At an average, about 50% of elderly hospitalized patients experience some kind of complication related to hospitalization. About 23.3% of them are at risk of being unable to return home and require nursing home placement. About 35% of them decline in some basic activities of daily living. The aim of our study was to see if early ambulation and early physical therapy soon after hospital admission led to decreased hospital stay and increased the patient’s chances of returning to their independent living.
We performed a retrospective chart review of all hospitalized patients during the month of August 2012. Patient demographics, initial activity orders, timing of initiation of physical therapy, length of hospital stay and patient disposition were collected and analyzed. Patients were divided into two groups‐ “Ambulatory group” comprised of patients who had ambulation orders placed on the day of admission, and “Non ambulatory” group comprised of those who did not have ambulation orders placed on the day of admission.
The average age was 76.37 years in the “Ambulatory” group and 64.8 years in the “Non ambulatory” group. “Ambulatory group” consisted of 36 patients, of whom 19 (52.8%) were discharged home without any services and had an average length of stay of 6.65 days. The other group consisted of 88 patients of those only 26 (29.5%) were discharged home without any services with an average length of stay of 9 days. Physical therapy orders were placed earlier in the first group‐ at an average of 1.06 days as compared to 2.38 days in the second group.
Functional decline during hospital stay is one of the common hospitalization hazards. Loss of functional independence during hospitalization results from not only the effects of acute illness, but also from the inability to maintain functionality during hospitalization. We advocate early ambulation of all hospitalized patients and placement of physical therapy orders, as early as the first day of admission. These small changes could lead to considerable decrease in functional decline associated with bed rest during hospitalization as well as decreased length of stay.
To cite this abstract:Soota K, Ramesh N, Alkhoury Z. Bed Rest Is Not Always Therapeutic. Abstract published at Hospital Medicine 2014, March 24-27, Las Vegas, Nev. Abstract 138. Journal of Hospital Medicine. 2014; 9 (suppl 2). https://www.shmabstracts.com/abstract/bed-rest-is-not-always-therapeutic/. Accessed September 16, 2019.