What is the role of physical therapy in shunt placement?

• A. Initiate PT immediately after placement
• B. Discontinue PT entirely
• C. Wait for clearance from the MD before initiating/resuming PT
• D. PT is not involved at all

Answer: (C)

After shunt placement, the priority is to protect intracranial stability while supporting rehabilitation. A shunt changes how CSF drains and how intracranial pressure can respond to activity. Because physical therapy activities can influence pressure dynamics, therapy should not begin or resume until the medical team has reviewed the surgical site, confirmed shunt function, and deemed the patient medically stable. Waiting for clearance ensures that the surgeon has verified there are no post-operative complications and that the patient can safely participate in PT. Once clearance is given, PT can be started or resumed with a gradual plan tailored to the patient, emphasizing safe movements, pacing, and monitoring for any signs of shunt-related issues. Initiating therapy immediately, discontinuing PT altogether, or excluding PT from care all miss the balance of safety and rehabilitation that this scenario requires.