Patients, families, caregivers, and other consumers of acute care physical therapy services are encouraged to use this information to learn more about the specifics of physical therapy for the acutely ill.
If you are a health care provider, please visit our Provider Page for more information.
How can physical therapy help me or my loved one?
Acutely ill persons can experience many complications related to their medical conditions and/or the surgeries they have had. In many cases, early physical therapy focusing on movement, exercise, and mobility can reduce or eliminate some of these complications. Later in a hospital stay or after a critical illness, many people may benefit from physical therapy to regain the ability to walk, balance themselves, move safely in their environment, and/or perform everyday activities like they did before their illness or surgery. Acute care physical therapy may include:
- Lowering the chances of longer hospital stay or longer stay in an intensive care unit, which can be associated with complications of immobility and bedrest.
- Activities of daily living such as moving in bed, sitting up, getting out of bed, and getting up to a chair or wheelchair.
- Exercises tailored specifically given the medical condition(s) and/or surgical procedure(s).
- Recommendations for home modifications, medical equipment, or other adaptations to allow safe and sucessful discharge.
- Ambulation and gait training, including the proper instruction, fitting, and safe use of equipment such as canes, crutches, or walkers, to help someone walk safely.
- Training for your family and/or caregivers for how to best assist you with moving and walking.
- Discharge recommendations including need for continued physical therapy, need for assistance, need for medical equipment, and/or recommendation for transfer to inpatient rehabilitation, skilled nursing, or other discharge destinations based on safety and need for continued rehabilitation.
Physical therapists have extensive education and training in recognizing and treating movement dysfunction. Let an acute care physical therapist help you or your family member regain and maintain function and health.
Current Research Supporting Acute Care Physical Therapy
Exciting research supporting acute care physical therapy has been published in the last year. Here are some descriptions and excerpts demonstrating the safe, effective, and beneficial aspects of acute care physical therapy.
Discharge Planning Recommendations by Acute Care Physical Therapists:
One study (see reference #1 by Smith below) explored the role of physical therapist recommendations on discharge planning, and the effect of following those recommendations on hospital readmission rates in 762 patients in a large academic medical center. It found that when the recommendations about discharge made by the physical therapist were not followed, patients were 2.9 times more likely to be readmitted to the hospital.
"Overall, physical therapists' discharge recommendations were implemented 83% of the time. Patients were 2.9 times more likely to be readmitted when the therapist's discharge recommendation was not implemented and recommended follow-up services were lacking (mismatch with services lacking) compared with patients with a match."
"This study supports the role of physical therapists in discharge planning in the acute care setting. Physical therapists demonstrated the ability to make accurate and appropriate discharge recommendations for patients who are acutely ill."
After Stroke, Early and Intensive Acute Care Therapy Beneficial:
Early and intensive physical therapy after stroke not only is safe, but may improve patient mobility outcomes. This study (see reference #2 by Hu below) found that early and intensive rehabilitation, including physical therapy, benefitted patients with severe stroke and improved outcomes such as walking.
"Rehabilitation commencement time and intensity, after adjusting for admission functional status and severity of stroke, remained to be important predictors of stroke functional outcomes. This study supported the recommendation to commence rehabilitation early and intensively and provided evidence that this claim can be extended to acute stroke patients admitted to an ICU."
Physical Therapist-led Exercise in the ICU Reduces Length of Stay and Sedative Use:
In persons with acute respiratory failure, physical therapist-led exercise improved function, reduced sedation, decreased length of stay in the ICU, and decreased overall length of stay in the hospital, per a study out of John Hopkins (see reference #3 below by Needham).
"Compared with before the quality improvement project, benzodiazepine use decreased markedly, with lower median daily sedative doses. Patients had improved sedation and delirium status. There were a greater median number of rehabilitation treatment per patient with a higher level of functional mobility. Hospital administrative data demonstrated that across all MICU patients, there was a decrease in intensive care unit and hospital length of stay by 2.1 and 3.1 days, respectively."
1. Smith BA, Fields CJ, Fernandez N. Physical therapists make accurate and appropriate discharge recommendations for patients who are acutely ill. Phys Ther. 2010;90(5):693-703. Epub 2010 Mar 18.
2. Hu MH, Hsu SS, Yip PK, Jeng JS, Wang YH. Early and intensive rehabilitation predicts good functional outcomes in patients admitted to the stroke intensive care unit. Disabil Rehabil. 2010;32(15):1251-1259.
3. Needham DM, Korupolu R, Zanni JM, Pradhan P, Colantuoni E, Palmer JB, Brower RG, Fan E. Early physical medicine and rehabilitation for patients with acute respiratory failure: a quality improvement project. Arch Phys Med Rehabil. 2010;91(4):536-542.
I think my loved one would benefit from physical therapy. What can I do?
Even though many states allow direct access to a physical therapist, oftentimes insurance or hospital regulations will require you obtain a referral or prescription for physical therapy from a physician, physician assistant, or nurse practitioner.
If you think you or someone you know could benefit from acute care physical therapy services, speak to your primary health care provider and ask for a "physical therapy referral." Most health care facilities will then contact the physical therapy service to arrange an initial examination by a physical therapist, or if an outpatient, you can take this referral to a physical therapist for an examination. To find a local physical therapist who is a member of the American Physical Therapy Association, visit the American Physical Therapy Association's Find A PT database.