Rethinking Hospital-Associated Deconditioning: Proposed Paradigm Shift

Area of Science:

• Geriatric rehabilitation
• Physical therapy interventions
• Hospital-associated deconditioning (HAD)

Background:

• Older adults frequently experience physical function deficits post-hospitalization, termed hospital-associated deconditioning (HAD).
• Limited evidence objectively demonstrates physical therapy's efficacy for older adults with HAD.
• The heterogeneity of this population complicates study and intervention development using current strategies.

Purpose of the Study:

• To outline an innovative framework for operationalizing and treating older adults with HAD.
• To guide therapists in applying emerging exercise strategies to this population.
• To facilitate research supporting the comprehensive value of physical therapy in post-acute care.

Main Methods:

• This is a perspective article, outlining a conceptual framework.
• Focuses on operationalizing treatment and intervention strategies for HAD.
• Emphasizes the need for research into novel exercise approaches.

Main Results:

• A proposed framework to address the complexities of HAD in older adults.
• Potential for improved application of exercise strategies in post-acute care.
• Highlights the need for further research to validate the framework's effectiveness.

Conclusions:

• The proposed framework offers a novel approach to managing hospital-associated deconditioning in older adults.
• It aims to enhance the application of physical therapy and guide future research.
• The framework supports a broader definition of value in physical therapy, including reduced disability, rehospitalization, and institutionalization.