Rehabilitation prescription tools in adult critical care: A scoping review

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PURPOSE: Rehabilitation for critically ill patients aims to reduce immobility and intensive care unit (ICU) acquired weakness. However, evidence regarding effectiveness remains inconclusive. Prescription tools enabling individualised rehabilitation may improve outcomes. We aimed to chart the evidence on rehabilitation prescription tools applicable across the acute care continuum, including in-ICU, post-ICU, and acutely hospitalised phases. MATERIALS AND METHODS: We searched six databases (January 1990-January 2026). We included studies describing development and/or application of rehabilitation prescription tools designed for or used with our patient population. RESULTS: We identified six rehabilitation prescription tools, supported by 11 empirical and six non-empirical studies/citations. Tools commonly included functional assessments and checklists. None met our criteria for use in-ICU; two tools (four studies) focused on ICU survivors. Four tools (five studies/citations) were intended for transition between hospital settings, e.g., ICU step-down. Where specified, tools were commonly intended for use by rehabilitation staff, particularly physiotherapists, supported by eight studies/citations. One (pilot) study considered patient outcomes following implementation. Implementation barriers included: integrating tools into health records, lack of confidence in application and teaching of rehabilitation prescriptions, and time constraints. CONCLUSIONS: Six rehabilitation prescription tools were identified; however, none met predefined criteria for use during ICU admission. Rehabilitation prescription tool development and application are in the early stages; few high-quality studies were identified, all published within the last decade, and none examined effectiveness at scale. Development strategies for widespread adoption, prioritising co-design, effectiveness testing, and implementation planning, are recommended to optimise continuity of patient care and safety.

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