• Michelle E Kho, Abdulla Damluji, and Jennifer M Zanni.
• Department of Physical Medicine and Rehabilitation, Critical Care Physical Medicine and Rehabilitation Program, Johns Hopkins University, Baltimore, MD 21287, USA. michelle.kho@jhmi.edu
• J Crit Care. 2012 Apr 1;27(2):219.e1-6.

BackgroundEarly rehabilitation in the intensive care unit (ICU) improves patients' physical function. Despite reports of using commercially available interactive video game systems for rehabilitation, there are few data evaluating feasibility and safety as part of routine in-patient rehabilitation, particularly in the ICU.MethodsWe conducted an observational study from September 1, 2009, to August 31, 2010, of adults admitted to a 16-bed medical ICU receiving video games as part of routine physical therapy (PT), evaluating use and indications and occurrence of 14 prospectively monitored safety events.ResultsOf 410 patients receiving PT in the medical ICU, 22 (5% of all patients; male, 64%; median age, 52 years) had 42 PT treatments with video games (median [interquartile range] per patient, 1.0 [1.0-2.0]). Main indications for video game therapy included balance (52%) and endurance (45%), and the most common activities included boxing (38%), bowling (24%), and balance board (21%). Of 42 treatments, 69% occurred while standing and 45% while mechanically ventilated. During 35 hours of PT treatment, 0 safety events occurred (95% upper confidence limit for safety event rate, 8.4%).ConclusionsNovel use of interactive video games as part of routine PT in critically ill patients is feasible and appears safe in our case series. Video game therapy may complement existing rehabilitation techniques for ICU patients.Copyright © 2011 Elsevier Inc. All rights reserved.

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