Pub Date : 2023-07-01DOI: 10.1097/cpt.0000000000000231
A. Fick
{"title":"Advocacy and Service: Opening Your Heart to Make a Vital Impact","authors":"A. Fick","doi":"10.1097/cpt.0000000000000231","DOIUrl":"https://doi.org/10.1097/cpt.0000000000000231","url":null,"abstract":"","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41699009","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 : 2023-06-09DOI: 10.1097/cpt.0000000000000225
Kerry Lammers, Daniel Ludwig
This clinical perspectives article provides a comprehensive and evidence-based overview of diagnosing and treating dizziness in complex patients. These patients typically present with overlapping comorbidities and symptoms that can create difficulty in discovering an accurate diagnosis and treatment plan. Vestibular dysfunction affects over 35% of adults older than 40 years, and that prevalence significantly increases with age. Eighty-five percent of adults older than 80 years had evidence of balance/vestibular dysfunction. We believe this differential diagnosis between cardiopulmonary and vestibular dizziness transcends all rehab environments across the continuum of care. We will provide evidence for vestibular background knowledge and clinical skills that intersects with evidence regarding pharmacology and competing cardiopulmonary diagnoses to provide clinicians with the framework, skills, and knowledge to differentially diagnose dizziness across multiple care settings. In addition, we will provide examples of appropriate interdisciplinary communication to assist the clinician in decision making and best practice management.
{"title":"Defining Dizziness: Acknowledging Vestibular Differential in Cardiopulmonary Diagnoses","authors":"Kerry Lammers, Daniel Ludwig","doi":"10.1097/cpt.0000000000000225","DOIUrl":"https://doi.org/10.1097/cpt.0000000000000225","url":null,"abstract":"This clinical perspectives article provides a comprehensive and evidence-based overview of diagnosing and treating dizziness in complex patients. These patients typically present with overlapping comorbidities and symptoms that can create difficulty in discovering an accurate diagnosis and treatment plan. Vestibular dysfunction affects over 35% of adults older than 40 years, and that prevalence significantly increases with age. Eighty-five percent of adults older than 80 years had evidence of balance/vestibular dysfunction. We believe this differential diagnosis between cardiopulmonary and vestibular dizziness transcends all rehab environments across the continuum of care. We will provide evidence for vestibular background knowledge and clinical skills that intersects with evidence regarding pharmacology and competing cardiopulmonary diagnoses to provide clinicians with the framework, skills, and knowledge to differentially diagnose dizziness across multiple care settings. In addition, we will provide examples of appropriate interdisciplinary communication to assist the clinician in decision making and best practice management.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45272081","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 : 2023-06-05DOI: 10.1097/CPT.0000000000000222
C. DiPerna, L. Tucker, Danielle E. Rice, Cori Shank, Abigail J. Kettler, Colin L. Terry, Linda Ulerich, D. Roe, C. Hage
Supplemental Digital Content is Available in the Text. Purpose: Functional recovery after lung transplant is crucial to long-term outcomes. Despite rehabilitation, few reach the threshold of healthy function. The purpose of this study was to assess the potential benefit of rehabilitation in the Center of Life for Thoracic Transplant (COLTT) program by (1) measuring time to functional recovery, (2) identifying factors associated with functional recovery, (3) examining program outcomes, and (4) examining COLTT impact on unplanned hospital readmission. Methods: The study retrospectively examined 105 patients in COLTT after hospital discharge. Functional measures collected at enrollment and completion included 6-minute walk distance, walking speed, 1-minute sit-to-stand test, and single-leg stance. Demographic and hospital stay data were examined for associations between time to achieve COLTT goals and readmissions. Results: The median number of visits in COLTT was 18 (9–53). Significant functional gains were made across all outcome measures and near thresholds for healthy individuals. Age, hospital and intensive care unit (ICU) length of stay (LOS), lung disease type, and ventilation time were significantly associated with COLTT visits. The 30-day hospital readmission free rate after hospital discharge was 71.4%. Conclusions: Healthy adult functional outcomes were achieved in 18 visits. Age, hospital and ICU LOS, lung disease type, and prolonged ventilation are associated with functional recovery.
