Physical Therapy Intervention Summary

When I began the intervention phase with JY, he was able to perform bed mobility and sit at the edge of the bed (EOB) with minimal assistance. JY’s goal for therapy was to return home and cook for his family. After the initial evaluation, I designed the plan of care so JY would qualify for inpatient rehabilitation. Additionally, I recommended outpatient physical therapy once JY achieved stated goals or was discharged from inpatient rehabilitation. JY’s medical team worked to stabilize his medical status; improve bowel/bladder continence; and increase his level of independence in communication/cognition, mobility, and performance of activities of daily living (ADLs). JY’s initial examination was performed on Day 1 of his admission in the ICU. JY’s physical therapy interventions were applied Day 3 of his hospital stay. Physical, occupational, and speech therapy worked collaboratively to coordinate and provide rehabilitation for JY that integrated all of the functional skills he would need to achieve functional goals and return home to his family in an active role. Current evidence supports implementation of early mobilization of patients following stabilization of hemodynamic and respiratory parameters as soon as 24 to 48 hours after admission in the ICU (Rehder et al. 2013).
Research by Cumming et al. (2011) investigated the impact of introducing early and intensive out-of-bed activity in acute stroke patients. In their research, Cumming et al. (2011) included range of motion exercises, EOB activities, activities in standing, static and dynamic balance in standing, and ambulatory activities. Engle et al. (2013) established the following activity progression: bed-level activities, sitting activities, standing activities, bed-to-chair transfer activities, and gait training. These recommendations were incorporated into my intervention plan for