Cardiopulmonary physical therapy journal最新文献

{"title":"A Novel “Eccentric” Therapeutic Approach for Individuals Recovering From COVID-19","authors":"A. Gurovich, Sangeeta Tiwari, Stephanie R Kehl, Emre Umucu, L. Peñailillo","doi":"10.1097/cpt.0000000000000163","DOIUrl":"https://doi.org/10.1097/cpt.0000000000000163","url":null,"abstract":"","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49446330","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":"A Survey of Factors That May Cause Practice Inconsistencies and Impact Care in Pulmonary Rehabilitation","authors":"Rachel Pata, Jillian Giblin, Emily Cassata, R. Cortez, Alicia Pascale, Megan Hall","doi":"10.1097/CPT.0000000000000168","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000168","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Purpose: Research about methods implemented in pulmonary rehabilitation is needed. Inconsistencies in this multifaceted intervention may impact care. Methods: A survey was administered to outpatient pulmonary rehabilitation programs, addressing program characteristics, and perceived importance and frequency of rehabilitation components. Descriptive statistics and post-hoc correlations were analyzed. Results: Clinicians present during exercise included respiratory therapists (72.2%), exercise physiologists (50%), registered nurses (44.4%), physical therapists (11.1%), occupational therapists (5.6%), dieticians (5.6%), and physicians (5.6%). On a scale of 1 to 5 (never vs always), programs provided: exercises for all extremities (5), individualized exercise (4.89, SD = 0.46), resistance training (4.5, SD = 0.83), balance training (3.28, SD = 1.1), alternative exercise methods (1.94, SD = 1.55), home equipment education (3.44, SD = 1.12), social support avenues (3.83, SD = 1.26), and home safety assessments (1.56, SDs = 1.07). All programs offered warm-up, cool down, and breathing exercises; 44% offered inspiratory resistance training, 22% high-intensity aerobic, and 11% high-intensity interval training. Twenty-four varied resources were used for patient education. Smoking cessation and nutritional consults were inconsistently offered. Reported limiting factors included compliance (66.7%), transportation (55.6%), staffing (33.3%), and facility size (33.3%). Conclusions: Limited resources, varied personnel, and patient compliance may contribute to practice inconsistencies. Improved resources, transportation, and an inclusive team may improve care standardization.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"33 1","pages":"15 - 23"},"PeriodicalIF":0.0,"publicationDate":"2020-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43872099","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":"Mobility Deterioration During Acute Pneumonia Illness Is Associated With Increased Hospital Length of Stay and Health Service Costs: An Observational Study","authors":"Melanie Lloyd, E. Callander, Koen Simons, A. Karahalios, G. Maguire, E. Janus, H. Karunajeewa","doi":"10.1097/CPT.0000000000000165","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000165","url":null,"abstract":"Purpose: To assess the association of mobility deterioration during community-acquired pneumonia (CAP) illness on length of stay (LOS), readmissions, and institutional costs. Methods: This longitudinal observational study included 347 individuals hospitalized with CAP. All were offered routine early mobilization with a physiotherapist within 24 hours of admission and then daily during hospital stay. The exposure of interest was mobility status at time of clinical stability when compared with the premorbid level. Modelling adjusted for factors such as age, residential status, premorbid mobility level, comorbidities, and pneumonia severity. Results: One hundred forty-one (41%) individuals met the definition of mobility deterioration during the acute illness. The mean (95% confidence interval [CI]) time from achievement of clinical stability to hospital discharge for the groups with and without mobility deterioration was 5.7 (4.2–7.2) and 2.3 (1.4–3.2) days, respectively, with associated higher hospitalization costs (arithmetic mean ratio [95% CI] 1.61 [1.24–2.10]) in the mobility deterioration group. There was no evidence of an association between mobility deterioration and 90-day readmission (odds ratio [95% CI]: 1.34 [0.81–2.24]). Conclusions: Mobility deterioration during acute pneumonia illness has a significant impact on hospital LOS and resource use even in a hospital system that has an early mobility program. Further research is needed to investigate these associations and alternative interventions. Trial registration: ClinicalTrials.gov, Identifier: NCT02835040.