Guideline Development Group

The Role of Physical Therapists in the Management of Individuals at Risk for or Diagnosed with Venous Thromboembolism – An Evidence-Based Clinical Practice Guideline

Guideline Development Group:

Ellen Hillegass, PT, PhD, CCS, FAPTA - Mercer University, Atlanta, Georgia

Michael Puthoff, PT, PhD, GCS - St Ambrose University, Davenport, Iowa

Ethel Frese, PT, DPT, MHS, CCS - St Louis University, St Louis, Missouri

Mary Thigpen, PT, PhD - Brenau University, Gainesville, Georgia

Dennis Sobush, PT, MA, DPT, CCS, CEEAA – Marquette University, Milwaukee, Wisconsin

Beth Auten – Librarian, MLIS, MA, AHIP

ABSTRACT

The American Physical Therapy Association (APTA), in conjunction with the Cardiovascular & Pulmonary and Acute Care Sections of the APTA, have developed this clinical practice guideline (CPG) to assist physical therapists in their decision making process when managing patients at risk for venous thromboembolism (VTE) or diagnosed with a lower extremity deep vein thrombosis (DVT). No matter the practice setting, physical therapists work with patients who are at risk for and/or have a history of VTE. This document will guide physical therapy practice in the prevention of, screening for and management of patients at risk for or diagnosed with lower extremity DVT (LE DVT).

Through a systematic review of published studies and a structured appraisal process, key action statements were written to guide the physical therapist. The evidence supporting each action was rated and the strength of statement was determined. Table 1 lists the 14 action statements. Clinical practice algorithms (Figures 2-4), based upon the key action statements , were developed that can assist with clinical decision making. Physical therapists, along with other members of the healthcare team, should work to implement these key action statements to decrease the incidence of VTE, improve the diagnosis and acute management of LE DVT, and reduce the long term complications of LE DVT.