A patient is found to have a DVT in LE and is given anticoag, how long will PT be on hold? Is there a certain amount of time to wait to make sure the anticoag will have therapeutic effect?

Below is an excerpt from a 2004 study,  ‘When can the patient with deep venous thrombosis begin to ambulate?’ by Aldrich D and Hunt DP published in the Journal of the American Physical Therapy Association:

‘…In the past, patients with active deep venous thrombosis (DVT) were placed on bed rest for periods up to 7 to 10 days due to the fear of pulmonary embolism (PE) among patients who remain active. The logical, if simplistic, argument was that vigorous movement of the involved limb would cause the proximal clot to “break off and travel to the lungs.” More recent practice has included earlier ambulation, but there has been reluctance to begin ambulation immediately after diagnosis and initial management of DVT. In practice, there appears to be no standard protocol for activity progression…’

It appears that this observation will hold true even if ‘ to ambulate’ is substituted for ‘physical therapy’ in the study title – in other words, there is no standard protocol for commencing physical therapy after the administration of anticoagulants in patients with DVT. Clinically, however, irrespective of the allowed period of immobilization, DVT patients are not good candidates for vigorous passive movements, manipulations and deep massage due to the risk of PE which can be fatal.