scholarly journals EARLY PHYSICAL THERAPY INTERVENTION CAN REDUCE THE CHANCE OF RESPIRATORY COMPLICATIONS IN COVID-19

2020 ◽  
Vol 4 (1) ◽  
pp. 137-138
Author(s):  
Syed Alamadar Hussein ◽  
◽  
Raheela Kanwal ◽  
Huma Balqias ◽  
Usman Farooq ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Pulmonary Function ◽  
Physical Therapist ◽  
World Health ◽  
Respiratory Complications ◽  
Positive Effects ◽  
Breathing Exercises ◽  
Lung Expansion ◽  
Postural Drainage ◽  
Initial Symptoms

Since the start of 2020, a COVID-19 emerged as a new strain of Coronavirus. Initially, it affected the population of Wuhan, China and after that it outspread all over the world and was declared as a pandemic by World Health Organization on 30th January, 2020.1 It has been identified that COVID-19 can cause mild illness including common cold to more severe condition known as acute respiratory distress syndrome (ARDS), if not treated promptly.2 While people of all ages are susceptible to COVID-19, those over 60 years of age and with cardiovascular diseases along with diabetes have even more chances of becoming seriously ill Whereas children seem to be less affected.3 Currently there is no pharmacological treatment, still some antiviral drugs have been proven to be helpful along with plasma transfusion in which plasma is extracted from the blood of patient who got recovered from COVID-19 an is transfused into the patient still suffering from the said disease.4 Symptoms of respiratory complications due to this disease influence the mind of a Physical Therapist (PT). Though after discussing the maneuvers of respiratory Physical Therapy with fellow professional colleagues as well as clinicians and practically applying it on respective relatives, friends and advice seekers after getting the informed consent from them; those who started to have initial symptoms of COVID-19 before being tested positive and then later got positive. It resulted in great ease for most of them to breathe and did not led to serious respiratory complications that include dyspnea and accumulation of thick and tenacious secretions inside the lungs, which ultimately is a precursor of pneumonia. Following were the PT interventions suggested to the patients showing acute symptoms; Steam inhalation, breathing exercises and postural drainage positions were inculcated in the treatment plan and guided respectively, steam inhalation therapy is normally advised to be used as primary care in acute respiratory diseases.5 It is most commonly used therapy at home and is inexpensive, moreover it promotes self-reliance in the patients; it is used therapeutically by inhaling steam through nose so that it reaches the respiratory system.6-8 Steam inhalation helps in loosening the mucus, it opens the nasal airway passages decreases mucosal inflammation and heat can prevent replication of viruses.9 It helps to relax muscles and relieves coughing by preventing excessive dryness in the mucosal membranes.10 Moreover, breathing exercises have been reported to have beneficial effects in improving symptoms and optimizing pulmonary function in patients. Breathing programs have been reported to have positive effects in alleviating symptoms and optimizing pulmonary function in patients.11 Breathing exercises aim to improve the individuals breathing pattern and increase in lung expansion, they also enhance the performance of respiratory muscles thus leading towards increase in functional residual capacity, and inspiratory reserve volume.12 Breathing exercises reduces breathlessness, increase exercise capacity and improve overall well-being of a person 13,14,15,16 The physiological effect of breathing exercises comprises of increase in intra-bronchial pressure thus preventing the collapse of bronchi and leading towards increase in inspiratory and expiratory flow rate.13,15 It act by stimulating the autonomic system thereby promoting relaxation and in return improves the physiological parameters.16 Furthermore, body positioning improves the efficiency and effectiveness of both primary and accessory muscles of breathing leading to ease in dyspnea and reduction in work of breathing.17 These positions improve the ventilation perfusion ratio and utilize the gravity to remove secretions.18 Positioning decrease the ventilation demand resulting in longer expiratory time thereby preventing hyperinflation and ultimately resolving dyspnea.19 As a healthcare professional and specially a Physical Therapist we would like to ask the imminent researchers to fill this gap by conducting different surveys and trials. Through our experience we’ve found that the manoeuvres we applied have been very effective and improved the overall outcome of the patients suffering from COVID -19.