{"title":"Functional Recovery After Lung Transplantation Using a Comprehensive Rehabilitation Model","authors":"C. DiPerna, L. Tucker, Danielle E. Rice, Cori Shank, Abigail J. Kettler, Colin L. Terry, Linda Ulerich, D. Roe, C. Hage","doi":"10.1097/CPT.0000000000000222","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000222","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Purpose: Functional recovery after lung transplant is crucial to long-term outcomes. Despite rehabilitation, few reach the threshold of healthy function. The purpose of this study was to assess the potential benefit of rehabilitation in the Center of Life for Thoracic Transplant (COLTT) program by (1) measuring time to functional recovery, (2) identifying factors associated with functional recovery, (3) examining program outcomes, and (4) examining COLTT impact on unplanned hospital readmission. Methods: The study retrospectively examined 105 patients in COLTT after hospital discharge. Functional measures collected at enrollment and completion included 6-minute walk distance, walking speed, 1-minute sit-to-stand test, and single-leg stance. Demographic and hospital stay data were examined for associations between time to achieve COLTT goals and readmissions. Results: The median number of visits in COLTT was 18 (9–53). Significant functional gains were made across all outcome measures and near thresholds for healthy individuals. Age, hospital and intensive care unit (ICU) length of stay (LOS), lung disease type, and ventilation time were significantly associated with COLTT visits. The 30-day hospital readmission free rate after hospital discharge was 71.4%. Conclusions: Healthy adult functional outcomes were achieved in 18 visits. Age, hospital and ICU LOS, lung disease type, and prolonged ventilation are associated with functional recovery.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"34 1","pages":"141 - 149"},"PeriodicalIF":0.0,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41986901","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 : 2023-06-01DOI: 10.1097/CPT.0000000000000228
PT Dpt Ccs Kari DiVito, PT Anne K. Swisher, MD Mph J.W. Awori Hayanga
Objective: Extracorporeal membrane oxygenation (ECMO) is a lifesaving modality that was in great demand for persons with severe COVID-19 infection. Although mobility of these patients has previously been safely reported anecdotally, there were no established guidelines to implement in a greatly expanded patient population, as occurred in the pandemic period. We describe the development and implementation of a program (Cannulate, Extubate, Ambulate) for team-based safe mobilization. Methods: The 3-phase protocol advances based on patient alertness/ability to actively participate. A physical therapist determined initial stage and progression and recommended mobility activities for carryover by nurses and/or ECMO specialists between skilled sessions. Results: The mobility program has been successfully implemented for 104 patients with severe COVID-19 without significant adverse events. Most patients (51%) ambulated while cannulated, and 60% were able to discharge directly home after hospitalization. Conclusions: This safe, effective program allowed extension of physical therapy goals in a highly complex patient population during a time of very high demand. Making early mobility a team goal enhanced buy-in, instead of relying exclusively on rehabilitation providers for mobilization. Utilization of the Cannulate, Extubate, Ambulate program may assist other programs to minimize complications of immobility in the ECMO population.
{"title":"Cannulate, Extubate, Ambulate: How the Pandemic Accelerated Development and Implementation of Early Mobility for Patients Requiring Extracorporeal Membrane Oxygenation","authors":"PT Dpt Ccs Kari DiVito, PT Anne K. Swisher, MD Mph J.W. Awori Hayanga","doi":"10.1097/CPT.0000000000000228","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000228","url":null,"abstract":"Objective: Extracorporeal membrane oxygenation (ECMO) is a lifesaving modality that was in great demand for persons with severe COVID-19 infection. Although mobility of these patients has previously been safely reported anecdotally, there were no established guidelines to implement in a greatly expanded patient population, as occurred in the pandemic period. We describe the development and implementation of a program (Cannulate, Extubate, Ambulate) for team-based safe mobilization. Methods: The 3-phase protocol advances based on patient alertness/ability to actively participate. A physical therapist determined initial stage and progression and recommended mobility activities for carryover by nurses and/or ECMO specialists between skilled sessions. Results: The mobility program has been successfully implemented for 104 patients with severe COVID-19 without significant adverse events. Most patients (51%) ambulated while cannulated, and 60% were able to discharge directly home after hospitalization. Conclusions: This safe, effective program allowed extension of physical therapy goals in a highly complex patient population during a time of very high demand. Making early mobility a team goal enhanced buy-in, instead of relying exclusively on rehabilitation providers for mobilization. Utilization of the Cannulate, Extubate, Ambulate program may assist other programs to minimize complications of immobility in the ECMO population.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"34 1","pages":"164 - 170"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45390793","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 : 2023-06-01DOI: 10.1097/cpt.0000000000000230
Paul Ricard, Stephen Cameron Ramsey, Hannah Fernald McHugh, Benjamin Michael Carrion
Practitioners need access to and the ability to openly discuss advances in practice and concepts as they apply to the practice of cardiovascular and pulmonary physical therapy (PT). Lack of accessibility to research literature, limited personal time, or insufficient knowledge to adequately review the breadth of literature published each year can hinder this process. This article provides a limited overview of cardiovascular and pulmonary research published in 2022 that the authors believe most important and relevant or speaks to the volume or trend of current topics in the clinical practice of cardiovascular and pulmonary PT. Each topic area is followed by a brief overview of clinical relevance and was open to discussion with the participants present at the 2023 Combined Sections Meeting held on February 24, 2023.
