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The Necessity, Effectiveness, and Inhibiting Factors of Physical Therapy in the Psychiatric Ward of a General
Tomoyuki Nakamura1,2, Mikoto Baba2, Shuhei Kurosaki2
1Department of Rehabilitation Medicine, Dokkyo Medical University, Mibu, Japan.
Objectives:
Physical complications in psychiatric patients and the role of physical therapy (PT) are gaining attention. However, research remains limited. This study examined the necessity, effectiveness, and inhibiting factors of PT in a psychiatric ward.
Methods:
This retrospective observational study evaluated inpatients undergoing rehabilitation in the psychiatric ward of a general hospital between April 2017 and March 2022. The data collected included characteristics, psychiatric diagnosis, physical complications, time to rehabilitation initiation, training implementation rate, training time, Barthel Index (BI) at admission and discharge, length of hospital stay, and residence before and after hospitalization. Univariate analysis was performed to compare patients who received PT with those who did not receive PT. Among patients who received PT, factors inhibiting independence in ADLs (BI ≥85) and the BI gain were analyzed using binomial logistic regression and multiple regression analysis.
Results:
Of all patients, 772 received PT, and they were significantly older, more likely to be institutionalized, and had higher rates of organic mental disorders, musculoskeletal disorders, and internal conditions compared to the 317 patients who did not receive PT. PT resulted in a significant BI gain, with 596 individuals achieving independence. Independence and BI gain were significantly associated with pre-hospitalization factors, including age, psychiatric diagnosis, residence, and BI, whereas rehabilitation-related indicators showed no significant association.
Conclusions:
Many patients with advanced age, organic mental disorders, physical complications, and low BI achieved functional independence following PT. However, reduced activity levels before hospitalization hindered recovery. Preventive efforts should target physical decline in both community and hospital settings.
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