Abstract
To examine whether hospital-based physical therapy is associated with functional changes and early hospital readmission among hospitalized older adults with community-acquired pneumonia and declining physical function. Study design was a retrospective observation study. Participants were community-dwelling older adults admitted to medicine floor for community-acquired pneumonia (n = 1,058). Their physical function using Katz activities of daily living (ADL) Index declined between hospital admission and 48 hours since hospital admission (Katz ADL Index 6→5). The intervention group was those receiving physical therapy for ≥ 0.5 hour/day. Outcomes were Katz ADL Index at hospital discharge and all-cause 30-day hospital readmission rate. The intervention and control groups did not differ in the Katz ADL Index at hospital discharge (p = 0.11). All-cause 30-day hospital readmission rate was lower in the intervention than in control groups (OR = 0.65, p = 0.02). Hospital-based physical therapy has the benefits toward reducing 30-day hospital readmission rate of acutely ill older adults with community-acquired pneumonia and declining physical function.
Highlights
Functional decline in older adults is common and occurs in up to one-third of recently hospitalized older adults [1]
The Katz activities of daily living (ADL) Index at hospital discharge did not differ between the intervention and the control
We examined whether physical therapy for hospitalized older adults is associated with functional changes and early hospital readmission rate
Summary
Functional decline in older adults is common and occurs in up to one-third of recently hospitalized older adults [1]. PT to restore functional reserve has been applied to certain acute illness, such as stroke and hip fracture, with excellent rehabilitation potential in both acute and post-acute hospital settings [13, 14]. There is evidence of dose-dependent effects of PT on functional recovery in a post-acute care setting [16, 17]. Few studies have investigated the effects of PT on functional changes when applied to common acute medical illnesses aside from stroke and hip fracture [13, 14]. Other studies have evaluated the hospital outcomes of hospital-based PT when applied to pneumonia
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