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"32 1","pages":"156 - 166"},"PeriodicalIF":0.0,"publicationDate":"2020-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46362541","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":"Clinical Implications for Cardiovascular Compromise in Patients With Spinal Cord Injury: A Case Study of Autonomic Dysreflexia, Cardiac Pacing Abnormality, and Orthostatic Hypotension in Contemporary Physical Therapy Management","authors":"D. Stam, J. Pernu","doi":"10.1097/CPT.0000000000000164","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000164","url":null,"abstract":"Purpose: Although recent advances in the neurological care of spinal cord injury have made great strides, cardiovascular disease has emerged as a leading contributor to mortality within this population. Achieving a greater understanding of the pathophysiology of acute cardiovascular dysfunction may aid the physical therapist in establishing more effective clinical care and decision making. The purpose of this article is to review the pathophysiology of acute cardiovascular dysfunction after cervical and thoracic spinal cord injury (injuries above the T6 vertebrae) and translate this knowledge to the clinical management of a medically complex patient case. Methods: A 62-year-old man sustained a traumatic sensory and motor complete T2 spinal cord injury. During the course of acute hospitalization, the patient suffered multiple episodes of cardiac arrest, and a permanent pacemaker was implanted. Inpatient rehabilitation was further complicated by orthostatic hypotension and emergence of autonomic dysreflexia. Results: Orthostatic hypotension was addressed with a combination of positional tolerance progression and patient education. Autonomic dysreflexia episodes required prompt recognition and appropriate response. After a 6-month hospitalization, the patient was discharged to home. Conclusion: Cardiovascular concerns after spinal cord injury have become increasingly prevalent leading to significant implications to physical therapists. Understanding the pathophysiology of these conditions as well as normal and abnormal cardiovascular responses to activity is crucial for establishing safe patient outcomes.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"32 1","pages":"167 - 177"},"PeriodicalIF":0.0,"publicationDate":"2020-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41558078","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":"Novel Physical Therapist Lens on Developing a SARS-CoV-2 Vaccine: “Healthy Lifestyle Practices” Are Safe and Cost-Effective","authors":"E. Dean","doi":"10.1097/cpt.0000000000000157","DOIUrl":"https://doi.org/10.1097/cpt.0000000000000157","url":null,"abstract":"Once the SARS-CoV-2 virus hit the planet in the fall of 2019 and an understanding of its infectiousness and severity quickly became apparent, the starting gun in the race for a vaccine sounded. The trajectory for vaccine development follows a typical path: the identification of a specific pathogen, deconstruction of its structural characteristics, construction of a vaccine to counter it, and years of phased clinical trials to establish its safety, efficacy, and eventual effectiveness when administered to humans. Correspondingly, as the race for a vaccine escalated, research emerged examining susceptibility and risk factors for poor outcomes of COVID-19, the disease caused by SARS-CoV-2. Based on the concurrence of findings from multiple studies that were being published at a feverish rate, a pattern arose. Multimorbidity including obesity, hypertension, diabetes, cancer, heart disease, chronic lung disease, and renal failure; aging; and frailty emerged as key predictors of susceptibility and poor outcomes of COVID-19 includingmortality. Between 96% and 99% of individuals who die from SARS-CoV-2 infection have at least one underlying chronicmorbidity or risk factor. This proportion cannot be overlooked. Not only are physical therapists well qualified to prevent as well as manage these morbidities and risk factors, but the cardiopulmonary physical therapy community has a primary responsible to lead the way. Vaccines not only take years to formulate and test before becoming widely available and distributed, but typically have variable rates of effectiveness. This is particularly true of viruses that adapt and mutate quickly. The earliest predictions for the development of a safe and reasonably effective vaccine may be several years. But, what if we shifted our lens on conceptualizing and developing a safe and effective vaccine?What if we focused on the immune status, general health status, and lifestyle practices of those who are uninfected by SARS-CoV-2; those who are infected but experience few, if any, symptoms; and those who are infected and have severe symptoms and recover? What if we stratified these 3 cohorts and compared them with respect to their immune status, their general health status, and lifestyle practices? Based on the extant literature, such an analysis leads one to reasonably hypothesize whether the reach of SARS-CoV-2 would have resulted in being a mere blip on the global health radar screen rather than a full-blown pandemic, had unhealthy lifestyle practices, that largely underlie the prevalence of lifestyle-related noncommunicable diseases, been minimal. One cannot deny that the food industry (perhaps better termed the “edible products” industry) in high-income countries and increasingly in middle-income and lowincome countries, contributes substantially to the unhealthy western diet that typically consists of excessive amounts of fat, sugar, salt, and consumable processed products and dangerously inadequate amounts of