A patient with a RASS score of -1, 0, or +1 would typically warrant which level of physical therapy intervention?

• A. Active exercise
• B. AROM
• C. Sit
• D. ADLs

Answer: (B)

RASS levels of -1 to +1 indicate the patient is awake enough to participate in movement but not severely agitated or deeply sedated. At this level, you can safely engage the patient in active range of motion because they can follow simple commands and actively move their joints, which helps preserve joint mobility and muscle length without requiring high endurance or complex tasks. This makes active range of motion the most appropriate starting intervention, preserving function while staying within the patient’s current tolerance and safety. More demanding activities like full active exercise require greater alertness and endurance, and sitting up or performing ADLs often need higher stability and cognitive engagement, which may not be consistently present at -1 to +1. So, initiating with active range of motion aligns with the patient’s able-to-participate level and lays the groundwork for progression as tolerance improves.