Rethinking Hospital-Associated Deconditioning: Proposed Paradigm Shift

Phys Ther. 2015 Sep;95(9):1307-15. doi: 10.2522/ptj.20140511. Epub 2015 Apr 23.

Abstract

Physical therapists often treat older adults with marked deficits in physical function secondary to an acute hospitalization. These deficits are often collectively defined as hospital-associated deconditioning (HAD). However, there is a paucity of evidence that objectively demonstrates the efficacy of physical therapy for older adults with HAD. Older adults with HAD represent a highly variable and complex population and thus may be difficult to study and develop effective interventions for using our current rehabilitation strategies. This perspective article outlines an innovative framework to operationalize and treat older adults with HAD. This framework may help therapists apply emerging exercise strategies to this population and facilitate additional research to support the total value of physical therapy for older adults in postacute care settings-with value measured not only by improvements in physical performance but perhaps also by reduced rates of disability development, rehospitalization, and institutionalization.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Aged
  • Appetite
  • Exercise Therapy
  • Fatigue / rehabilitation*
  • Gait
  • Hospitalization*
  • Humans
  • Muscle Weakness / rehabilitation*
  • Physical Conditioning, Human / methods*
  • Physical Conditioning, Human / physiology
  • Physical Endurance*
  • Physical Therapists
  • Physical Therapy Modalities*
  • Postural Balance
  • Professional Role
  • Recovery of Function*
  • Resistance Training / methods
  • Syndrome