Journal of Clinical Physiotherapy Research

Abstract

Introduction: Physiotherapy in Pediatric Intensive Care Units (PICUs) plays a critical role in optimizing respiratory function and promoting early mobilization. Despite its importance, implementation remains inconsistent due to multiple barriers at institutional, patient, and professional levels. Identifying these barriers and facilitators is essential for improving physiotherapy integration in pediatric critical care. This study aimed to investigate barriers and facilitators of physiotherapy practice among physiotherapists working in PICUs across multiple centers in Iran, focusing on both respiratory and mobilization domains.  Methods: A multi‑center cross‑sectional descriptive‑analytic study was conducted between September–November 2025 in four pediatric hospitals (Mofid, Ali Asghar, Children’s Medical Center, and Tabriz Pediatric Hospital). A total of 20 physiotherapists were recruited using convenience sampling. Data were collected using a structured, self‑administered questionnaire covering demographic information and four domains: institutional barriers, patient‑related barriers, staff cooperation, and facilitators. Statistical analysis was performed using SPSS version 26.  Results: A total of 20 questionnaires were analyzed. Institutional barriers make up the largest portion at 40%, indicating systemic challenges such as limited resources or lack of formal protocols. Facilitators account for 30%, showing that supportive elements like staff training and administrative backing play a significant role. Staff cooperation (20%) and patient-related barriers (10%) also contribute, highlighting interpersonal dynamics and clinical limitations. Institutional barriers were the most prominent obstacles to physiotherapy implementation in the PICU, with limited supportive administrative policies receiving the highest rating among these factors (80%). Conclusion: Physiotherapy implementation in the PICU is mainly hindered by institutional and professional barriers, while patient-related factors were less significant. Facilitators were unanimously recognized as essential, and physician engagement, clear protocols, and multidisciplinary collaboration are key to advancing practice. The limited number of PICU staff, reflected in our sample of only 20 cases across several centers, highlights the need for broader multicenter studies.