Physical therapy practice patterns in acute exacerbations of chronic obstructive pulmonary disease.
OBJECTIVE
The importance of the multidisciplinary approach to the management of chronic obstructive pulmonary disease is increasingly emphasized. The present study aimed to examine the current practice patterns of physical therapists involved in the management of patients hospitalized with an acute exacerbation of chronic obstructive pulmonary disease.


METHODS
A self-administered postal survey was distributed to the rehabilitation departments of all Canadian acute care hospitals with more than 250 beds. The survey addressed patient assessment, treatment, education and discharge planning for intensive care unit and/or ward admissions.


RESULTS
In total, 66% of hospitals (n=109) participated in the study, with provincial representation mainly from Ontario (n=36 [33%]) and Quebec (n=36 [33%]). Assessment and treatment techniques did not differ greatly between the ward and the intensive care unit. Assessment focused on patient observation, pulse oximetry and auscultation, and was reported to be used 'always or frequently' by 76%, 76% and 69% of respondents, respectively. Less than 18% of respondents used a measure of functional capacity, and health-related quality of life measures were rarely used. Treatment focused on ambulatory techniques, with 78% and 75% of respondents using mobility and transfer training 'always or frequently', respectively. The most common educational topics were breathing exercises and positioning, which were addressed by 68% and 67% of respondents, respectively.


CONCLUSIONS
Patient assessment focused on physical impairments, with little use of measures of function or health-related quality of life, whereas treatment focused on mobility, with a lesser focus on airway clearance. Further study is needed to identify the factors that impact these practice patterns.
Harth
Leslie
L
Department of Physical Therapy, University of Toronto, Toronto, Canada.
Stuart
Jennifer
J
Montgomery
Catherine
C
Pintier
Karol
K
Czyzo
Susan
S
Hill
Kylie
K
Goldstein
Roger
R
Brooks
Dina
D
D001945:Breathing Exercises; D018450:Disease Progression; D019538:Health Care Surveys; D006760:Hospitalization; D006801:Humans; D010351:Patient Discharge; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D011795:Surveys and Questionnaires