Cardiopulmonary physical therapy journal最新文献

{"title":"Development and Reliability of the Physical Therapy Healthy Lifestyle Appraisal: A New Assessment Tool to Guide Behavior Change","authors":"MarySue Ingman, J. Bezner, B. Black, Phillip W. Vaughan","doi":"10.1097/CPT.0000000000000191","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000191","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Purpose: Physical therapists are well positioned to encourage their patients to live a healthy lifestyle. Physical therapists report barriers that limit their ability to practice health promotion counseling with their patients including the availability of a brief tool to gather information about their patient's current level of activity related to specific health behaviors. The purpose of this study was to describe the development and testing of the Physical Therapy Healthy Lifestyle Appraisal (PTHLA). Methods: The PTHLA is a patient self-report questionnaire that assesses stage of change, importance of changing, and confidence in engaging in 6 health behaviors. Physical Therapy Healthy Lifestyle Appraisal version 1 (106 items) was designed to compare different constructs for measuring stage of change and confidence in engaging in health behaviors. After pilot testing, 3 versions were tested to arrive at the 18 item PTHLA-version 3. Physical therapy patients in outpatient clinics in Michigan, Minnesota, and Texas were recruited for this multiphase study (version 1 n = 60, version 2 n = 65, and version 3 n = 28). Results: Physical Therapy Healthy Lifestyle Appraisal version 3 consists of 3 questions for each of 6 health behavior domains; a 3-option ordinal question for assessing stage of change and 11-point rulers for assessing importance of engaging in the behavior and confidence in engaging in the behavior. Unique items from version 1 and version 2 were retained in PTHLA-version 3, whereas those items that were somewhat redundant were excluded. Behavioral definitions for the “sleep” and “stress” domains were the only changes made from the first to the second versions. Across samples and behavioral domains, scores for the 18 items generally displayed satisfactory-to-high test–retest reliabilities (Cohen κw = 0.56–1.00, mean = 0.76; Spearman ρ = 0.53–1.00, mean = 0.77; intraclass correlation coefficient = 0.39–1.00, mean = 0.74). Confidence in behavior ruler scores displayed satisfactory-to-high convergent correlations with scores from lengthier multiple-item confidence in behavior measures (Pearson r validity coefficients = 0.33–0.90, mean = 0.63). The three-option stage of change items demonstrated satisfactory convergent validity with scores on the stage of change ruler (Pearson r validity coefficients = 0.16–0.86, mean = 0.61). Conclusions: The PTHLA-version 3 is a reliable and efficient tool for PT practice developed by physical therapists with expertise in prevention, health promotion, and wellness. Physical therapists can use the information provided from the PTHLA to initiate conversations about behavior change with their patients. Understanding the patient's current stage of change, level of interest in changing the behavior, and confidence for changing the behavior is important information for the PT to ensure a productive and respectful conversation about behavior change.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"33 1","pages":"77 - 86"},"PeriodicalIF":0.0,"publicationDate":"2021-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61664749","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":"Keeping the Torch Burning","authors":"A. Gurovich","doi":"10.1097/cpt.0000000000000186","DOIUrl":"https://doi.org/10.1097/cpt.0000000000000186","url":null,"abstract":"","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46610698","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":"Physical Therapy Practice for Critically Ill Patients With COVID-19 in the Intensive Care Unit","authors":"Catherine Stolboushkin, Rajashree Mondkar, Terrence Schwing, Bobby Belarmino","doi":"10.1097/CPT.0000000000000188","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000188","url":null,"abstract":"Purpose: To describe physical therapist (PT) practice for patients with COVID-19 in the intensive care unit (ICU) at a tertiary hospital and to describe a novel clinical decision-making algorithm (nCDM) and its use in enhancing clinical practice for this patient population. Methods: This is a single-center, retrospective chart review. An nCDM was formulated to assist with best practice. The Activity Measure for Post-Acute Care “6 clicks” (AM-PAC) score, highest level of mobility, discharge destination, and observed clinical complications at hospital discharge were collected. Results: Seventy-seven patients received ICU PT services. Of these, twenty-six patients were outside previously established parameters for initiating PT intervention and forty-four patients were on mechanical ventilation during the initial PT evaluation. All groups showed a statistically significant improvement in their respective AM-PAC scores from initial PT evaluation to ICU discharge. Conclusion: The authors have described our PT practice for this patient population in our setting. Patients who were outside previously established parameters for initiating PT intervention were able to participate with PT and showed functional improvement. This nCDM shows a promising use in enhancing clinical decision-making for PT practice while treating patients with COVID-19 in the ICU.