Pub Date : 2024-01-03DOI: 10.1097/cpt.0000000000000240
Emily Anne Gray, Margot Alison Skinner, Leigh Anne Hale
Following coronary artery bypass graft (CABG) surgery, people are required to navigate the majority of their physical recovery, including progressive engagement in physical activity, after they leave hospital. However, there are many physical and psychological challenges to physical activity during the early recovery period. The aim of this study was to identify facilitating factors that help overcome such challenges to physical activity following CABG surgery. A qualitative descriptive study using semistructured interviews (n = 22) was undertaken. Data analysis was informed by the COM-B model and Theoretical Domains Framework (TDF) and performed using the Framework Method. Interview data were first inductively coded to identify factors that facilitated physical activity followed by a deductive analysis to group these facilitators under the relevant COM-B and TDF headings. Facilitators relevant to all 6 COM-B elements and 13 of 14 TDF domains were identified. Although having physical capability and physical opportunity were important, the most prevalent facilitators identified by participants as being helpful related to psychological capability (for example, knowledge, having a plan, identifying barriers and coming up with solutions, and listening to their body), reflective motivation (for example, goals, experiencing positive benefits from activity, and being optimistic and determined), and social opportunity (for example, support from family, health professionals, and peers). Psychosocial facilitators play a large role in overcoming barriers to physical activity following CABG surgery. The findings provide insight for clinicians regarding potential factors to address when preparing and supporting people to engage in physical activity.
{"title":"Perceived Facilitators of Physical Activity Following Coronary Artery Bypass Graft Surgery: A Qualitative Study","authors":"Emily Anne Gray, Margot Alison Skinner, Leigh Anne Hale","doi":"10.1097/cpt.0000000000000240","DOIUrl":"https://doi.org/10.1097/cpt.0000000000000240","url":null,"abstract":"\u0000 \u0000 Following coronary artery bypass graft (CABG) surgery, people are required to navigate the majority of their physical recovery, including progressive engagement in physical activity, after they leave hospital. However, there are many physical and psychological challenges to physical activity during the early recovery period. The aim of this study was to identify facilitating factors that help overcome such challenges to physical activity following CABG surgery.\u0000 \u0000 \u0000 \u0000 A qualitative descriptive study using semistructured interviews (n = 22) was undertaken. Data analysis was informed by the COM-B model and Theoretical Domains Framework (TDF) and performed using the Framework Method. Interview data were first inductively coded to identify factors that facilitated physical activity followed by a deductive analysis to group these facilitators under the relevant COM-B and TDF headings.\u0000 \u0000 \u0000 \u0000 Facilitators relevant to all 6 COM-B elements and 13 of 14 TDF domains were identified. Although having physical capability and physical opportunity were important, the most prevalent facilitators identified by participants as being helpful related to psychological capability (for example, knowledge, having a plan, identifying barriers and coming up with solutions, and listening to their body), reflective motivation (for example, goals, experiencing positive benefits from activity, and being optimistic and determined), and social opportunity (for example, support from family, health professionals, and peers).\u0000 \u0000 \u0000 \u0000 Psychosocial facilitators play a large role in overcoming barriers to physical activity following CABG surgery. The findings provide insight for clinicians regarding potential factors to address when preparing and supporting people to engage in physical activity.\u0000","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"53 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139389079","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}
Pub Date : 2023-11-22DOI: 10.1097/cpt.0000000000000237
A. Gustavson, Alana Rasmussen, Melissa Ludescher, Brionn Tonkin, Amy Toonstra
The persistent postacute effects of the coronavirus 2019 (COVID-19) illness are and will continue to negatively impact the growing numbers of people recovering from acute viral illness. Rehabilitation providers are critical members of the interdisciplinary care team that screen for, evaluate, treat, and manage Long COVID sequalae. However, current models of outpatient rehabilitation may lack the organizational capacity to effectively treat a large volume of patients at a higher frequency and longer duration currently indicated under emerging clinical consensus. Thus, the purpose of this special communication is to outline challenges in organizational capacity to scaling Long COVID care through illustrative examples.