scholarly journals Comparison of three respiratory physical therapy techniques and their impact on pulmonary function restoration among cardiac surgery patients in hospital settings

2021 ◽  
Vol 23 (4) ◽  
pp. 531-535
Author(s):  
V. V. Vitomskyi
Keyword(s):  
Cardiac Surgery ◽  
Physical Therapy ◽  
Pulmonary Function ◽  
Vital Capacity ◽  
Physical Therapist ◽  
Forced Expiratory Volume ◽  
Control Group ◽  
Therapeutic Exercises ◽  
Significant Difference ◽  
Respiratory Exercises

The aim. To compare three respiratory physical therapy techniques and their impact on pulmonary function restoration among cardiac surgery patients in hospital settings. Materials and methods. The study involved 126 patients of both sexes who were admitted for cardiac surgery. All the procedures were performed by sternotomy with cardiopulmonary bypass and cardioplegic arrest. The patients were randomly divided (with a ratio of 1:1:1 by envelope method) into the control group (CG, n = 42), incentive spirometry group (ISG, n = 42) and іnspiratory muscle training group (IMTG, n = 42). The examined patients underwent standardized physical therapy (early mobilization; therapeutic exercises; coughing). The groups varied in respiratory therapy. Patients of the ISG group performed additional respiratory exercises using a Tri-Ball respiratory exerciser (three repetitions of 10 forced, full and rapid inspirations through the respiratory exerciser under the supervision of a physical therapist; besides, they were recommended to perform 3 repetitions with 10 inspirations each hour). Patients of the IMTG group performed additional respiratory exercises using Respironics Threshold IMT breathing exerciser, received explanations and recommendations like patients of the ISG group. The pulmonary function test (PFT) was performed for the patients of all groups before the surgery and on the 7 postoperative day. Results. PFT scores did not differ statistically between the groups of patients before the surgery. The three groups of patients had a negative dynamic of all test indicators, except Tiffeneau index. The analysis of PFT final scores did not confirm a significant difference in the studied indicators among the groups: vital capacity (P = 0.599), forced vital capacity (P = 0.393), forced expiratory volume in one second (P = 0.589), peak expiratory flow (P = 0.326), forced inspiratory vital capacity (P = 0.258), peak inspiratory flow (P = 0.569). Conclusions. Statistical analysis of PFT indicators did not reveal any significant differences among the groups of cardiac surgery patients at the preoperative examination and on the 7 postoperative day, despite the differences in postoperative respiratory physical therapy.

scholarly journals Health Competency Standards in Physical Therapist Practice

2019 ◽  
Vol 99 (9) ◽  
pp. 1242-1254 ◽  
Author(s):  
Elizabeth Dean ◽  
Margot Skinner ◽  
Hellen Myezwa ◽  
Vyvienne Mkumbuzi ◽  
Karien Mostert ◽  
...  
Keyword(s):  
Health Promotion ◽  
Physical Therapy ◽  
Weight Control ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Leadership Role ◽  
Noncommunicable Disease ◽  
World Health ◽  
Health Improvement ◽  
The World

AbstractAlthough the physical therapist profession is the leading established, largely nonpharmacological health profession in the world and is committed to health promotion and noncommunicable disease (NCD) prevention, these have yet to be designated as core physical therapist competencies. Based on findings of 3 Physical Therapy Summits on Global Health, addressing NCDs (heart disease, cancer, hypertension, stroke, diabetes, obesity, and chronic lung disease) has been declared an urgent professional priority. The Third Summit established the status of health competencies in physical therapist practice across the 5 World Confederation for Physical Therapy (WCPT) regions with a view to establish health competency standards, this article's focus. Three general principles related to health-focused practice emerged, along with 3 recommendations for its inclusion. Participants acknowledged that specific competencies are needed to ensure that health promotion and NCD prevention are practiced consistently by physical therapists within and across WCPT regions (ie, effective counseling for smoking cessation, basic nutrition, weight control, and reduced sitting and increased activity/exercise in patients and clients, irrespective of their presenting complaints/diagnoses). Minimum accreditable health competency standards within the profession, including use of the WCPT-supported Health Improvement Card, were recommended for inclusion into practice, entry-to-practice education, and research. Such standards are highly consistent with the mission of the WCPT and the World Health Organization. The physical therapist profession needs to assume a leadership role vis-à-vis eliminating the gap between what we know unequivocally about the causes of and contributors to NCDs and the long-term benefits of effective, sustained, nonpharmacological lifestyle behavior change, which no drug nor many surgical procedures have been reported to match.

