Physical therapy (PT) is an important part of the recovery process after a serious medical event or surgery. Acute care physical therapy refers to services provided while a patient is hospitalized and medically unstable or recovering from an immediate health crisis. This early intervention is essential for improving patient outcomes. The goal is to maximize a patient’s physical capacity within the initial phase of their medical treatment.
Defining Acute Care Physical Therapy
Acute care physical therapy is a specialized area of practice that occurs within the hospital environment, including general medical wards, the emergency department, and Intensive Care Units (ICUs). Therapists in this setting work with patients admitted due to a sudden illness, injury, or major surgical procedure. The defining characteristic of this care is the requirement for continuous medical monitoring while the patient receives therapy.
The services are rapid and responsive, focusing on a patient’s immediate functional needs and safety in a medically complex setting. This type of physical therapy differs significantly from sub-acute rehabilitation or outpatient therapy. Acute care focuses on preventing decline and achieving basic mobility for a safe discharge, whereas sub-acute or outpatient care focuses on long-term functional gains outside of the hospital setting.
Patient Populations and Primary Goals
Acute care physical therapists treat a wide range of patient populations following a severe health event. Common patients include those recovering from major orthopedic surgery, individuals with traumatic injuries, and people who have experienced acute neurological incidents like a stroke. Patients with severe cardiac or respiratory conditions, as well as those with debilitating infections, also frequently receive this specialized care.
A primary goal is to combat the rapid deconditioning, or muscle wasting, that occurs with prolonged bed rest, often called ICU-acquired weakness. Therapists work to maintain or improve the patient’s respiratory function. They also assess the patient’s readiness for basic functional tasks, such as rolling over, sitting up, and standing. Ensuring patient safety during these tasks and preventing falls is paramount, as the patient’s medical status can fluctuate quickly.
Core Interventions and Treatment Focus
The practical application of acute care therapy centers on early and progressive mobilization tailored to the patient’s medical stability. Therapists initiate bed mobility training, helping patients safely move within the confines of their bed. They progress to transfer training, teaching patients how to move safely between surfaces, such as from the bed to a chair or commode.
Initial gait training is often performed with specialized assistance and medical monitoring, focusing on short, safe distances to restore the ability to walk. A specific intervention is chest physical therapy, also known as pulmonary hygiene, which involves techniques like postural drainage, percussion, and breathing exercises to clear airway secretions. The therapist must constantly modify the treatment plan based on real-time changes in the patient’s vital signs and medical status.
Preparing for the Next Phase of Care
A fundamental role of the acute care physical therapist is to assess the patient’s functional status and make recommendations for their next environment. This assessment determines the patient’s ability to perform necessary tasks like walking, transferring, and managing assistive devices relative to the requirements of their home or future care setting. The assessment provides objective data about the patient’s physical limitations and helps inform the discharge planning team.
Based on this evaluation, the therapist recommends the most appropriate level of continued care to ensure a smooth and safe transition. Options include discharging the patient home with or without home health physical therapy services, transferring to a skilled nursing facility (SNF) for less intensive rehabilitation, or moving to an inpatient rehabilitation facility (IRF) for a higher intensity of daily therapy. The recommendation balances the patient’s functional needs with their medical tolerance for continued rehabilitation.