Abstract
A 68-year-old male with an acute exacerbation of chronic obstructive pulmonary disease (COPD) was seen by a student physical therapist for 5 sessions within 4 days at an acute care hospital under the supervision of a licensed physical therapist. The patient was diagnosed with pneumonia during his hospital stay which increased his hospital length of stay from 2 days to 4 days.
The patient was evaluated at the initial encounter with the Six Minute Walk Test (6MWT), Checklist Individual Strength (CIS) questionnaire, and COPD Assessment Test (CAT), and a plan of care was established to address respiratory impairments, fatigue, limitations in exercise capacity, and decreased quality of life. Pulse oximetry and the Dyspnea Scale were used to monitor his exercise tolerance throughout the episode of care. Main goals were to improve ambulation capacity, prevent physical deconditioning during hospitalization, and decrease mortality risk. Main interventions used were functional training, resistance training, interprofessional coordination with members of the healthcare team regarding patient care, and patient education on self-management techniques including proper breathing and energy conservation to reduce hospital readmissions. The patient responded well to physical therapy interventions and showed improved oxygen saturation and decreased dyspnea during ambulation. While there were no clinically significant improvements noted in the patient’s 6MWT, he maintained his exercise capacity and showed no evidence of hospital deconditioning following his bout of pneumonia. While his fatigue, as measured with the CIS, increased significantly during his pneumonia bout, he returned to baseline function by discharge. The patient was discharged to home with family and caregiver assistance and follow-up with home health physical therapy.