scholarly journals Validation of the Comprehensive ICF Core Set for Vocational Rehabilitation From the Perspective of Physical Therapists: International Delphi Survey

2016 ◽  
Vol 96 (8) ◽  
pp. 1262-1275 ◽  
Author(s):  
Veronika M. Kaech Moll ◽  
Reuben Escorpizo ◽  
Ruth Portmann Bergamaschi ◽  
Monika E. Finger
Keyword(s):  
Physical Therapy ◽  
Vocational Rehabilitation ◽  
Content Validity ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Small Sample ◽  
World Health ◽  
Convenience Sample ◽  
Icf Core Set ◽  
Core Set

Abstract Background The Comprehensive ICF Core Set for vocational rehabilitation (VR) is a list of essential categories on functioning based on the World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF), which describes a standard for interdisciplinary assessment, documentation, and communication in VR. Objective The aim of this study was to examine the content validity of the Comprehensive ICF Core Set for VR from the perspective of physical therapists. Design A 3-round email survey was performed using the Delphi method. Methods A convenience sample of international physical therapists working in VR with work experience of ≥2 years were asked to identify aspects they consider as relevant when evaluating or treating clients in VR. Responses were linked to the ICF categories and compared with the Comprehensive ICF Core Set for VR. Results Sixty-two physical therapists from all 6 WHO world regions responded with 3,917 statements that were subsequently linked to 338 ICF categories. Fifteen (17%) of the 90 categories in the Comprehensive ICF Core Set for VR were confirmed by the physical therapists in the sample. Twenty-two additional ICF categories were identified that were not included in the Comprehensive ICF Core Set for VR. Limitations Vocational rehabilitation in physical therapy is not well defined in every country and might have resulted in the small sample size. Therefore, the results cannot be generalized to all physical therapists practicing in VR. Conclusion The content validity of the ICF Core Set for VR is insufficient from solely a physical therapist perspective. The results of this study could be used to define a physical therapy–specific set of ICF categories to develop and guide physical therapist clinical practice in VR.

scholarly journals Influence of Physical Activity and Socio-Economic Status on Depression and Anxiety Symptoms in Patients after Stroke

2021 ◽  
Vol 18 (15) ◽  
pp. 8058
Author(s):  
Małgorzata Paprocka-Borowicz ◽  
Mona Wiatr ◽  
Maria Ciałowicz ◽  
Wojciech Borowicz ◽  
Agnieszka Kaczmarek ◽  
...  
Keyword(s):  
Physical Activity ◽  
Physical Therapy ◽  
Economic Status ◽  
Depression Scale ◽  
Post Stroke ◽  
Positive Effects ◽  
Socio Economic Status ◽  
Treatment Of Depression ◽  
Post Stroke Depression ◽  
The Impact

Stroke is a high-risk factor for depression. Neurological rehabilitation is greatly difficult and often does not include treatment of depression. The post-stroke depression plays an important role in the progress of treatment, health, and the life of the patient. The appropriate treatment of depression could improve the quality of life of the patient and their family. The study aimed to evaluate the impact of physical activity and socio-economic status of the patient on the effectiveness of recovery from depression and the severity of the symptoms of depression. The study was conducted with 40 patients after stroke aged 42–82 years, and included 10 women and 30 men who were hospitalized for two weeks. The severity of depression/anxiety (D/A) symptoms were evaluated two times; at admission and after two weeks of physical therapy. The hospital anxiety and depression scale (HADS) questionnaire was used for this purpose. Socio-economic status was evaluated by several simple questions. It was revealed that physical therapy has a positive influence on mental state. The severity of D/A symptoms after stroke is related to the financial status of the patients (2 = 11.198, p = 0.024). The state of health (2 = 20.57, p = 0.022) and physical fitness (2 = 12.95, p = 0.044) changed the severity of symptoms of anxiety and depressive disorders. The kinesiotherapy in the group of patients with post-stroke depression had positive effects; however, economic and health conditions may influence the prognosis of the disease.