{"title":"Building and Sustaining Organizational Capacity for the Rehabilitation Profession to Support Long COVID Care","authors":"A. Gustavson, Alana Rasmussen, Melissa Ludescher, Brionn Tonkin, Amy Toonstra","doi":"10.1097/cpt.0000000000000237","DOIUrl":"https://doi.org/10.1097/cpt.0000000000000237","url":null,"abstract":"The persistent postacute effects of the coronavirus 2019 (COVID-19) illness are and will continue to negatively impact the growing numbers of people recovering from acute viral illness. Rehabilitation providers are critical members of the interdisciplinary care team that screen for, evaluate, treat, and manage Long COVID sequalae. However, current models of outpatient rehabilitation may lack the organizational capacity to effectively treat a large volume of patients at a higher frequency and longer duration currently indicated under emerging clinical consensus. Thus, the purpose of this special communication is to outline challenges in organizational capacity to scaling Long COVID care through illustrative examples.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"21 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139249530","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}
Pub Date : 2023-09-25DOI: 10.1097/cpt.0000000000000239
Alvaro N. Gurovich
The physical therapy profession is amazing. This statement could come from a close (maybe too close) source, but high job satisfaction rates do not lie.1 The intellectual capacity that physical therapists have is incredible because clinicians need to juggle patient's needs and goals, with normal and abnormal physiology, and design a successful plan of care. All that within the constraints of a Machiavellian heath care system that prioritizes profits over care. On top of that, most of the cardiopulmonary physical therapy specialists deal with life-or-death situations on a daily basis. Their decision-making skills are second to none because hemodynamics, end-organ perfusion, or alveolar ventilation can change in any second during interventions emphasizing the premise that not all patients are the same. The only way to support our profession is with relevant work that will enhance evidence-based practice and novel discoveries to improve the human experience. In this issue, we present you with 2 clinical perspectives, 1 case report, and 2 original research articles. First, Drs. Brockway, Ayres, and Shoemaker2 bring us their 2022 CSM educational session on high-intensity interval training in patients with complex comorbidities. Their lecture was one of the highlights in CSM 2022 and I am very happy that we are able to bring it in written form to our readers. Then, and still under the lessons learned because of the COVID-19 pandemic, DiVitto et al3 propose a 3-phase protocol for patients under extracorporeal membrane oxygenation (ECMO), which has enhanced mobility and decreased hospitalization stay. Continuing with the APTA Academy of Cardiovascular and Pulmonary Physical Therapy's “Vitals are Vital” campaign, Smith et al4 bring us a case report on the impact of in-service education to improve blood pressure measurement in outpatient rehabilitation. In addition, Connors et al5 performed a quality improvement project to standardize physical therapy in patients with single or bilateral lung transplant. Their preliminary results showed that their standardized intervention could improve exercise capacity in these patients. Finally, the Cardiopulmonary Physical Therapy Journal is proud to present the updated version of the Academy's cardiovascular and pulmonary entry-level physical therapy competencies by Johanson et al.6 This updated version followed a modified Delphi process to shape competent physical therapy education in our field. This is CPTJ Volume 34's last issue, and I am extremely proud of the editorial board, associated editors, reviewers, and authors who have brought in 2023 their relevant work to help clinicians perform their even more relevant work and take good care of the human experience.
{"title":"Relevant Work","authors":"Alvaro N. Gurovich","doi":"10.1097/cpt.0000000000000239","DOIUrl":"https://doi.org/10.1097/cpt.0000000000000239","url":null,"abstract":"The physical therapy profession is amazing. This statement could come from a close (maybe too close) source, but high job satisfaction rates do not lie.1 The intellectual capacity that physical therapists have is incredible because clinicians need to juggle patient's needs and goals, with normal and abnormal physiology, and design a successful plan of care. All that within the constraints of a Machiavellian heath care system that prioritizes profits over care. On top of that, most of the cardiopulmonary physical therapy specialists deal with life-or-death situations on a daily basis. Their decision-making skills are second to none because hemodynamics, end-organ perfusion, or alveolar ventilation can change in any second during interventions emphasizing the premise that not all patients are the same. The only way to support our profession is with relevant work that will enhance evidence-based practice and novel discoveries to improve the human experience. In this issue, we present you with 2 clinical perspectives, 1 case report, and 2 original research articles. First, Drs. Brockway, Ayres, and Shoemaker2 bring us their 2022 CSM educational session on high-intensity interval training in patients with complex comorbidities. Their lecture was one of the highlights in CSM 2022 and I am very happy that we are able to bring it in written form to our readers. Then, and still under the lessons learned because of the COVID-19 pandemic, DiVitto et al3 propose a 3-phase protocol for patients under extracorporeal membrane oxygenation (ECMO), which has enhanced mobility and decreased hospitalization stay. Continuing with the APTA Academy of Cardiovascular and Pulmonary Physical Therapy's “Vitals are Vital” campaign, Smith et al4 bring us a case report on the impact of in-service education to improve blood pressure measurement in outpatient rehabilitation. In addition, Connors et al5 performed a quality improvement project to standardize physical therapy in patients with single or bilateral lung transplant. Their preliminary results showed that their standardized intervention could improve exercise capacity in these patients. Finally, the Cardiopulmonary Physical Therapy Journal is proud to present the updated version of the Academy's cardiovascular and pulmonary entry-level physical therapy competencies by Johanson et al.6 This updated version followed a modified Delphi process to shape competent physical therapy education in our field. This is CPTJ Volume 34's last issue, and I am extremely proud of the editorial board, associated editors, reviewers, and authors who have brought in 2023 their relevant work to help clinicians perform their even more relevant work and take good care of the human experience.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135866616","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}
Pub Date : 2023-09-20DOI: 10.1097/cpt.0000000000000238
Diane M. Wrisley, Eder A. Garavito, Brittany Jones, Tamara Klintworth-Kirk, Ashley K. Poole
Background and Purpose: Individuals with cardiorespiratory dysfunction demonstrate postural instability and increased risk of falls. Given that coronavirus disease (COVID-19) is commonly defined as a respiratory condition, it could be presumed that these patients may demonstrate similar balance deficits. This study aimed to determine deficits and characterize balance dysfunction (sensory or motor) in hospitalized patients classified as “COVID-19 recovered.” Methods: Twenty-five participants consented for this study. Participants completed the Activity-Specific Balance Confidence Scale (ABC), a questionnaire about dizziness, the Timed “Up & Go” (TUG), and the modified Clinical Test of Sensory Interaction and Balance in a single session. The percentage of subjects who scored abnormal on the outcome measures was calculated. Correlations between demographics, respiratory function, and clinical outcome measures were determined using Spearman correlation coefficient. Results: All participants had abnormal scores on the TUG, 88% had abnormal scores on the ABC, and 48% of the subjects had abnormal scores on standing on foam eyes closed indicating difficulty using vestibular information. No correlation coefficient above 0.50 was found between the demographic information, respiratory function, and clinical outcome measures. Discussion: Clinical outcome measure scores did not correlate with respiratory function indicating that the deficits may be due to the extrapulmonary components of COVID-19. Conclusion: Both young and older adults presented with motor and sensory balance deficits acutely after COVID-19 infection. It is recommended that individuals acutely post–COVID-19 receive education and interventions to increase mobility, improve balance, decrease fall risk, and specifically receive activities that stimulate the vestibular system.
{"title":"Motor and Sensory Balance Deficits in Individuals Immediately After COVID-19, a Cohort Study","authors":"Diane M. Wrisley, Eder A. Garavito, Brittany Jones, Tamara Klintworth-Kirk, Ashley K. Poole","doi":"10.1097/cpt.0000000000000238","DOIUrl":"https://doi.org/10.1097/cpt.0000000000000238","url":null,"abstract":"Background and Purpose: Individuals with cardiorespiratory dysfunction demonstrate postural instability and increased risk of falls. Given that coronavirus disease (COVID-19) is commonly defined as a respiratory condition, it could be presumed that these patients may demonstrate similar balance deficits. This study aimed to determine deficits and characterize balance dysfunction (sensory or motor) in hospitalized patients classified as “COVID-19 recovered.” Methods: Twenty-five participants consented for this study. Participants completed the Activity-Specific Balance Confidence Scale (ABC), a questionnaire about dizziness, the Timed “Up & Go” (TUG), and the modified Clinical Test of Sensory Interaction and Balance in a single session. The percentage of subjects who scored abnormal on the outcome measures was calculated. Correlations between demographics, respiratory function, and clinical outcome measures were determined using Spearman correlation coefficient. Results: All participants had abnormal scores on the TUG, 88% had abnormal scores on the ABC, and 48% of the subjects had abnormal scores on standing on foam eyes closed indicating difficulty using vestibular information. No correlation coefficient above 0.50 was found between the demographic information, respiratory function, and clinical outcome measures. Discussion: Clinical outcome measure scores did not correlate with respiratory function indicating that the deficits may be due to the extrapulmonary components of COVID-19. Conclusion: Both young and older adults presented with motor and sensory balance deficits acutely after COVID-19 infection. It is recommended that individuals acutely post–COVID-19 receive education and interventions to increase mobility, improve balance, decrease fall risk, and specifically receive activities that stimulate the vestibular system.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136264755","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}
Pub Date : 2023-09-06DOI: 10.1097/cpt.0000000000000233
R. Byrd, Rachel Breslin, Peijin Wang, Sarah Peskoe, Shein-Chung Chow, Sean Lowers, Laurie D. Snyder, A. Pastva
Pulmonary rehabilitation both before and after lung transplant is associated with improved functional exercise capacity and physical quality of life. There is wide variation in rehabilitation program provision. This study's aim was to compare the effects of group versus individual rehabilitation. Individuals who completed pre- and/or posttransplant outpatient rehabilitation at a single, academic, medical center between March 2019 and March 2021 were included in this study. Noninferiority analysis was used to assess differences in change in 6-minute walk distance (6MWD) between group and individual rehabilitation. Multivariable linear regression models examined 6MWD, Short Physical Performance Battery (SPPB), Ferrans and Powers Quality of Life Index Pulmonary Version (QLI), Center for Epidemiological Studies-Depression Scale (CESD), and San Diego Shortness of Breath Questionnaire (SOBQ). Preoperatively, 93 patients completed group and 81 completed individual rehabilitation. Postoperatively, 110 completed group and 105 completed individual rehabilitation. Individual rehabilitation was noninferior to group rehabilitation (α = 0.05). In addition, there was no significant difference in changes in 6MWD, SPPB, QLI, CESD, or SOBQ, between cohorts pre- and postoperatively (all P > .25). Individual rehabilitation seems to be an acceptable alternative to group rehabilitation for lung transplant candidates and recipients.
肺移植前后的肺康复与功能运动能力和身体生活质量的改善有关。康复计划的规定有很大的差异。这项研究的目的是比较团体康复和个人康复的效果。2019年3月至2021年3月期间在单一学术医疗中心完成移植前和/或移植后门诊康复的个体被纳入本研究。采用非劣效性分析评估组间和个体间6分钟步行距离(6MWD)变化的差异。多变量线性回归模型检验了6MWD、短体力表现电池(SPPB)、ferans and Powers生活质量指数肺版(QLI)、流行病学研究中心抑郁量表(CESD)和圣地亚哥呼吸急促问卷(SOBQ)。术前93例患者完成群体康复，81例患者完成个体康复。术后组康复110例，个体康复105例。个体康复效果不低于组康复效果(α = 0.05)。此外，患者术前和术后6MWD、SPPB、QLI、CESD或SOBQ的变化无显著差异(P均为0.25)。对于肺移植候选人和受者而言，个体康复似乎是一种可接受的替代方案。
{"title":"Group Versus Individual Rehabilitation in Lung Transplantation: A Retrospective Noninferiority Assessment","authors":"R. Byrd, Rachel Breslin, Peijin Wang, Sarah Peskoe, Shein-Chung Chow, Sean Lowers, Laurie D. Snyder, A. Pastva","doi":"10.1097/cpt.0000000000000233","DOIUrl":"https://doi.org/10.1097/cpt.0000000000000233","url":null,"abstract":"\u0000 \u0000 Pulmonary rehabilitation both before and after lung transplant is associated with improved functional exercise capacity and physical quality of life. There is wide variation in rehabilitation program provision. This study's aim was to compare the effects of group versus individual rehabilitation.\u0000 \u0000 \u0000 \u0000 Individuals who completed pre- and/or posttransplant outpatient rehabilitation at a single, academic, medical center between March 2019 and March 2021 were included in this study. Noninferiority analysis was used to assess differences in change in 6-minute walk distance (6MWD) between group and individual rehabilitation. Multivariable linear regression models examined 6MWD, Short Physical Performance Battery (SPPB), Ferrans and Powers Quality of Life Index Pulmonary Version (QLI), Center for Epidemiological Studies-Depression Scale (CESD), and San Diego Shortness of Breath Questionnaire (SOBQ).\u0000 \u0000 \u0000 \u0000 Preoperatively, 93 patients completed group and 81 completed individual rehabilitation. Postoperatively, 110 completed group and 105 completed individual rehabilitation. Individual rehabilitation was noninferior to group rehabilitation (α = 0.05). In addition, there was no significant difference in changes in 6MWD, SPPB, QLI, CESD, or SOBQ, between cohorts pre- and postoperatively (all P > .25).\u0000 \u0000 \u0000 \u0000 Individual rehabilitation seems to be an acceptable alternative to group rehabilitation for lung transplant candidates and recipients.\u0000","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44521522","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}
Pub Date : 2023-08-22DOI: 10.1097/cpt.0000000000000236
G. Ntoumenopoulos, S. Patman
The aim of this study was to report on the cardiorespiratory assessments, interventions, and outcome measures used by physical therapists with critically ill patients and the impact of COVID-19. An anonymous international online survey of practice (through Google Forms) of physical therapists was conducted. The study was conducted in adult intensive care units. A total of 309 physical therapists participated in the study. A survey was used to determine current cardiopulmonary physical therapy practices in ICU. Predominantly participants were female (74%), aged 31 to 40 years (40%), having worked in intensive care unit (ICU) for either 0 to 5 years (38%) or 11 to 20 years (28%), and worked full time (72%). Most participants worked in the United Kingdom (36%), Europe (21%), or Australia/Oceania (18%). The 3 most frequently reported assessment indicators for cardiopulmonary physical therapy interventions were lobar collapse/atelectasis, audible secretions, and decreased/added lung auscultation sounds. The 3 most commonly used outcome measures included lung auscultation, arterial blood gas analysis, and transcutaneous arterial saturation. The 3 most commonly used physical therapy interventions (“very often” in a descending order) included patient mobilization, repositioning to optimize gas exchange, and endotracheal suctioning. For the COVID-19 cohort, participants reported similar use of patient repositioning to optimize gas exchange and postural drainage, and lower use of patient mobilization and endotracheal suctioning, deep breathing exercises, active cycle of breathing technique, and oropharyngeal suctioning. This survey reports on the characteristics of physical therapists who work in ICU, and their cardiopulmonary physical therapy assessments, interventions, and outcome measures most commonly used, inclusive of patients with COVID-19. There were some differences in interventions provided to the COVID-19 cohort compared with the non–COVID-19 cohort.
{"title":"International Survey of Cardiopulmonary Physical Therapy Management of Adult Intensive Care Unit Patients and the Impact of COVID-19","authors":"G. Ntoumenopoulos, S. Patman","doi":"10.1097/cpt.0000000000000236","DOIUrl":"https://doi.org/10.1097/cpt.0000000000000236","url":null,"abstract":"\u0000 \u0000 The aim of this study was to report on the cardiorespiratory assessments, interventions, and outcome measures used by physical therapists with critically ill patients and the impact of COVID-19.\u0000 \u0000 \u0000 \u0000 An anonymous international online survey of practice (through Google Forms) of physical therapists was conducted.\u0000 \u0000 \u0000 \u0000 The study was conducted in adult intensive care units.\u0000 \u0000 \u0000 \u0000 A total of 309 physical therapists participated in the study.\u0000 \u0000 \u0000 \u0000 A survey was used to determine current cardiopulmonary physical therapy practices in ICU.\u0000 \u0000 \u0000 \u0000 Predominantly participants were female (74%), aged 31 to 40 years (40%), having worked in intensive care unit (ICU) for either 0 to 5 years (38%) or 11 to 20 years (28%), and worked full time (72%). Most participants worked in the United Kingdom (36%), Europe (21%), or Australia/Oceania (18%). The 3 most frequently reported assessment indicators for cardiopulmonary physical therapy interventions were lobar collapse/atelectasis, audible secretions, and decreased/added lung auscultation sounds. The 3 most commonly used outcome measures included lung auscultation, arterial blood gas analysis, and transcutaneous arterial saturation. The 3 most commonly used physical therapy interventions (“very often” in a descending order) included patient mobilization, repositioning to optimize gas exchange, and endotracheal suctioning. For the COVID-19 cohort, participants reported similar use of patient repositioning to optimize gas exchange and postural drainage, and lower use of patient mobilization and endotracheal suctioning, deep breathing exercises, active cycle of breathing technique, and oropharyngeal suctioning.\u0000 \u0000 \u0000 \u0000 This survey reports on the characteristics of physical therapists who work in ICU, and their cardiopulmonary physical therapy assessments, interventions, and outcome measures most commonly used, inclusive of patients with COVID-19. There were some differences in interventions provided to the COVID-19 cohort compared with the non–COVID-19 cohort.\u0000","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44021776","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}
Pub Date : 2023-08-22DOI: 10.1097/CPT.0000000000000232
M. Johanson, P. Bartlo, Naomi Bauer, Angela Campbell, Sagan Everett, Nancy Smith
Purpose: Competency-based education and creation of profession-based entrustable professional activities are current trends in physical therapist (PT) education. The purpose of this project is to determine the current entry-level PT competencies for cardiovascular & pulmonary (CVP) physical therapy. Methods: The Academy of Cardiovascular & Pulmonary Physical Therapy Competency Task Force was established to update and expand previous competencies. A mixed method approach of Subject Matter Expert (SME) consensus (modified Delphi process) and a broader survey process was used to develop these entry-level competencies. With SME guidance, a modified version of the levels of competence, None-to-Proficient, was adopted based on previous competency work by the American Council of Academic Physical Therapy. Results: Twenty-nine SME members engaged in the consensus process, and 268, 194, 305, and 222 respondents completed the 4 surveys, respectively. Six hundred fifty-one competency items were rated across most Commission on the Accreditation of Physical Therapy Education Standard 7 Curriculum areas, following the patient–client management model. Conclusions: These competencies establish specific expected levels of knowledge, skills, and behaviors essential for entry-level CVP PT practice. Adopting these competencies will help lay the groundwork for future competency-based PT education and aid in the development of the physical therapy profession's core entrustable professional activities.
{"title":"Cardiovascular and Pulmonary Entry-Level Physical Therapist Competencies: Update by Academy of Cardiovascular & Pulmonary Physical Therapy Task Force","authors":"M. Johanson, P. Bartlo, Naomi Bauer, Angela Campbell, Sagan Everett, Nancy Smith","doi":"10.1097/CPT.0000000000000232","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000232","url":null,"abstract":"Purpose: Competency-based education and creation of profession-based entrustable professional activities are current trends in physical therapist (PT) education. The purpose of this project is to determine the current entry-level PT competencies for cardiovascular & pulmonary (CVP) physical therapy. Methods: The Academy of Cardiovascular & Pulmonary Physical Therapy Competency Task Force was established to update and expand previous competencies. A mixed method approach of Subject Matter Expert (SME) consensus (modified Delphi process) and a broader survey process was used to develop these entry-level competencies. With SME guidance, a modified version of the levels of competence, None-to-Proficient, was adopted based on previous competency work by the American Council of Academic Physical Therapy. Results: Twenty-nine SME members engaged in the consensus process, and 268, 194, 305, and 222 respondents completed the 4 surveys, respectively. Six hundred fifty-one competency items were rated across most Commission on the Accreditation of Physical Therapy Education Standard 7 Curriculum areas, following the patient–client management model. Conclusions: These competencies establish specific expected levels of knowledge, skills, and behaviors essential for entry-level CVP PT practice. Adopting these competencies will help lay the groundwork for future competency-based PT education and aid in the development of the physical therapy profession's core entrustable professional activities.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"34 1","pages":"183 - 193"},"PeriodicalIF":0.0,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49180285","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}
Pub Date : 2023-07-25DOI: 10.1097/CPT.0000000000000234
Leslie M. Smith, Sindhuja Muralidharan, Diana Stanek, A. Yorke
Supplemental Digital Content is Available in the Text. Purpose: Hypertension (HTN) is a prevalent and preventable risk factor for several medical conditions that can lead to death. The purpose of this study was to investigate the frequency of physical and occupational therapists taking blood pressure (BP) in outpatient clinics before and after education focused on the clinical importance of monitoring BP. Methods: This pre/posttest model consists of 2 phases. In phase 1, physical and occupational therapists were surveyed regarding attitudes, behaviors, and barriers toward monitoring BP; and electronic medical records (EMR) were audited to determine frequency of BP documentation. For phase 2, educational webinars were developed highlighting the importance of BP monitoring and followed by another EMR audit. Results: Nine clinicians participated in our survey. Survey results indicated that one-third agreed that BP should be monitored during evaluations, but 100% responded that they rarely take BP. An audit of 488 EMR charts pre-education showed there was no BP documented. Three months after education, another 237 EMR charts were audited, with a 12.7% improvement in the frequency of BP documented. A chi-square analysis showed that this improvement was statistically significant (P < .001). Conclusions: Therapists did not monitor and document BP. After the webinar series, there was a significant increase, however still below recommendations for monitoring BP.
{"title":"Is Education Enough to Change the Practice of Monitoring of Blood Pressure in Outpatient Clinics? Case Report","authors":"Leslie M. Smith, Sindhuja Muralidharan, Diana Stanek, A. Yorke","doi":"10.1097/CPT.0000000000000234","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000234","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Purpose: Hypertension (HTN) is a prevalent and preventable risk factor for several medical conditions that can lead to death. The purpose of this study was to investigate the frequency of physical and occupational therapists taking blood pressure (BP) in outpatient clinics before and after education focused on the clinical importance of monitoring BP. Methods: This pre/posttest model consists of 2 phases. In phase 1, physical and occupational therapists were surveyed regarding attitudes, behaviors, and barriers toward monitoring BP; and electronic medical records (EMR) were audited to determine frequency of BP documentation. For phase 2, educational webinars were developed highlighting the importance of BP monitoring and followed by another EMR audit. Results: Nine clinicians participated in our survey. Survey results indicated that one-third agreed that BP should be monitored during evaluations, but 100% responded that they rarely take BP. An audit of 488 EMR charts pre-education showed there was no BP documented. Three months after education, another 237 EMR charts were audited, with a 12.7% improvement in the frequency of BP documented. A chi-square analysis showed that this improvement was statistically significant (P < .001). Conclusions: Therapists did not monitor and document BP. After the webinar series, there was a significant increase, however still below recommendations for monitoring BP.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"34 1","pages":"171 - 176"},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45946349","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}
Pub Date : 2023-07-01DOI: 10.1097/CPT.0000000000000223
D. O’Connell, Jill Jumper, Brad Hicks, Bubba Klostermann, Christopher Carl, Carmen Bell
Purpose: To examine pulse pressure (PP), systolic (SBP), and diastolic (DBP) pressure in outpatient physical therapy or maintenance fitness subjects by age (5 age groups) and in those younger than versus those who were 65 years and older. To test for differences in SBP, DBP, and PP in those with and without a hypertension (HTN) diagnosis. Methods: Ninety-eight physical therapy and maintenance fitness subjects in 1 urban outpatient clinic had PP and SBP/DBP measured and classified (ACC/AHA 2017 guidelines) using two different age classifications: (1) 20 to 44, 45 to 54, 55 to 64, 65 to 74, or ≥75 and (2) ≤64 or ≥65. Comparisons were also made in SBP, DBP, and PP based on a known hypertension diagnosis. Results: Forty male and 58 female subjects (height: 65.98 inches [SD = 4.19]; weight: 180.91 pounds [SD = 39.62]; body mass index: 29.11 [SD = 5.86]; age: 64.34 years [SD = 15.92]) participated in this investigation. Systolic blood pressure, DBP, and PP were significantly higher in those older than 65 years. Systolic blood pressure significantly increases across 5 age groups. Systolic blood pressure, DBP, and PP were significantly higher in those older than 65 years. Pulse pressure was significantly greater in those with hypertension. Pulse pressure was abnormal in 36.2% of the sample. Conclusions: Thirty-six percent of subjects receiving physical therapy treatment or participating in maintenance fitness had elevated PP while 78.9% and 47.3% had abnormal SBP and DBP, respectively. Both PP and blood pressure were significantly influenced by age. Therapists should measure resting BP and PP before treatment and refer as needed to achieve improved control.
{"title":"Prevalence of Elevated Pulse Pressure and Hypertension in Adults Participating in Outpatient Physical Therapy","authors":"D. O’Connell, Jill Jumper, Brad Hicks, Bubba Klostermann, Christopher Carl, Carmen Bell","doi":"10.1097/CPT.0000000000000223","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000223","url":null,"abstract":"Purpose: To examine pulse pressure (PP), systolic (SBP), and diastolic (DBP) pressure in outpatient physical therapy or maintenance fitness subjects by age (5 age groups) and in those younger than versus those who were 65 years and older. To test for differences in SBP, DBP, and PP in those with and without a hypertension (HTN) diagnosis. Methods: Ninety-eight physical therapy and maintenance fitness subjects in 1 urban outpatient clinic had PP and SBP/DBP measured and classified (ACC/AHA 2017 guidelines) using two different age classifications: (1) 20 to 44, 45 to 54, 55 to 64, 65 to 74, or ≥75 and (2) ≤64 or ≥65. Comparisons were also made in SBP, DBP, and PP based on a known hypertension diagnosis. Results: Forty male and 58 female subjects (height: 65.98 inches [SD = 4.19]; weight: 180.91 pounds [SD = 39.62]; body mass index: 29.11 [SD = 5.86]; age: 64.34 years [SD = 15.92]) participated in this investigation. Systolic blood pressure, DBP, and PP were significantly higher in those older than 65 years. Systolic blood pressure significantly increases across 5 age groups. Systolic blood pressure, DBP, and PP were significantly higher in those older than 65 years. Pulse pressure was significantly greater in those with hypertension. Pulse pressure was abnormal in 36.2% of the sample. Conclusions: Thirty-six percent of subjects receiving physical therapy treatment or participating in maintenance fitness had elevated PP while 78.9% and 47.3% had abnormal SBP and DBP, respectively. Both PP and blood pressure were significantly influenced by age. Therapists should measure resting BP and PP before treatment and refer as needed to achieve improved control.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"34 1","pages":"133 - 140"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46488300","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}
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