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Research Snapshot Theater: Neuroscience/Future of Critical Care, Adult

Critical Care Survey on Neurorehabilitation Practices in Severely Ill Patients in the Neuro-ICU

Monday, March 23, 2026
10:15 AM - 11:15 AM Central Time
Location: Connections Central - RST 06

  • Aris Desai, MSc

    Baylor College of Medicine, Texas

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • ST

    Spyridoula Tsetsou, MD

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • RD

    Rahul Damani, MD

    Associate Professor of Neurology and Neurosurgery, Baylor College of Medicine
    Baylor College of Medicine

    Disclosure information not submitted.

  • SG

    Shankar Gopinath, MD

    Professor of Neurosurgery, Baylor College of Medicine
    Baylor Saint Lukes Medical Center McNair Campus

    Disclosure information not submitted.

Introduction: Early neurorehabilitation (NR) in critically ill patients with severe neurological injury admitted to the neurointensive care unit (NICU) plays a vital role in improving functional outcomes. Despite various available modalities, standardized protocols remain inconsistently applied. This survey aimed to assess the timing, availability, and types of NR services in the NICU, with attention to differences by hospital type and provider background.


Methods: A cross-sectional, anonymous, self-administered 28-question online survey was distributed to neurocritical care professionals through the Neurocritical Care Society.


Results: Eighteen providers completed the survey. Most were neurointensivists (83%) with neurology backgrounds (78%). The majority practiced in the United States (89%) and within teaching academic hospitals (72%). All respondents reported using NR in the NICU, typically initiating it within 1–3 days of admission. Hemodynamic instability, intracranial hypertension, sedation, and presence of Extraventricular or Lumbar Drains (EVD/LD were the most cited barriers to early NR. Core therapies—physical, occupational, and speech—were universally employed. Supplemental interventions such as music therapy (56%), massage or lymphatic stimulation (28%), and cognitive behavioral therapy (22%) were less consistently available. Only 33% of centers had institutional protocols for acute NR, more frequently reported by academic hospitals. Outcome measures used included the Functional Independence Measure (FIM), modified Rankin Scale (mRS), and Glasgow Outcome Scale-Extended (GOS-E), though choice varied by diagnosis. Just 39% of institutions reported involvement in NR-related trials, and 33% tracked NR data within NICU databases.


Conclusions: Neurorehabilitation is widely practiced in the NICU, yet variability persists in timing, modality use, and institutional support. While core therapies are standard, adoption of adjunctive modalities remains inconsistent. These findings highlight the need for institutional protocols, outcome measure standardization, and expanded research to optimize NR implementation in neurocritical care.