Lung Cancer in Brazil

2012 ◽  
pp. 426-431
Author(s):  
Gilberto Schwartsmann
Keyword(s):  
Lung Cancer ◽  
Cause Of Death ◽  
Public Health Problem ◽  
Lung Cancer Mortality ◽  
World Health ◽  
Cancer Type ◽  
Positive Effects ◽  
Incident Cancer ◽  
Health Organization ◽  
Tremendous Challenge

Overview: Cancer is now the second leading cause of death in Brazil (after cardiovascular diseases) and a public health problem, with around 500,000 new cases in 2012. Excluding nonmelanoma skin cancer, lung cancer is the second most incident cancer type in men, with 17,210 expected new cases. In women, it is the fifth most incident cancer, with 10,110 expected new cases. The estimated age-adjusted lung cancer mortality rate is about 13/100,000 for men and 5.4/100,000 for women. Lung cancer rates in men increased until the early 1990s and decreased thereafter, especially in the younger population. In contrast, a steady upward trend was observed for women. The positive effects in men were probably due to the successful anti-tobacco campaign conducted in Brazil over the last decades, which led to a decrease in the adult smoking population, from 32% in the early 1980s to 17% in the 2000s. Although the Brazilian National Cancer Institute is strongly committed to providing excellence in multimodality care to cancer patients, limitations in availability and adequate geographic distribution of specialists and well-equipped cancer centers are evident. Major disparities in patient access to proper staging and state-of-the-art treatment still exist. Considering that World Health Organization (WHO) officials estimate that cancer will become the number one cause of death in most developing countries, including Brazil, in the next decades, it is highly recommended for government authorities to implement firm actions to face this tremendous challenge.

scholarly journals Physical Therapist–Established Intensive Care Unit Early Mobilization Program: Quality Improvement Project for Critical Care at the University of California San Francisco Medical Center

2013 ◽  
Vol 93 (7) ◽  
pp. 975-985 ◽  
Author(s):  
Heidi J. Engel ◽  
Shintaro Tatebe ◽  
Philip B. Alonzo ◽  
Rebecca L. Mustille ◽  
Monica J. Rivera
Keyword(s):  
Quality Improvement ◽  
Physical Therapy ◽  
San Francisco ◽  
Physical Therapist ◽  
Medical Center ◽  
Early Mobilization ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Icu Admission ◽  
Number Of Patients

Background Long-term weakness and disability are common after an intensive care unit (ICU) stay. Usual care in the ICU prevents most patients from receiving preventative early mobilization. Objective The study objective was to describe a quality improvement project established by a physical therapist at the University of California San Francisco Medical Center from 2009 to 2011. The goal of the program was to reduce patients' ICU length of stay by increasing the number of patients in the ICU receiving physical therapy and decreasing the time from ICU admission to physical therapy initiation. Design This study was a 9-month retrospective analysis of a quality improvement project. Methods An interprofessional ICU Early Mobilization Group established and promoted guidelines for mobilizing patients in the ICU. A physical therapist was dedicated to a 16-bed medical-surgical ICU to provide physical therapy to selected patients within 48 hours of ICU admission. Patients receiving early physical therapy intervention in the ICU in 2010 were compared with patients receiving physical therapy under usual care practice in the same ICU in 2009. Results From 2009 to 2010, the number of patients receiving physical therapy in the ICU increased from 179 to 294. The median times (interquartile ranges) from ICU admission to physical therapy evaluation were 3 days (9 days) in 2009 and 1 day (2 days) in 2010. The ICU length of stay decreased by 2 days, on average, and the percentage of ambulatory patients discharged to home increased from 55% to 77%. Limitations This study relied upon the retrospective analysis of data from 6 collectors, and the intervention lacked physical therapy coverage for 7 days per week. Conclusions The improvements in outcomes demonstrated the value and feasibility of a physical therapist–led early mobilization program.

scholarly journals Breathing: A Sign of Life and a Unique Area for Reflection and Action

2008 ◽  
Vol 88 (7) ◽  
pp. 832-840 ◽  
Author(s):  
Kirsten Ekerholt ◽  
Astrid Bergland
Keyword(s):  
Physical Therapy ◽  
Physical Therapist ◽  
Well Being ◽  
Qualitative Approach ◽  
Breathing Patterns ◽  
Daily Lives ◽  
The World ◽  
Body And Soul ◽  
Bodily Sensations ◽  
Conscious Attention

Background and Purpose The aim of this study was to clarify patients’ experiences of breathing during therapeutic processes in Norwegian psychomotor physical therapy (NPMP). Subjects and Methods A qualitative approach was used based on interviews with 9 women and 1 man aged between 41 and 65 years. The data were analyzed with the aid of grounded theory. Results Three categories were identified from the participants’ experiences: (1) “Breathing: An Incomprehensible and Disparate Phenomenon,” (2) “Breathing: Access to Meaning and Understanding,” and (3) “Breathing: Enhancing Feelings of Mastery.” Initially, breathing difficulties and bodily pains were described as physical reactions that seemed utterly incomprehensible to the participants. Communication, both verbal and nonverbal, between the patient and the physical therapist was described as vitally important, as was conscious attention to occurrences during the treatment sessions. The participants learned to recognize changes in their breathing patterns, and they became familiar with new bodily sensations. Consequently, they acquired new understanding of these sensations. The feeling and understanding of being an entity (ie, “body and soul”) emerged during therapy. The participants increased their understanding of the interaction between breathing and internal and external influences on their well-being. Their feelings of mastery over their daily lives were enhanced. The therapeutic dialogues gave them the chance to explore, reflect, and become empowered. Discussion and Conclusion In experiencing their own breathing, the participants were able to access and identify the muscular and emotional patterns that, linked to particular thoughts and beliefs, had become their characteristic styles of relating to themselves and the world.

A Knowledge Translation Framework for Optimizing Physical Therapy in Patients With Heart Failure

2021 ◽  
Author(s):  
Konrad J Dias ◽  
Michael J Shoemaker ◽  
Kristin M Lefebvre ◽  
John D Heick
Keyword(s):  
Heart Failure ◽  
Clinical Practice ◽  
Physical Therapy ◽  
Knowledge Translation ◽  
Cardiorespiratory Fitness ◽  
Practice Guideline ◽  
Physical Therapist ◽  
Evidence Based ◽  
Patients With Heart Failure ◽  
The Continuum

Abstract The American Physical Therapy Association (APTA) has supported the development of clinical practice guidelines to promote and support evidence-based practice and reduce unwarranted practice variation. Essential to the success of this effort is the generation of knowledge translation—a concept that emphasizes the translation of global knowledge to an application that can be effectively integrated into clinical practice. The Physical Therapy Clinical Practice Guideline for the Management of Individuals with Heart Failure published in the Physical Therapy Journal in January 2020 provides a broad base of knowledge related to evidence-based treatment interventions for patients with heart failure. However, the application and integration of this knowledge in clinical practice need further elucidation. Therefore, this perspective paper aims to serve as a complementary knowledge translation resource to the recently published practice guideline to maximize the utilization of contemporary evidence in clinical practice. This resource provides the physical therapist with practical guidance in the management of patients with heart failure by placing research findings in the context of other knowledge and practice norms that can be applied at the point of care and across the continuum of care. We propose a novel ABCDE (Assessment, Behavior, Cardiorespiratory Fitness, Dosage, and Education) practical framework. This clinical paradigm is grounded in ongoing physical therapist assessment throughout the episode of care, along with behavior modification, assessment of cardiorespiratory fitness, appropriate selection and dosing of interventions and patient education. Examples highlighting the use of this model in patients with heart failure across the continuum of care are provided for application in clinical care.

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