Increasing numbers of critically ill and injured patients are surviving their initial hospitalization. The immobilization associated with long-term critical care can lead to deterioration of the musculoskeletal system within 6 h of bed rest, and muscle strength can decline by as much as 40% within a week of immobilization. Advances in critical care and mechanical ventilation over the past 2 decades have resulted in the increased survival of patients who are critically ill. Some patients require prolonged mechanical ventilation (PMV). 

Two important parameters have to be considered

1. Does physiotherapy in the mechanically ventilated patient impact functional status, including both physical and cognitive dimensions. 
2. The effect of physiotherapy on ventilatory dependency and the length of stay in an intensive care unit.

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