Rethinking Hospital-Associated Deconditioning: Proposed Paradigm Shift

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...

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Bibliographic Details
Published in:Physical therapy 2015-09, Vol.95 (9), p.1307-1315
Main Authors: Falvey, Jason R, Mangione, Kathleen K, Stevens-Lapsley, Jennifer E
Format: Article
Language:English
Subjects:
Activities of Daily Living
Aged
Appetite
Care and treatment
Exercise Therapy
Fatigue - rehabilitation
Gait
Hospitalization
Humans
Innovations
Medical research
Medicare
Medicine, Experimental
Mortality
Muscle Weakness - rehabilitation
Patient care
Patients
Physical Conditioning, Human - methods
Physical Conditioning, Human - physiology
Physical Endurance
Physical Therapists
Physical therapy
Physical Therapy Modalities
Postural Balance
Practice
Precision medicine
Professional Role
Recovery of Function
Resistance Training - methods
Syndrome
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Summary: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.
ISSN:0031-9023
1538-6724
DOI:10.2522/ptj.20140511