/ajot.2021.048827

Rapolthy-Beck, A., Fleming, J., Turpin, M., Sosnowski, K., Dullaway, S., & White, H. (2021). A comparison of standard occupational therapy versus early enhanced occupation-based therapy in a medical/surgical intensive care unit: Study protocol for a single site feasibility trial (EFFORT-ICU). Pilot and Feasibility Studies, 7(1), 51. https://doi.org/10.1186/s40814-021-00795-2

Roberts, P., Robinson, M., Furniss, J., & Metzler, C. (2020). Occupational therapy’s value in provision of quality care to prevent readmissions. The American Journal of Occupational Therapy, 74(3), 1-9. https://doi.org/10.5014/ajot.2020.743002

Rogers, A. T., Bai, G., Lavin, R. A., & Anderson, G. F. (2017). Higher hospital spending on occupational therapy is associated with lower readmission rates. Medical Care Research & Review, 74(6), 668–686. https://doi.org/10.1177/1077558716666981

Smith, L. C., Whittaker, B., Eldridge, M., & Creekmore, J. (2020, June). Caring for the critically ill client in the intensive care unit. OT Practice, 25(6), 10–14.

Weeks, A. (2016, August). Integration of theory into assessment and treatment: The Person-Environment-Occupation model in the intensive care unit. SIS Quarterly Practice Connections, 1(3), 22–24.

Chen, T.-J., Traynor, V., Wang, A.-Y., Shih, C.-Y., Tu, M.-C., Chuang, C.-H., Chiu, H.-Y., & Chang, H.-C. R. (2022). Comparative effectiveness of non-pharmacological interventions for preventing delirium in critically ill adults: A systematic review and network meta-analysis.International Journal of Nursing Studies, 131, 104239. https://doi.org/10.1016/j.ijnurstu.2022.104239

Dayton, K., Hudson, M., & Lindroth, H. (2023). Stopping delirium using the awake-and-walking intensive care unit approach: True mastery of critical thinking and the ABCDEF bundle. AACN Advanced Critical Care, 34(4), 359–366. https://doi.org/10.4037/aacnacc2023159

Deemer, K., Zjadewicz, K., Fiest, K., Oviatt, S., Parsons, M., Myhre, B., & Posadas-Calleja, J. (2020). Effect of early cognitive interventions on delirium in critically ill patients: A systematic review.Canadian Journal of Anesthesia, 67(8), 1016–1034. https://doi.org/10.1007/s12630-020-01670-z

Devlin, J. W., Skrobik, Y., Gélinas, C., Needham, D. M., Slooter, A. J. C., Pandharipande, P. P., Watson, P. L., Weinhouse, G. L., Nunnally, M. E., Rochwerg, B., Balas, M. C., van den Boogaard, M., Bosma, K. J., Brummel, N. E., Chanques, G., Denehy, L., Drouot, X., Fraser, G. L., Harris, J. E., … Alhazzani, W. (2018). Executive summary: Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU.Critical Care Medicine, 46(9), 1532–1548. https://doi.org/10.1097/CCM.0000000000003259

Edelstein, J., Messenger, L., Kinney, A. R., Graham, J. E., & Malcolm, M. P. (2022). Predicting receipt and types of occupational therapy services for patients with arousal deficits in the neuro critical care unit.Occupational Therapy In Health Care, 1–16. https://doi.org/10.1080/07380577.2022.2041781

Faustino, T. N., Suzart, N. A., Rabelo, R. N. dos S., Santos, J. L., Batista, G. S., Freitas, Y. S. de, Saback, D. A., Sales, N. M. M. D., Brandao Barreto, B., & Gusmao-Flores, D. (2022). Effectiveness of combined non-pharmacological interventions in the prevention of delirium in critically ill patients: A randomized clinical trial.Journal of Critical Care, 68, 114–120. https://doi.org/10.1016/j.jcrc.2021.12.015

Herling, S. F., Greve, I. E., Vasilevskis, E. E., Egerod, I., Bekker Mortensen, C., Møller, A. M., Svenningsen, H., & Thomsen, T. (2018). Interventions for preventing intensive care unit delirium in adults.The Cochrane Database of Systematic Reviews, 2018(11). https://doi.org/10.1002/14651858.CD009783.pub2

Kotfis, K., van Diem-Zaal, I., Williams Roberson, S., Sietnicki, M., van den Boogaard, M., Shehabi, Y., & Ely, E. W. (2022). The future of intensive care: Delirium should no longer be an issue.Critical Care, 26(1), 1–11. https://doi.org/10.1186/s13054-022-04128-4

Lee, C. D., Chippendale, T. L., & McLeaming, L. (2020). Postoperative delirium prevention as standard practice in occupational therapy in acute care.Physical & Occupational Therapy in Geriatrics, 38(3), 264–270. https://doi.org/10.1080/02703181.2020.1740374

Nassar, A. P., Ely, E. W., & Fiest, K. M. (2023). Long-term outcomes of intensive care unit delirium.Intensive Care Medicine, 49(6), 677–680. https://doi.org/10.1007/s00134-023-07029-4

Tobar, E., Alvarez, E., & Garrido, M. (2017). Cognitive stimulation and occupational therapy for delirium prevention.Revista Brasileira de Terapia Intensiva, 29(2), 248–252. https://doi.org/10.5935/0103-507X.20170034

Xu, C., Chen, Z., Zhang, L., & Guo, H. (2022). Systematic review and meta-analysis on the incidence of delirium in intensive care unit inpatients after cognitive exercise intervention.Annals of Palliative Medicine, 11(2), 663–672. https://doi.org/10.21037/apm-21-3938

Perry, A., Mallah, M. D., Cunningham, K. W., Christmas, A. B., Marrero, J. J., Gombar, M. A., Davis, M. L., Miles, W. S., Jacobs, D. G., Fischer, P. E., Sing, R. F., & Thomas, B. W. (2020). PATHway to success: Implementation of a multiprofessional acute trauma health care team decreased length of stay and cost in patients with neurological injury requiring tracheostomy. Journal of Trauma and Acute Care Surgery, 88(1), 176–179. https://doi.org/10.1097/TA.0000000000002494

Rains, J., & Chee, N. (2017). The role of occupational and physiotherapy in multi-modal approach to tackling delirium in the intensive care. Journal of the Intensive Care Society, 18(4), 318–322. https://doi.org/10.1177/1751143717720589

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