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"33 1","pages":"60 - 69"},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43419815","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":"Differences in Blood Pressure and Workload Intensity During Arm and Leg Ergometry at Submaximal Target Heart Rates in College-Aged Individuals","authors":"K. Dias, Ethan DuClos, James Heath, Shelbi Nelson, Bethany Coffey, Steven Schahl, Nicholas Giacalone, S. Collins","doi":"10.1097/CPT.0000000000000181","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000181","url":null,"abstract":"Purpose: Blood pressure (BP) during arm (AE) and leg ergometry (LE) have traditionally been compared at submaximal intensities of the peak oxygen uptake, which is often challenging to interpret in clinical practice. The purpose of this investigation was to evaluate the relationship of the heart rate with systolic blood pressure (SBP), diastolic blood pressure (DBP), and workload (WL) during AE and LE exercise. Methods: A prospective, observational, cross-sectional design with 35 healthy subjects compared BP and WL during AE and LE at specific submaximal target heart rates (HRs) of 110, 120, 130, 140, and 150 beats per minute. A linear mixed model tested for differences in SBP, DBP, and WL between AE and LE. Results: There was a larger increase in SBP {0.55 mm Hg (95% CI [0.38, 0.73])} per heart beat during LE. There was a larger increase in WL {0.62 watts (95% CI [0.38, 0.85])} and WL relative to body mass {0.01 watts/kg (95% CI [0.006, 0.011])} per heart beat during LE. Statistical models were developed that estimated SBP, DBP, and WL based on the submaximal heart rate. Conclusion: The findings from this investigation informs physical therapists that lower SBP, higher DBP, and lower WL is achieved at any given submaximal HR during AE compared with LE. Furthermore, prediction equations derived from the statistical models can be used to compare actual against predicted SBP and DBP responses to determine tolerance to exercise. Finally, differences in WL per beat increase in HR are valuable in dosing exercise on the AE or LE.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"33 1","pages":"31 - 39"},"PeriodicalIF":0.0,"publicationDate":"2021-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48363108","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":"Effects of Rehabilitation Before Lung Transplantation on Balance","authors":"R. Byrd, S. Vallabhajosula, Stephen Bailey, Tiffany Champion","doi":"10.1097/CPT.0000000000000187","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000187","url":null,"abstract":"Purpose: This study examined the effects of prelung transplant rehabilitation on balance and examined the relationship between clinical balance tests, instrumented balance assessments, and functional measures of strength and exercise capacity. Methods: Participants completed 1-month of 5 d/wk, multimodal, outpatient rehabilitation. They performed the Short Physical Performance Battery (SPPB), Four Square Step Test, Fullerton Advanced Balance (FAB) Scale, Short-Form FAB, Modified Clinical Test of Sensory Interaction with Balance (mCTSIB), Limits of Stability Test (LOS), 6-minute walk distance (6MWD), and clinical strength assessments. Changes prerehabilitation to postrehabilitation were assessed using t tests. Pearson correlation coefficient assessed the relationship between baseline tests. Effect size was calculated using Cohen d. Results: Thirty-nine participants (age = 50 [16] years) completed pretransplant rehabilitation. Participants showed impaired dynamic balance measured through clinical balance tests and LOS which significantly improved with moderate change postrehabilitation. Most mCTSIB components had a small, nonsignificant change. Functional strength and 6MWD improved significantly prerehabilitation to postrehabilitation. Changes in clinical balance were correlated with changes in LOS, SPPB, 5 times sit-to-stand, and arm strength. Conclusions: Balance improvements in candidates for lung transplant, after a multimodal rehabilitation program, seem to be most closely associated with improvement in dynamic balance and lower extremity functional strength.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"33 1","pages":"50 - 59"},"PeriodicalIF":0.0,"publicationDate":"2021-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43395534","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":"Is Prone Positioning Effective in Improving Hypoxemia for Nonventilated Patients With Covid-19? A Rapid Evidence Assessment","authors":"Klair Holmes, Kathryn Kazmierczak, Kent E. Irwin, C. C. Evans","doi":"10.1097/CPT.0000000000000184","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000184","url":null,"abstract":"Purpose: A relatively high percentage of patients with COVID-19 develop hypoxemia and must be mechanically ventilated. Although prone positioning (PP) has been shown to be effective in improving peripheral oxygen saturation (SpO2) in mechanically ventilated patients with hypoxemia, whether it is effective in nonventilated patients with COVID-19 is not known. The purpose of this rapid evidence assessment was to examine the effectiveness of PP on SpO2 for nonventilated adults with COVID-19 and hypoxemia. Methods: The PEDro, Medline Complete, and Cochrane Central Register of Controlled Trials databases were searched. The inclusion criteria included nonventilated adults, diagnosed with COVID-19, and treated with PP. The exclusion criteria included patients on mechanical ventilation and <18 years old. The primary outcome was SpO2, and secondary outcomes included PaO2 and PaO2/FiO2 ratio. The methodologic quality was appraised using the Scottish Intercollegiate Guidelines Network Methodology Checklist 3. Results: Eight studies met all inclusion/exclusion criteria, and a total of 199 patients were included. All studies were cohort or retrospective design, and 4 of 8 met the acceptable threshold for risk of bias. All 5 of the studies that reported SpO2 found an increase in post-PP compared with pre-PP, and 5 studies found that PaO2, PaO2/FiO2, or both increased post-PP compared with pre-PP. Conclusions: Owing to heterogeneity in methods and outcomes, as well as varied results, we conclude there is low–moderate support that PP improves SpO2 and other indicators of hypoxemia in nonventilated patients with COVID-19, but not all patients may benefit. In addition, well-controlled studies are needed to confirm these results.