{"title":"Cardiovascular and Pulmonary Research: The Year (2022) in Review","authors":"Paul Ricard, Stephen Cameron Ramsey, Hannah Fernald McHugh, Benjamin Michael Carrion","doi":"10.1097/cpt.0000000000000230","DOIUrl":"https://doi.org/10.1097/cpt.0000000000000230","url":null,"abstract":"Practitioners need access to and the ability to openly discuss advances in practice and concepts as they apply to the practice of cardiovascular and pulmonary physical therapy (PT). Lack of accessibility to research literature, limited personal time, or insufficient knowledge to adequately review the breadth of literature published each year can hinder this process. This article provides a limited overview of cardiovascular and pulmonary research published in 2022 that the authors believe most important and relevant or speaks to the volume or trend of current topics in the clinical practice of cardiovascular and pulmonary PT. Each topic area is followed by a brief overview of clinical relevance and was open to discussion with the participants present at the 2023 Combined Sections Meeting held on February 24, 2023.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136370976","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 : 2023-05-31DOI: 10.1097/CPT.0000000000000227
C. Connors, T. Betts, Shelby Lawrence, Homer B. Walag, Julie Buchl, V. Kaza
Purpose: A quality initiative assessed standardized physical therapy (SPT) with lung transplant (LT) recipients in the hospital setting. The objective was to improve physical function evidenced by 6-minute walk distance (6MWD) and 30-second chair stand test (30s-CST). Methods: Standardized physical therapy was implemented with patients who underwent LT after March 8, 2021. Data were collected from July 19, 2019 to July 23, 2020 as baseline measures. Six-minute walk distance and 30s-CST were measured after hospital discharge. Results: After data collection, statistical analysis included descriptive statistics and a 2-sample t test with P-value <.05. The baseline group (BG) consisted of 19 patients that participated in traditional physical therapy (PT). The BG mean 6MWD was 891 feet, and mean 30s-CST was 4 repetitions. The SPT group consisted of 25 patients. The SPT group demonstrated a mean 6MWD of 1054 feet with a P-value of 0.0299 and mean 30s-CST of 7 repetitions with a P-value of 0.078. Conclusions: All functional outcome measures improved, with the 6MWD demonstrating statistical significance. Hospitalized LT recipients may demonstrate improved physical function with SPT; however, limited conclusions can be made.
{"title":"Implementing Standard Physical Therapy Guidelines With Patients Acutely After Single or Bilateral Lung Transplant: A Quality Improvement Project in the Hospital Setting","authors":"C. Connors, T. Betts, Shelby Lawrence, Homer B. Walag, Julie Buchl, V. Kaza","doi":"10.1097/CPT.0000000000000227","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000227","url":null,"abstract":"Purpose: A quality initiative assessed standardized physical therapy (SPT) with lung transplant (LT) recipients in the hospital setting. The objective was to improve physical function evidenced by 6-minute walk distance (6MWD) and 30-second chair stand test (30s-CST). Methods: Standardized physical therapy was implemented with patients who underwent LT after March 8, 2021. Data were collected from July 19, 2019 to July 23, 2020 as baseline measures. Six-minute walk distance and 30s-CST were measured after hospital discharge. Results: After data collection, statistical analysis included descriptive statistics and a 2-sample t test with P-value <.05. The baseline group (BG) consisted of 19 patients that participated in traditional physical therapy (PT). The BG mean 6MWD was 891 feet, and mean 30s-CST was 4 repetitions. The SPT group consisted of 25 patients. The SPT group demonstrated a mean 6MWD of 1054 feet with a P-value of 0.0299 and mean 30s-CST of 7 repetitions with a P-value of 0.078. Conclusions: All functional outcome measures improved, with the 6MWD demonstrating statistical significance. Hospitalized LT recipients may demonstrate improved physical function with SPT; however, limited conclusions can be made.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"34 1","pages":"177 - 182"},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43939199","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 : 2023-05-31DOI: 10.1097/cpt.0000000000000224
Kaelee S. Brockway, L. Ayres, M. Shoemaker
{"title":"Putting It All Together: An Evidence-Based Guide to High-Intensity Interval Exercise Prescription for Patients With Complex Comorbidities","authors":"Kaelee S. Brockway, L. Ayres, M. Shoemaker","doi":"10.1097/cpt.0000000000000224","DOIUrl":"https://doi.org/10.1097/cpt.0000000000000224","url":null,"abstract":"","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45673532","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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