Intensive Care Unit Psychosis and Tendons and Ligaments manipulation

[Joanna fox]

Hi, I am writing to ask what is itu psychosis as my father has been in intensive care for three months, he has been sedated for quite along period of time approx one month, since then he has been on a ventilator through a tacheostomy so he has not been able to communicate, he has had various infections which keep setting him back.  Whilst he has been in this situation he has not had enough physiotherapy which has left his ligaments and tendons hard, with this, a manipulation of his joints has been done and has found to have only certain movement of at the most 50 degrees.  My question on this is, if he was to have private physiotherapy would he be able to have full movement and be mobile again,  and is there such a procedure of lazer treatment which can soften the ligaments and tendons? Kind Regards Joanna

[HFHS-M.D.-HG]

Dear Joanna

People with severe acute medical illnesses can go into a condition called Delirium which is a confused state with waxing and waning of consciousness and some times associated with psychotic symptoms such as delusions and hallucinations. It is a life threatening condition and can be treated adequately if diagnosed. Patients in ICU may show fear, anxiety, denial, shock, grief, excessive dependence and several others. Even though I would not be able to diagnose your father with the limited information that was provided, I would think that he must be getting adequate treatment in ICU. I am not the best person to provide any information regarding physiotherapy. I would recommend you to consult a specialist (orthopedic surgeon/ physiotherapist) regarding your concerns.

Sincerely
HFHS-M.D.

[Silent all these years]

If the tendons are just tight you might be able to regain some range of motion with the use of dynamic splinting and daily ranging exercises. Once the tendons start to get fibrous it is very difficult to regain ROM (range of motion) without doing a tendon release. Whether he becomes mobile again will depend a lot on his cognitive status. If he is alert he will be able to obtain mobility even with decreased AROM (active range of motion) possibly with the aid of a walker or wheelchair. If he is not alert enough to make voluntary movements, then even aggressive treatment of these contractures will not add much to his quality of life. You should be able to get training from the physio dept at the hospital in how to do range of motion exercises and get family members involved in carrying them out. I have not heard of laser treatment for this problem.