I agree with all your comments. My junior carried out an audit a couple of years ago in Wales and south England to ascertain the use and pattern of use of PMs in the ITU setting. People certainly do use them in varying degrees. I personally prefer to use positioning to maintain joint ROM and splint (usually Feet/ ankles) when ROM starts to decrease. I think it would be relatively easy to set up a multi- centre RCT looking at the effects of PMs. I am working in the academic setting now and don't have access to patients but would be happy to be involved in the planning process for such a trial. Are other people interested in getting something going?