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"33 1","pages":"40 - 48"},"PeriodicalIF":0.0,"publicationDate":"2021-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45100012","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":"Passing the Torch","authors":"S. Collins","doi":"10.1097/CPT.0000000000000179","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000179","url":null,"abstract":"","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"32 1","pages":"85-85"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47892972","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":"An Executive Summary of the Physical Therapist Clinical Practice Guideline for the Management of Individuals With Heart Failure","authors":"K. Dias, M. Shoemaker, K. Lefebvre, J. Heick, S. Collins","doi":"10.1097/CPT.0000000000000166","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000166","url":null,"abstract":"The American Physical Therapy Association (APTA), in conjunction with the Cardiovascular and Pulmonary Section of APTA, published a clinical practice guideline (CPG) in January 2020 in the Physical Therapy journal to assist physical therapists in their clinical decision-making when treating patients with heart failure (HF). The purpose of this executive summary is to briefly describe the major themes of the CPG and provide current recommendations for evidence-based interventions in the management of patients with HF. A summary table of the 9 key action statements along with clinical algorithms guides the physical therapist in appropriate clinical decision-making.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"33 1","pages":"5 - 14"},"PeriodicalIF":0.0,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46539011","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":"Condensed Outpatient Rehabilitation Early After Lung Transplantation: A Retrospective Analysis of 6-Minute Walk Distance and Its Predictors","authors":"R. Byrd, P. Smith, Hannah F. McHugh, L. Snyder, A. Pastva","doi":"10.1097/CPT.0000000000000174","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000174","url":null,"abstract":"Purpose: The objectives were to evaluate the effect of a condensed post-lung transplant outpatient rehabilitation program started immediately after hospital discharge on 6-minute walk distance (6MWD) and to explore predictors of change in 6MWD and time to complete rehabilitation. Methods: Data were retrospectively collected from July 2009 to February 2019 on recipients who completed physical therapy-based posttransplant outpatient rehabilitation (PTOR). Changes in 6MWD prerehabilitation to postrehabilitation were assessed using repeated measures, and predictors were assessed using multiple linear regression. Results: Participants (N = 819, 61% men, 61 years) began PTOR 2 days (interquartile range [IQR] 1–3) after hospital discharge. The mean 6MWD of 324 m (SD = 107) improved after rehabilitation to 488 m (SD = 105). Factors associated with improvement were younger age (P = .003), higher baseline forced expiratory volume in 1 second (FEV1) (P < .001), and lower baseline 6MWD (P < .001). Participants averaged 22 sessions in 41 days (IQR 35–50); with lower baseline FEV1 (P = .002) and 6MWD (P < .001) associated with longer completion time. Conclusions: A condensed outpatient rehabilitation program early after lung transplantation was associated with a large, clinically meaningful improvement in 6MWD. Salient predictors of improvement included age, lung function, and starting 6MWD. These findings from a large cohort of lung transplant recipients who participated in PTOR can assist clinicians in tailoring strategies to optimize patient management.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"33 1","pages":"24 - 30"},"PeriodicalIF":0.0,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43832971","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":"Adapting Physical Therapy Management of Patients With COVID-19 in the Acute Care Setting: A Clinical Perspective","authors":"Grant D. Bitzer, Karly Green, Ricki Christopherson, Sabrina Fogleman, Sara Dorn, Thomas R. Medlin, Heather Eustis","doi":"10.1097/CPT.0000000000000177","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000177","url":null,"abstract":"Purpose: Using emerging evidence and information pertaining to the SARS-CoV-2 virus, a team of physical therapists (PTs) and occupational therapists (OTs) at the Duke University Hospital (DUH) created a screening algorithm to guide PT/OT evaluation readiness and treatment decisions. This article aims to discuss factors that were considered in the initial development of therapy guidelines and, in so doing, emphasizes the need for ongoing analysis of such screening algorithms and treatment guidelines as evidence continues to emerge. Summary of Key Points: The interdisciplinary team, leveraging their collective experience combined with the updated literature, changed the initial medical management for patients diagnosed with coronavirus disease 2019 (COVID-19). As a result, the screening algorithm was adapted to reflect evolving evidence-based practices. This facilitated earlier and more skillful PT intervention as well as continued PT involvement in the treatment process throughout the course of the patients' stay in the hospital. Conclusions: To guide clinical decisions regarding medical stability of patients and appropriate timing for PT intervention, the therapists at DUH considered factors including defining and identifying stages of disease severity, assessment of laboratory values, and monitoring oxygen stability. Beyond medical complexity, mobility was limited by several additional isolation barriers which presented challenges for PTs, nursing staff, and the patient.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"32 1","pages":"140 - 146"},"PeriodicalIF":0.0,"publicationDate":"2021-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45720224","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}