vegetabl","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47733885","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":"Sustained Abdominal Exercises Affect Abdominal Muscle Activation and Maximal Expiratory Pressures Differently in Healthy Men and Women","authors":"BScPT MSc Karina Tamy Kasawara, MD Arnaud Delafontaine, PT Shirin Tajali, MD Ewan Goligher, MD Laurent Brochard, PT Romain Artico, Bmrpt W. Darlene Reid","doi":"10.1097/CPT.0000000000000158","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000158","url":null,"abstract":"Purpose: To compare the effects of sustained abdominal exercises—pelvic tilt and twist curl-up—on the magnitude of abdominal muscle activation and maximal expiratory pressure (MEP) in healthy men and women. It was hypothesized that the activation would differ between men and women during these 3 exercise maneuvers. Methods: Using a cross-sectional design, 10 healthy men and 10 women sustained pelvic tilt and twist curl-up exercises until task failure. Baseline MEP was compared with MEP immediately after both exercises. The root mean square of the internal oblique, rectus abdominis, external oblique, and transverse abdominis were evaluated during pelvic tilt, twist curl-up, and MEP. Results: Pelvic tilt and twist curl-up were sustained for similar durations. Twist curl-up induced higher activations and more shifts to lower median frequency in all 4 abdominals compared with pelvic tilt. Although internal oblique activation was highest during MEP and lowest during pelvic tilt in women, these comparisons did not differ in men. Maximal expiratory pressure tended to decrease after sustained pelvic tilt in women but did not change in men. Conclusions: Twist curl-up activated abdominal muscles more so than pelvic tilt. Some sex differences were shown that should be considered in future research of abdominal muscle exercise prescription.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"32 1","pages":"147 - 155"},"PeriodicalIF":0.0,"publicationDate":"2020-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45176690","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":"How Can Physical Therapists Engage the Social Ecology of Health to Mitigate Service Disruptions in a Post-COVID World?","authors":"T. Davenport, Sean D. Rundell","doi":"10.1097/CPT.0000000000000149","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000149","url":null,"abstract":"The role for physical therapists related to addressing the novel coronavirus (COVID-19) crisis is still crystallizing in acute and post-acute settings. It is not too early to begin learning from the recent unprecedented disruptions in physical therapists’ ability to provide care related to public health orders for infection control. Emerging evidence suggests that disruptions to health services, such as COVID infections and outcomes, are associated with various population characteristics. These observations suggest the importance of multilevel strategies for physical therapists to mitigate future service disruptions. The purpose of this perspective is to propose a set of practice, research, and advocacy imperatives using the social–ecological model of health. The viewpoint describes the model and then applies it to COVID-related health service disruptions. The perspective then culminates in a specific set of practice, research, and policy recommendations that can be applied to the current experiencewith COVID-19 and also potential future sources of service disruption, such as future epidemics and climate change. (Cardiopulm Phys Ther J. 2021;32:S4–S7)","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42375989","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":"How Effective Is Aerobic Exercise Training in Improving Aerobic Capacity After Heart Transplant? A Systematic Review and Meta-analysis","authors":"Keriann Groen, P. Robison, Annie Xiong, Kent E. Irwin, Amy B Stein, C. C. Evans","doi":"10.1097/CPT.0000000000000159","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000159","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Purpose: Studies suggest that additional exercise (Ex) training beyond “usual care” increases peak VO2 in people post-heart transplant (HTx); however, no recent studies have quantified improvements or compared moderate-intensity aerobic Ex (MOD) to high-intensity interval training (HIIT). The purpose of this study was to quantify improvements in VO2 for patients post-HTx undergoing additional Ex training and compare effectiveness of MOD to HIIT. Methods: Inclusion criteria were: randomized clinical trials, systematic reviews, or meta-analyses published between 2008 to 2018, subjects post-HTx, participated in an aerobic Ex program beyond usual care, and reported peak VO2. Results: A total of 242 records were obtained and 7 randomized clinical trials were reviewed. The average PEDro score was 4.86 (range 2–7). The within-group weighted mean difference (WMD) in peak VO2 comparing baseline to post-training for the Ex group = 3.3 (0.5) ml/kg/min and for the control group = −0.2 (0.2) ml/kg/min. The between-group WMD in peak VO2 = 3.5 (7.9) ml/kg/min, Hedge's g = 0.606 (95% confidence intervals = 0.337–0.874), P < .001, favoring Ex. Comparison between Ex protocols indicated that there was no difference between HIIT and MOD (Q = 1.83, P = .176). Conclusions: Physical therapists should challenge patients post-HTx with aerobic Ex that goes beyond usual post-HTx care and should consider incorporating HIIT into the treatment plan or home program to maximize the benefits of rehabilitation when possible.