J.R. Falvey, PT, DPT, Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Anschutz Medical Campus, Mail Stop C244, 13121 East 17th Ave, Room 3116, Aurora, CO 80045 (USA).
K.K. Mangione, PT, PhD, FAPTA, Department of Physical Therapy, Arcadia University, Glenside, Pennsylvania.
Phys Ther. 2015 Sep;95(9):1307-15. doi: 10.2522/ptj.20140511. Epub 2015 Apr 23.
Physical therapists often treat older adults with marked deficits in physical function secondary to an acute hospitalization. These deficits are often collectively defined as hospital-associated deconditioning (HAD). However, there is a paucity of evidence that objectively demonstrates the efficacy of physical therapy for older adults with HAD. Older adults with HAD represent a highly variable and complex population and thus may be difficult to study and develop effective interventions for using our current rehabilitation strategies. This perspective article outlines an innovative framework to operationalize and treat older adults with HAD. This framework may help therapists apply emerging exercise strategies to this population and facilitate additional research to support the total value of physical therapy for older adults in postacute care settings-with value measured not only by improvements in physical performance but perhaps also by reduced rates of disability development, rehospitalization, and institutionalization.
物理治疗师经常治疗因急性住院而导致身体功能明显缺陷的老年人。这些缺陷通常被统称为医院相关失能（HAD）。然而，缺乏客观证据表明物理疗法对 HAD 老年患者的疗效。HAD 老年患者代表了一个高度可变和复杂的人群，因此使用我们当前的康复策略对其进行研究和制定有效的干预措施可能会很困难。本文观点概述了一个创新的框架，以实现 HAD 老年患者的治疗。该框架可以帮助治疗师将新兴的运动策略应用于这一人群，并促进额外的研究，以支持物理治疗在急性后护理环境中对老年人的总体价值——不仅通过提高身体机能来衡量，还可能通过降低残疾发展、再住院和住院率来衡量。
