Cardiopulmonary physical therapy journal最新文献

{"title":"Secondary Analysis of Walking Activities during the Acute Stroke Hospital Stay and Cerebrovascular Health.","authors":"Alicen A Whitaker,&nbsp;Madison L Henry,&nbsp;Allegra Morton,&nbsp;Jaimie L Ward,&nbsp;Sarah M Eickmeyer,&nbsp;Michael G Abraham,&nbsp;Sandra A Billinger","doi":"10.1097/CPT.0000000000000196","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000196","url":null,"abstract":"<p><strong>Purpose: </strong>Physical activity within the hospital post-stroke is recommended for cardiovascular and musculoskeletal health, but no studies have examined cerebrovascular health. We hypothesized individuals who walked farther distances (FARhigh) during the acute phase of stroke recovery in a hospital setting would have a higher resting middle cerebral artery blood velocity (MCAv) and a greater cerebrovascular response (CVR) to moderate-intensity exercise at 3-months post-stroke, compared to individuals who walked shorter distances (FARlow).</p><p><strong>Methods: </strong>At 3-month post-stroke, we recorded 90-seconds of resting baseline (BL) MCAv followed by 6-minutes of moderate-intensity exercise. We calculated CVR as the change in MCAv from BL to steady-state exercise. We <b>retrospectively</b> collected farthest distance walked within the hospital post-stroke from the electronic medical record. Participants were classified as FARhigh or FARlow based on average farthest walking distance.</p><p><strong>Results: </strong>Twenty participants completed the study, age 63 (15) years. BL MCAv was not different between groups (p = 0.07). In comparison to FARlow, we report a higher CVR in FARhigh's ipsilesional ( <math><mover><mi>x</mi> <mo>¯</mo></mover> </math> = 7.38 (5.42) vs <math><mover><mi>x</mi> <mo>¯</mo></mover> </math> = 2.19 (3.53), p = 0.02) and contralesional hemisphere ( <math><mover><mi>x</mi> <mo>¯</mo></mover> </math> = 8.15 (6.37) vs <math><mover><mi>x</mi> <mo>¯</mo></mover> </math> = 2.06 (4.76), p = 0.04).</p><p><strong>Conclusions: </strong>Physical activity during the hospital stay post-stroke may support cerebrovascular health after discharge. Prospective studies are needed to support this finding.</p>","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"33 3","pages":"130-137"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9327803/pdf/nihms-1754547.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9729200","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}

{"title":"The Association of the Medical Research Council Scale and Quantitative Computerized Dynamometry in Patients After Critical Illness: An Exploratory Study","authors":"A. Michalski, Leanna Souza-Barros, Priscila Robles, Ji Cameron, M. Herridge, S. Mathur","doi":"10.1097/CPT.0000000000000207","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000207","url":null,"abstract":"Purpose: The purpose of this study was to determine the association between isometric peak torque obtained using the Biodex dynamometer (gold standard) to the Medical Research Council (MRC) scale for knee extension (KE), ankle dorsiflexion (DF), and shoulder flexion (SF) in patients after intensive care unit (ICU) discharge. Methods: A cross-sectional observational substudy was conducted. Adults with at least 7 days of mechanical ventilation were recruited from a parent study of outcomes after critical illness. Muscle strength of KE, DF, and SF was measured using the MRC scale (grades 0–5) and the Biodex dynamometer (peak torque, % predicted) at 3 months post-ICU discharge. Results: Twenty participants were included in the study. The median and interquartile ranges for MRC scores for KE, DF, and SF were 4.5 (IQR = 1), 4.5 (IQR = 1), 4.0 (IQR = 1), respectively. No significant correlations were found between isometric peak torque and MRC scores for any muscle group at 3 months post-ICU discharge. Conclusion: Medical Research Council scale may be limited in the ability to detect muscle weakness post-ICU discharge. Quantitative dynamometry is recommended in the post-ICU period to identify individuals with muscle weakness who may benefit from physical rehabilitation.