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"32 1","pages":"114 - 128"},"PeriodicalIF":0.0,"publicationDate":"2020-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49044853","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 Student Reports of Blood Pressure Guidelines Learned in the Classroom, and Observed and Practiced in Clinical Experiences","authors":"Ted L. Marks, Sarah Leah Berg, Batsheva Granek, Peter Rybakov, Irina Taranenko, Dana Yee, Ralph K. Garcia","doi":"10.1097/CPT.0000000000000145","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000145","url":null,"abstract":"Purpose: The purposes of this study were (1) to investigate discrepancies between what physical therapy students report learning in the classroom regarding blood pressure (BP) guidelines and what physical therapy students report observing and practicing in clinical settings and (2) to establish whether students felt discomfort when discrepancies were encountered. Methods: This was a prospective descriptive survey study generated using a sample of convenience employing a survey developed by the researchers. Face and content validity were established through expert review. An email was sent to 21 New York State Physical Therapy Programs asking each program to share the survey with students in their programs who had completed clinical experiences. The responses were analyzed descriptively using frequency counts, percentages, and cross tabulations. Results: Responses were received from 206 students attending 13 different programs, or 61.9% of the programs contacted. More than half the students (53.4%) reported there were differences between what they learned during classroom instruction regarding BP assessment and what they saw and practiced in the clinic; 24.8% of students expressed discomfort related to discrepancies between what they learned in school and what they saw and practiced in the clinic. Inpatient and outpatient experiences were compared. Statistical differences were found indicating patients had their BP assessed less often in outpatient settings. In addition, students were less likely to discuss BP assessment with their clinical instructors (CIs) in outpatient settings and students were more likely to express increased competence taking BP after inpatient clinical experiences. Across all settings, 20.4% of students reported that neither they nor their CI ever measured BP during their most recent clinical experience. Conclusions: Across all settings, the BP assessment practices that students encounter in clinic differ from what students report learning is best practice during their physical therapy education. Students are more likely to encounter discrepancies in outpatient settings. For many students, encountering discrepancies gives rise to feelings of discomfort.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"32 1","pages":"86 - 96"},"PeriodicalIF":0.0,"publicationDate":"2020-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48762931","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":"Keep Them in the Game: Screening for Cardiovascular Disease and Diabetes in Aging Athletes","authors":"Becca Jordre, Brody W. Brisk, William E. Schweinle","doi":"10.1097/CPT.0000000000000148","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000148","url":null,"abstract":"Purpose: This observational cross-sectional study of aging athletes aims to (1) compare the prevalence of cardiovascular disease (CVD) and diabetes in aging athletes to the general population, (2) describe anthropometric values of aging athletes, (3) investigate the influence of cardiovascular sport competition on these measures, and (4) address any predictive value of evaluated measures. Methods: Health and sport history, blood pressure, waist circumference (WC), waist-to-hip ratio, and body mass index (BMI) were collected on 2351 aging athletes. Results: Aging athletes showed a significantly lower prevalence of CVD and diabetes than the general population. Athletes demonstrated BMI in the overweight range, WC in a healthy range, and waist-to-hip ratio in a healthy range for women but just over risk thresholds for men. Average blood pressure was near stage 1 hypertension. Waist circumference and waist-to-hip ratio were superior predictors of disease in the population. Cardiovascular athletes showed a lower disease risk and overall superior anthropometric values than other aging athletes. Conclusion: Aging athletes demonstrate a relatively low prevalence of CVD and diabetes despite demonstrating some anthropometric measurements over risk thresholds. Measures of central adiposity seem best for predicting disease in this population.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"32 1","pages":"106 - 113"},"PeriodicalIF":0.0,"publicationDate":"2020-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44721095","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}