Getting Physical Therapy in the Hospital

Physical therapists work in many different settings. Home care therapists come to your house to help you move and feel better when you are unable to leave the home. Other physical therapists work in schools. The outpatient clinic is another practice setting where you would find physical therapists.

Older adult in a hospital bed
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Physical therapists also work in hospitals. These therapists are usually called acute care physical therapists or inpatient physical therapists. They evaluate your functional mobility when you are 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 on the oncology, or cancer, unit. Others work solely in the intensive care unit (ICU).

The Main Job 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 when in the hospital, you are confined to bed and are staying 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 be using supplemental oxygen while 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 you may have difficulty with functional mobility. An acute care physical therapist works with you to ensure that you are able to function normally when you are ready to leave the hospital.

Functional Mobility in the Hospital

There are three main areas of functional mobility that your physical therapist will focus on when you are in the hospital. These are 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 he or she will assess your ability to perform these tasks while in bed.

If your physical therapist finds that you are having difficulty with a specific task regarding your bed mobility, he or she can prescribe exercises to help you improve your ability to move in bed. Your physical therapist can also instruct family members or caregivers in 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 when you are in the hospital. He or she 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 questions if you have any.

Problems with your balance may also limit your functional mobility, and the acute care physical therapist can assess your balance. He or she can offer balance exercises that you can do to improve balance.

The Team Approach to Hospital Care

Remember that your physical therapist in the hospital is a 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 the hospital. Your physical therapist can make recommendations about where you should go after you leave 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 are difficult to answer.

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

2 Sources
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  1. Masley PM, Havrilko CL, Mahnensmith MR, Aubert M, Jette DU. Physical therapist practice in the acute care setting: a qualitative study. Phys Ther. 2011;91(6):906-19. doi:10.2522/ptj.20100296

  2. 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

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