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"33 1","pages":"166 - 170"},"PeriodicalIF":0.0,"publicationDate":"2022-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47067074","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":"Self-reported Vital Sign Assessment Practices of Neurologic Physical Therapists","authors":"J. O'Brien, H. Wallmann, Jaclynne Karaffa, Marissa Kleilein, Katherine R. Prewitt, H. Schreiber, Hannah Zimmerman","doi":"10.1097/CPT.0000000000000206","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000206","url":null,"abstract":"Purpose: This study's purpose was to describe the vital sign assessment (VSA) practices of physical therapists (PTs) during evaluation and treatment of patients with neurologic conditions. Methods: A survey was distributed to clinicians from a clinical site database and the Academy of Neurologic Physical Therapy's list serve. Respondents included US licensed PTs who treat patients with neurologic conditions. Results: Usable surveys included 133 US PTs with 69.2% doctorally prepared and 79.7% American Physical Therapy Association (APTA) members. Although 58.6% of survey respondents indicated that VSA is an essential part of the PT evaluation, at evaluation, only 37.6% and 39.1% of respondents always take heart rate (HR) and blood pressure (BP), and only 8.3% of respondents always take respiratory rate (RR). During treatment, only 14.3% of respondents report taking HR or BP at each session, while only 5.3% always take RR. Board certification was correlated with an increased frequency of HR assessment (P = .0027) and BP (P = 0.038) at evaluation, while importance of VSA strongly correlated with increased assessment of HR (P = 0.000), BP (P = 0.000), and RR (P = 0.003) at evaluation and with HR (P = 0.000) and BP (0.000) during treatment. Conclusions: Although VSA by neurologic PTs is higher than other identified PT groups, it is still below-recommended assessment guidelines.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"34 1","pages":"30 - 38"},"PeriodicalIF":0.0,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46863970","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":"The Effect of Music Listening During Pulmonary or Cardiac Rehabilitation on Clinical Outcomes: A Systematic Review and Meta-analysis","authors":"Hannah E. Frank, P. Munro, I. Clark, A. Lee","doi":"10.1097/CPT.0000000000000204","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000204","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Purpose: To determine the effects of music listening during pulmonary rehabilitation (PR) or cardiac rehabilitation (CR) or their corresponding maintenance programs on clinical outcomes in people with respiratory or cardiac conditions. Methods: Studies were identified from 4 electronic databases. Two reviewers independently reviewed randomized controlled or crossover studies examining the effects of music listening compared with no music listening in individuals undertaking PR or CR or corresponding maintenance programs. Methodologic quality was assessed using the Cochrane Risk of Bias tool. Results: Nine studies were included. Music listening during PR improved the incremental shuttle walk distance (mean difference [MD] of 73 m [95% CI 25.9–119.8]) compared with no music listening. This impact was absent in a CR maintenance program. When applied during PR programs, music listening had no effect on quality of life (standardized MD −4.6 points [95% CI −11.8 to 2.6]). Music listening had inconsistent effects on dyspnea and fatigue during PR and PR maintenance programs, but no impact on physical activity levels following CR or CR maintenance programs. Conclusions: Music listening during PR improved exercise capacity, but had no effect on quality of life. When applied during CR or CR maintenance, the impact on physical activity was negligible.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"34 1","pages":"13 - 29"},"PeriodicalIF":0.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47829297","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":"Effect of Test Interface on Respiratory Muscle Activity and Pulmonary Function During Respiratory Testing in Healthy Adults: A Pilot Study.","authors":"Elaheh Sajjadi,&nbsp;Patrick C Mabe,&nbsp;Yasin B Seven,&nbsp;Barbara K Smith","doi":"10.1097/cpt.0000000000000183","DOIUrl":"https://doi.org/10.1097/cpt.0000000000000183","url":null,"abstract":"<p><strong>Purpose: </strong>The mouthpiece is the standard interface for spirometry tests. Although the use of a mouthpiece can be challenging for patients with orofacial weakness, maintaining a proper seal with a facemask can be an issue for healthy individuals during forceful efforts. We compared respiratory muscle activity and tests using a mouthpiece and facemask in healthy adults to investigate whether they can be used interchangeably.</p><p><strong>Methods: </strong>In this observational study, subjects (n=12) completed forced vital capacity, maximal respiratory pressure, and peak cough flow with a mouthpiece and facemask. Root mean square values of the genioglossus, diaphragm, scalene, and sternocleidomastoid were compared between conditions.</p><p><strong>Results: </strong>When switching from a mouthpiece to a facemask, significantly higher values were seen for peak cough flow (average bias= -54.36 L/min, p<0.05) and the difference seen with MEP and MIP were clinically significant (average bias: MEP=27.33, MIP=-5.2). Additionally, submental activity was significantly greater when MIP was conducted with a mouthpiece. No significant differences were seen in respiratory muscle activity during resting breathing or spirometry.</p><p><strong>Conclusion: </strong>There are clinically significant differences with cough and MEP tests and neck muscles are activated differently based on interface. Considering the small sample size, our findings suggest a facemask may be used to complete some PFTs.</p>","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"33 2","pages":"87-95"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9488548/pdf/nihms-1738734.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9227368","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}

{"title":"Current Research, Exciting Future","authors":"A. Gurovich","doi":"10.1097/cpt.0000000000000205","DOIUrl":"https://doi.org/10.1097/cpt.0000000000000205","url":null,"abstract":"","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42392212","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":"Impact of Blood Pressure Cuff Overinflation on Blood Pressure Measurements in Adults","authors":"Amy Toonstra, K. Lefebvre, Jessica Denn, Matthew Goecke, Lucas Grossoehme, E. Jarocki, Charlie Leslie, Rachel Peckumn, Peter J. Rundquist, Spencer Warfield","doi":"10.1097/CPT.0000000000000200","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000200","url":null,"abstract":"Purpose: The purpose of this study is to determine effects of cuff overinflation on blood pressure (BP) measurements compared with the standardized 20 mm Hg above the loss of Korotkoff sounds when taking manual BP in adults. Methods: One hundred twelve participants were recruited. American Heart Association standard procedure guidelines were referenced. Baseline BP was measured using standard cuff inflation of 20 mm Hg above loss of systolic Korotkoff sounds, followed by BP measurements with cuff inflations of 40, 60, and 80 mm Hg above the loss of Korotkoff sounds. Results: Friedman's analysis of variance found statistically significant differences in systolic measurements between standard and all 3 over-inflation methods (P = .015). Post-hoc Wilcoxon signed-rank tests demonstrated significant difference in systolic measurements between standard cuff inflation and 60 and 80 mm Hg above the loss of Korotkoff sounds (P = .005, .003). Conclusions: This study reveals blood pressure cuff inflation 60 mm Hg past the loss of Korotkoff sounds creates statistically significant differences in systolic BP measurements as compared with recommended procedures. Higher cuff inflation levels may significantly change BP measurements and decrease accuracy of clinical decision-making and medical management.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"33 1","pages":"171 - 176"},"PeriodicalIF":0.0,"publicationDate":"2022-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48994855","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":"Move in the Tube Sternal Precautions: A Retrospective Analysis of a Single Inpatient Rehabilitation Facility","authors":"H. McKenna, Jennifer Jones, Erin Y. Harmon","doi":"10.1097/CPT.0000000000000194","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000194","url":null,"abstract":"Purpose: To assess the admitting characteristics, adverse events, and rehabilitation outcomes of patients adhering to move in the tube (MIT) or standard sternal precautions in an inpatient rehabilitation facility (IRF). Methods: This study is a retrospective analysis of 273 patients admitted to a single IRF. Patients followed the sternal precautions recommended by their admitting acute care hospitals. One hundred ninety patients' assigned standard and 83 patients' assigned MIT sternal precautions were evaluated. Admitting characteristics, including comorbidities and functional status, were compared between cohorts. Hospital readmissions, sternal disruptions, length of stay, functional independence at discharge, and discharge destination were also assessed. Results: Patients adhering to MIT precautions had higher levels of functional independence at admission despite a higher frequency of combined coronary artery bypass grafts/valve surgeries, comorbidities, and prior functional limitations. There was no difference in sternal wound disruptions, return to hospital rates, length of IRF stay, or functional independence levels at discharge between cohorts. Conclusions: Patients on MIT precautions were admitted to an IRF with more medical complications but higher functional independence. Both groups had minimal sternal complications, providing evidence that modified sternal precautions are safe and can benefit patients in an IRF setting.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"33 1","pages":"108 - 115"},"PeriodicalIF":0.0,"publicationDate":"2022-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49084940","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":"TUG-10: A Modification of the Timed Up and Go Test for Aerobic Assessment in Older Adults","authors":"Colleen G. Hergott, Lori A. Bolgla, J. Waller, Aaron Dowling, Kennedy Ezzell, Corley Graves, William Peed","doi":"10.1097/CPT.0000000000000202","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000202","url":null,"abstract":"Purpose: Cardiorespiratory fitness tests are important for older adults to determine baseline cardiovascular fitness and appropriate aerobic exercise intensity. The Timed Up and Go (TUG) is a test that can be modified to challenge the aerobic system by performing 10 continuous repetitions (TUG-10). The TUG-10 advantages include less space and time requirements and incorporation of functional tasks with balance challenges. The purpose of this study was to relate the performance and physiologic responses of the TUG-10 to other common aerobic capacity tests. Methods: Fourteen independent community-dwelling adults performed the 6-minute-walk test (6MWT), 2-minute-step test (2MST), and TUG-10. Heart rate (HR), diastolic and systolic blood pressure, and rate of perceived exertion (RPE) were recorded before and after each test. Bland–Altman plots were used to determine the agreement between test performances. Repeated measures mixed models compared differences in the physiologic changes between the tests. Results: Participants had a clinically greater increase in the adjusted mean change in HR during the 2MST (22.5 bpm) than the 6MWT (17.0 bpm) and TUG-10 (12.3 bpm). Diastolic blood pressure response was similar across all 3 tests with no significant change. Systolic blood pressure increased less during the 6MWT (15.4 mm Hg) compared with the 2MST (33.3 mm Hg) and TUG-10 (28.7 mm Hg). Participants reported a higher RPE during the 2MST (7.9) than the 6MWT (6.1) and TUG-10 (5.2). The Bland–Altman plots indicated that participants' performance on the 3 tests was comparable. Conclusions: The TUG-10, 6MWT, and 2MST demonstrated comparable performances and clinically similar physiologic changes. Heart rate and RPE changes were greater during the 2MST than the other tests, suggesting that the 2MST was more demanding. Findings support the TUG-10 as a potential functional outcome measure to estimate cardiorespiratory fitness. Moreover, the TUG-10 required minimal space and time and may facilitate the gap in aerobic testing in physical therapy practice.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"33 1","pages":"157 - 165"},"PeriodicalIF":0.0,"publicationDate":"2022-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43085420","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":"Functional Status and Discharge Location of Patients Post–Left Ventricular Assist Devices Surgery in the Acute Care Setting","authors":"A. Fick, H. Tymkew, Morgan Deters, Kelsey Martin, Jordan Ratermann, Abigail Reilly, Brad Lohbeck, Yuan-ling Liu","doi":"10.1097/CPT.0000000000000193","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000193","url":null,"abstract":"Purpose: Left ventricular assist devices (LVAD) are an alternative treatment for patients with heart failure. The purposes of this study were to describe patients immediately post-LVAD surgery, determine differences between functional outcome measures and discharge location, and the potential for initial Functional Status Score of the Intensive Care Unit (FSS-ICU) to assist in discharge recommendations. Methods: A retrospective study (n = 100) was conducted with the following data obtained: general demographics, FSS-ICU, ICU Mobility Scale (IMS), maximal ambulation distance, and discharge location. Patients were divided into 2 groups based on discharge location (home vs facility). Results: The mean age was 52.8 years, with 64% male. A significant improvement in all functional outcomes was observed from evaluation to discharge. Patients discharged home (76%) exhibited significantly higher FSS-ICU and IMS scores and tolerated out-of-bed activity and ambulation earlier. A score of 14 or higher on the initial FSS-ICU was predictive for discharge to home recommendation. Conclusion: Patients post-LVAD implantation exhibited low levels of functional mobility initially, yet were able to tolerate early activity. Patients discharged home had higher functional scores during the initial evaluation. Using the results of the FSS-ICU may assist in discharge recommendations; further research is needed.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"33 1","pages":"116 - 122"},"PeriodicalIF":0.0,"publicationDate":"2022-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46272428","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}