I have been making the case for individually prescribed and appropriately dosed exercise programs in home health for as long as some of you have possibly known me.Years of practice, and a look at many, many records over the last 3 years just further convinces me many therapists in post-acute care settings are not following evidence based practice related to muscle strengthening.However, this has served as purely anecdotal musings (or rantings, at times) . . . until the publication of “Rethinking Hospital-Associated Deconditioning:Proposed Paradigm Shift” authored by Jason Falvey, PT, DPT, Kathleen MangionePT, PhD, FAPTA, and Jennifer Stevens-Lapsley, PT, PhD, in the September 2015 Journal of Physical Therapy.Have you read it??
It’s been almost a year since this perspective was published, and I keep waiting for the “revolution” to happen.I am not sure you could have read it and not be driven to action.I don’t want to assume this one was passed over by any therapist in their reading of the professional literature, but (again, anecdotally) I am not sure how any post-acute clinician could have read it and continue to practice as they did prior to this read.Take my word for it – a charge has been set forth and we must rise to meet it.Ample evidence is available in the research literature related to what appropriate standards of practice should include.
But before we go there, let me summarize some of the facts this perspective succinctly lays out based on research related to the effects of hospitalization on older adults: