Exercise in the hospital: Implementing exercise protocols in the ward

We have already mentioned in other posts how important is the application of a therapeutic exercise protocol in physiotherapy treatment.

The application of our own exercise protocols when we are in private practice is simple because we fully manage the treatment and all its aspects. We know when and how to prescribe exercise.

But if any of you have experience as a physiotherapist in a rehabilitation service gym or on a hospital ward you will understand the importance of addressing the issue of implementing exercise in inpatient rehabilitation.

When most people think of how a hospital physiotherapy department works, they imagine the typical gymnasium, often crowded, with its pulleys and heat lamps. An image that corresponds more to an outpatient or eminently trauma physiotherapy service.

However, the profile of the patient admitted to a referral hospital is very varied and always requires the integration of a multidisciplinary team. An ideal situation would be where the different medical, nursing and physiotherapy specialties should form a whole when providing service to the patient.

Let us focus, for example, on the operation of some of the most important hospitals in the country. The so-called reference hospitals, such as La Fe in Valencia or Virgen del Rocío in Seville.

Organization and cooperation: the keys to physiotherapy on the hospital ward

The team of physiotherapists attending the floors of this type of center is one of the essential components of the hospital’s rehabilitation service.

Their job is to go to the different rooms to perform respiratory therapy, teach exercises or help the patient to walk.

No matter the type of patient: ICU, pediatric ICU, cardiology, pulmonology, pediatrics or oncology, among others. It is an arduous task in which time plays against you and organization is essential when it comes to coordinating with extractions, meal times, tests, etc.

Cooperation with the physician is usually essential. It is in this area of collaboration that the work of hospital physiotherapy is highly respected and valued.


Why should a hospital exercise protocol be implemented?

One of the biggest problems faced by physiotherapists on the ward is the time that can be dedicated to each patient, either because of volume or because of the inconveniences related to the hospital stay itself that I mentioned earlier.

Many scientific articles have been published on the application of exercise programs in groups of hospital patients such as in dialysis or cardiology services. In others, such as traumatology services, exercise has long been prescribed for patients undergoing prosthetic surgery.

In-hospital exercise is the new medicine and its benefits are scientifically proven in patients suffering from chronic pathologies; it is no longer just a matter of avoiding the deterioration caused by bed rest. If we can get the patient to exercise during admission, we can get them to adhere to a home exercise program later, as is already being done in patients undergoing cardiac surgery.

It is important to emphasize that it must be a personalized exercise. It must be adapted to each case or hospital group in terms of intensity and number of repetitions, assessing the patient’s capabilities.

It is essential that the progression is correctly monitored by the healthcare professional. It is not enough to prescribe the typical conventional exercise and mobility tables that are often obsolete or not adaptable to the patient.

In this way, the patient will not only learn, but will evolve faster and will be able to be discharged in less time, which would also translate into interesting savings in the budgets of public and private hospitals.

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