Getting Physical Therapy in the Hospital

Physical therapists work in many different settings, including hospitals. These therapists are usually called acute care physical therapists or inpatient physical therapists. They evaluate your functional mobility in the hospital and offer techniques to help you improve your mobility.

Acute care physical therapists sometimes specialize within the hospital setting. For example, some acute therapists work with patients with cardiac conditions, while others work in the oncology unit. Others work solely in the intensive care unit (ICU).

This article will discuss the importance of acute physical therapy, the goals of treatment, and the differences between acute therapy and inpatient therapy. It also covers treatment recommendations once you leave the hospital.

Older adult in a hospital bed
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Role of Acute Care Physical Therapists

If you have been hospitalized, then you know how difficult it can be to move around and function normally while there. Usually, in the hospital, you are confined to bed and stay in a small room. An illness may prevent you from moving around normally. Sometimes, your healthcare provider may have placed intravenous (IV) lines in your body to administer medicine, or you might use supplemental oxygen in the hospital. These tubes and lines that are coming from your body may prevent you from being able to move around normally.

With so many barriers to normal movement in the hospital, your body may quickly lose strength and have difficulty with functional mobility. An acute care physical therapist works with you to ensure that you can function normally when you are ready to leave the hospital.

Goals of Acute Physical Therapy

Your physical therapist will focus on three main areas of functional mobility when you are in the hospital: bed mobility, transfers, and ambulation.

Bed Mobility

Bed mobility refers to your ability to move around while in bed. Are you able to roll from one side to the other in bed? Can you scoot sideways or up and down while in bed? What about moving from a lying position to a sitting position? These questions are all asked by the acute care physical therapist, and they will assess your ability to perform these tasks while in bed.

If your physical therapist finds you having difficulty with a specific task regarding your bed mobility, they can prescribe exercises to help you improve your ability to move in bed. Your physical therapist can also instruct family members or caregivers on techniques to assist you with bed mobility.

Transfers

Transfers refers to the ability to move your body from one position or surface to another. For example, if you are sitting and wish to stand, then you transfer from sit to stand. If you are sitting on the edge of your hospital bed and want to move from your bed to a chair, then you must perform a transfer to get to the chair.

Acute care physical therapists assess your ability to transfer and can offer exercises and techniques to help you transfer better. You may also use a device like a transfer slide board to help you transfer with improved safety.

Ambulation

Ambulation refers to your ability to walk. Your physical therapist will assess your ambulation status in the hospital and can offer suggestions to help you walk better. An assistive device like a walker or a quad cane may be ordered to help you improve your walking ability. Your physical therapist can help teach you how to use your assistive device correctly.

If muscle weakness or loss of range of motion prevents you from walking safely, your physical therapist can prescribe leg-strengthening exercises for you to perform while in the hospital to help improve your muscle function and ambulation. Be sure to follow your physical therapist's directions carefully and ask any questions.

Problems with your balance may also limit your functional mobility. The acute care physical therapist can assess your balance and offer balance exercises that you can do to improve it.

Acute Physical Therapy vs. Inpatient Therapy

Acute care physical therapy is similar to inpatient therapy (sometimes called rehabilitation therapy), but there are some differences. Acute care physical therapy usually occurs in the hospital while someone is being treated for a medical condition and prepares someone to be able to go home. It is usually the start of a rehabilitation process that might be continued after their hospitalization in an outpatient physical therapy office.

Inpatient rehabilitation therapy is usually appropriate for someone who needs more intensive and comprehensive therapy. Inpatient rehabilitation patients typically undergo at least three hours of therapy in five out of seven consecutive days. It is most used in cases such as spinal cord injury, limb amputation, brain injury such as a stroke or TBI, or hip fractures. In these cases, patients might be re-learning activities of daily life, such as how to dress themselves, use utensils, walk, or speak.

Recommendations After You Leave the Hospital

Remember that your physical therapist in the hospital is part of a team of healthcare professionals whose goal is to ensure that you are moving around safely while in the hospital and when you leave. Your physical therapist can also recommend where you should go after leaving the hospital. Are you safe to go home? Should you leave the hospital and be admitted to a rehabilitation hospital? Do you need nursing home care? All of these questions may be difficult to answer.

Your physical therapist can help determine your functional mobility for safe discharge from the hospital and ensure you receive the best care possible when you leave.

Summary

Acute physical therapy is an important part of beginning recovery from injury or illness. Physical therapists help patients find ways to be as mobile as possible within the constraints of their illness or injury. The main areas they focus on include mobility in bed and transfers from lying down to sitting, standing, and walking. It is usually the beginning of a longer rehabilitation journey that might occur in inpatient rehabilitation or at home.

3 Sources
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  2. Forrest G, Reppel A, Kodsi M, Smith J. Inpatient rehabilitation facilities. Medicine (Baltimore). 2019;98(37):e17096. doi:10.1097/MD.0000000000017096

  3. Falvey JR, Burke RE, Malone D, Ridgeway KJ, McManus BM, Stevens-Lapsley JE. Role of physical therapists in reducing hospital readmissions: Optimizing outcomes for older adults during care transitions from hospital to communityPhys Ther. 2016;96(8):1125–1134. doi:10.2522/ptj.20150526

Brett Sears, PT

By Brett Sears, PT
Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy.