Paul Ricard, Stephen Cameron Ramsey, Hannah Fernald McHugh, Benjamin Michael Carrion
{"title":"Cardiovascular and Pulmonary Research: The Year (2022) in Review","authors":"Paul Ricard, Stephen Cameron Ramsey, Hannah Fernald McHugh, Benjamin Michael Carrion","doi":"10.1097/cpt.0000000000000230","DOIUrl":"https://doi.org/10.1097/cpt.0000000000000230","url":null,"abstract":"Practitioners need access to and the ability to openly discuss advances in practice and concepts as they apply to the practice of cardiovascular and pulmonary physical therapy (PT). Lack of accessibility to research literature, limited personal time, or insufficient knowledge to adequately review the breadth of literature published each year can hinder this process. This article provides a limited overview of cardiovascular and pulmonary research published in 2022 that the authors believe most important and relevant or speaks to the volume or trend of current topics in the clinical practice of cardiovascular and pulmonary PT. Each topic area is followed by a brief overview of clinical relevance and was open to discussion with the participants present at the 2023 Combined Sections Meeting held on February 24, 2023.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136370976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Connors, T. Betts, Shelby Lawrence, Homer B. Walag, Julie Buchl, V. Kaza
{"title":"Implementing Standard Physical Therapy Guidelines With Patients Acutely After Single or Bilateral Lung Transplant: A Quality Improvement Project in the Hospital Setting","authors":"C. Connors, T. Betts, Shelby Lawrence, Homer B. Walag, Julie Buchl, V. Kaza","doi":"10.1097/CPT.0000000000000227","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000227","url":null,"abstract":"Purpose: A quality initiative assessed standardized physical therapy (SPT) with lung transplant (LT) recipients in the hospital setting. The objective was to improve physical function evidenced by 6-minute walk distance (6MWD) and 30-second chair stand test (30s-CST). Methods: Standardized physical therapy was implemented with patients who underwent LT after March 8, 2021. Data were collected from July 19, 2019 to July 23, 2020 as baseline measures. Six-minute walk distance and 30s-CST were measured after hospital discharge. Results: After data collection, statistical analysis included descriptive statistics and a 2-sample t test with P-value <.05. The baseline group (BG) consisted of 19 patients that participated in traditional physical therapy (PT). The BG mean 6MWD was 891 feet, and mean 30s-CST was 4 repetitions. The SPT group consisted of 25 patients. The SPT group demonstrated a mean 6MWD of 1054 feet with a P-value of 0.0299 and mean 30s-CST of 7 repetitions with a P-value of 0.078. Conclusions: All functional outcome measures improved, with the 6MWD demonstrating statistical significance. Hospitalized LT recipients may demonstrate improved physical function with SPT; however, limited conclusions can be made.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"34 1","pages":"177 - 182"},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43939199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Putting It All Together: An Evidence-Based Guide to High-Intensity Interval Exercise Prescription for Patients With Complex Comorbidities","authors":"Kaelee S. Brockway, L. Ayres, M. Shoemaker","doi":"10.1097/cpt.0000000000000224","DOIUrl":"https://doi.org/10.1097/cpt.0000000000000224","url":null,"abstract":"","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45673532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sternal Displacement During Activities","authors":"J. Rodrigues, George J. Beneck","doi":"10.1097/CPT.0000000000000221","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000221","url":null,"abstract":"Purpose: The purpose of this study was to determine whether sternal displacement occurs, decreases over time, and varies with adherence to sternal precautions during functional activities after median sternotomy. Methods: Seventeen subjects had ultrasound images taken at two and then six to eight weeks after median sternotomy to measure the sternal gap and displacement during five activities commonly limited by sternal precautions. The subjects were divided into two groups based on self-reported compliance with sternal precautions. Results: At the upper sternal site, displacement occurred with all activities in both sessions and decreased over time. At the lower sternal site, displacement only occurred during dynamic activities and decreased over time. Subjects who fully complied with sternal precautions had less upper sternal displacement during stand-to-sit (P = .043; ES = −1.076) and trend toward reduced displacement during sit-to-stand and horizontal abduction with large effect sizes, −.893 and −.975, respectively. Conclusion: Sternal displacement may vary with the task performed and between sternal sites. Reduced sternal displacement identified over time indicates sternal healing. Pectoralis major tension seems to be a primary mechanism of sternal displacement during common functional activities. Our findings suggest that full compliance with sternal precautions may promote sternal healing.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"34 1","pages":"97 - 106"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45532988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Wulke, K. Brown, J. Teel, M. Reynolds, T. Gilliland, E. McShan, J. Gillespie, S. Driver
{"title":"CSM 2023 Cardiovascular and Pulmonary Platform Abstracts","authors":"J. Wulke, K. Brown, J. Teel, M. Reynolds, T. Gilliland, E. McShan, J. Gillespie, S. Driver","doi":"10.1097/cpt.0000000000000219","DOIUrl":"https://doi.org/10.1097/cpt.0000000000000219","url":null,"abstract":"BACKGROUND AND PURPOSE: Firefighting is a demanding and hazardous profession requiring optimal physical and cognitive health. Occupational risk factors associated with firefighting (contact with the public, pulmonary damage from repeated exposure to fire) may place firefighters at an increased risk of contracting SARSCoV-2 as well as for suffering complications resulting from fulminant COVID-191, which can result in impaired physical2 and cognitive3 performance. Current recommendations for rehabilitation following COVID-19 may be insufficient to address the unique physical and cognitive demands required to perform fire suppression tasks.4 The purpose of this case report is to describe the efficacy of a high-intensity, occupation-specific physical therapy (HIOS-PT)5 program to improve aerobic capacity, muscular strength, and cognitive performance sufficient to return a firefighter to full duty within 6 months following hospital discharge for critical COVID-19. CASE DESCRIPTION: A 36-year-old firefighter completed 30 sessions of HIOS-PT with hopes of returning to his strenuous occupation as a firefighter following a 70-day complicated hospitalization for critical COVID-19 pneumonia and acute respiratory distress syndrome requiring invasive mechanical ventilation. Initial evaluation revealed impaired aerobic capacity of less than the first percentile for age and sex on cardiopulmonary exercise testing6, impaired muscular strength on isokinetic testing, and impaired cognitive performance as assessed by an app-based information processing task (reaction time and accuracy). The HIOS-PT program was symptom-limited simulated real work activities based on previous literature describing the effect of similar programming with first responders in cardiac rehabilitation5, while improving strength, cognition, and aerobic capacity sufficient to meet fitness standards required to return to work. Additionally, the patient performed 3 simulated candidate physical ability tests each increasing in intensity which consisted of 9 fire suppression activities required by his department7. Followup assessments were performed after completion of 30 HIOS-PT sessions. OUTCOME(S): Aerobic capacity increased 54% from a VO2=25.4 mL/kg/min (7.3 METs) to VO2=39.2 mL/kg/min (11.2 METs). Muscular strength increased from 59% to >96% body weight. Cognitive performance on an information processing test increased 175% from a score of 556 to 1530. Upon discharge from the HIOS-PT program, the patient returned to full duty as a firefighter. DISCUSSION: HIOS-PT was well tolerated and effective in rehabilitating a firefighter to return to work following a prolonged hospitalization for critical COVID-19. Rehabilitation guidelines for occupational athletes, such as firefighters, following critical COVID-19 is limited and may be insufficient to adequately prepare these individuals for return to strenuous work duties. This case supports the exploration into using HIOS-PT for individuals require","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43075506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Welcome to a New Era","authors":"A. Gurovich","doi":"10.1097/cpt.0000000000000218","DOIUrl":"https://doi.org/10.1097/cpt.0000000000000218","url":null,"abstract":"","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41618729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Liana C Wooten, Sarfaraz Hasni, Jamal A Mikdashi, Randall E Keyser
{"title":"Cardiorespiratory Insufficiency and Performance Fatigability in Women with Systemic Lupus Erythematosus.","authors":"Liana C Wooten, Sarfaraz Hasni, Jamal A Mikdashi, Randall E Keyser","doi":"10.1097/cpt.0000000000000210","DOIUrl":"10.1097/cpt.0000000000000210","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with systemic lupus erythematosus (SLE) experience excessive, debilitating fatigue with previously reported evidence of etiologically mediated cardiorespiratory impairments. Performance fatigability provides a precise characterization of fatigue as it can be quantified objectively as a function of time, frequency, and/or duration. Nevertheless, little consideration has been given to understanding performance fatigability and its physiological determinants in those with SLE. The purpose of this study was to characterize performance fatigability in patients with SLE, utilizing measures surrounding the anaerobic threshold, with emphasis on cardiorespiratory impairment as a potential mediating factor.</p><p><strong>Methods: </strong>This was a case-control study design. 44 physically inactive women, 26 with SLE and 18 controls, completed a treadmill cardiopulmonary exercise test to volitional exhaustion.</p><p><strong>Results: </strong>There were no significant differences in age (SLE 34.8(9.0) vs Control 36.9(7.3) yrs; p=0.422) between groups. BMI (SLE 27.1(5.4) vs Control 23.8(5.2) kg/m<sup>2</sup>; p=0.045) was significantly higher in the SLE vs Control group. Resting heart rate (SLE 68(16) vs Control 78(15) bpm; p=0.040) was significantly lower in the SLE compared to the Control group. The VO<sub>2</sub> corresponding to the anaerobic threshold (AT-VO<sub>2</sub>), used to identify the onset of exercise-induced fatigue, was significantly lower in women with SLE than in controls (SLE 12.4(3.1) vs Control 16.4(2.2) ml/kg/min; p<0.001), as was AT-stage (SLE 2.5(0.90) vs Control 3.4(0.78); p=0.002). Additionally, Fatigue Severity Score (FSS) was highly and inversely correlated with AT-VO<sub>2</sub> (rho=-0.615; p<0.001) and FSS was highly correlated with Functional Aerobic Impairment Index (FAI; rho=0.663; p<0.001).</p><p><strong>Conclusion: </strong>This study underscores severe performance fatigability in patients with SLE and its link to cardiorespiratory insufficiency. Physiological presentation of performance fatigability was observed during very low intensities of exercise, emphasizing the negative impact it may have on physical function in this population.</p>","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"34 1","pages":"51-60"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9897569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9214118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}