Background and Purpose: Rehabilitation of patients with low function, multisystems involvement, and concomitant fear of activity (kinesiophobia) is challenging in acute care. The purpose of this case report was to describe the physical therapy (PT) management of a patient admitted to an acute care hospital with an uncommon diagnosis and employment of a unique assessment and intervention component.
Case Description: A 48-year-old woman with mixed connective tissue disease–associated pulmonary artery hypertension was hospitalized after rapid decline in function and medical status. Because the patient presented with extreme fear of activity, PT management included the use of the Tampa Scale for Kinesiophobia and music therapy.
Outcomes: The patient made modest improvements in her impairments and functional limitations despite a poor medical prognosis. The use of music during PT increased her participation in therapeutic exercise and, therefore, activity tolerance. Objective assessment of the patient's level of kinesiophobia allowed clear identification of this barrier and the use of strategies to minimize it.
Discussion: This case describes the PT management of a complex patient using strategies that are not frequently used in acute care settings. The use of nontraditional PT outcome measures and interventions can be feasible, especially for patients with long hospital stays like the patient described in this case.