Cardiopulmonary physical therapy journal最新文献

英文中文

Implementing Standard Physical Therapy Guidelines With Patients Acutely After Single or Bilateral Lung Transplant: A Quality Improvement Project in the Hospital Setting 对单侧或双侧肺移植后急性患者实施标准物理治疗指南:医院环境中的质量改进项目

Cardiopulmonary physical therapy journal

Pub Date : 2023-05-31 DOI: 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.

目的：一项质量倡议评估了医院环境中肺移植（LT）接受者的标准化物理治疗（SPT）。目的是通过6分钟步行距离（6MWD）和30秒椅子站立测试（30s CST）来改善身体功能。方法：对2021年3月8日后接受LT的患者进行标准化物理治疗。数据收集于2019年7月19日至2020年7月23日，作为基线测量。出院后测量6分钟步行距离和30s CST。结果：数据收集后，统计分析包括描述性统计和P值<.05的2样本t检验。基线组（BG）由19名参与传统物理治疗（PT）的患者组成。BG平均6MWD为891英尺，平均30s CST为4次重复。SPT组由25名患者组成。SPT组的平均6MWD为1054英尺，P值为0.0299，平均30s CST为7次重复，P值值为0.078。结论：所有功能性结果指标均有改善，6MWD具有统计学意义。住院的LT接受者可能表现出SPT的身体功能改善；然而，得出的结论有限。

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引用次数: 1

Putting It All Together: An Evidence-Based Guide to High-Intensity Interval Exercise Prescription for Patients With Complex Comorbidities 综合:复杂合并症患者高强度间歇运动处方循证指南

Cardiopulmonary physical therapy journal

Pub Date : 2023-05-31 DOI: 10.1097/cpt.0000000000000224

Kaelee S. Brockway, L. Ayres, M. Shoemaker

引用次数: 1

Sternal Displacement During Activities: Erratum 活动时胸骨移位:勘误

Cardiopulmonary physical therapy journal

Pub Date : 2023-05-11 DOI: 10.1097/cpt.0000000000000229

引用次数: 0

Breadth and Depth 广度和深度

Cardiopulmonary physical therapy journal

Pub Date : 2023-04-01 DOI: 10.1097/cpt.0000000000000226

引用次数: 0

Sternal Displacement During Activities 活动时胸骨移位

Cardiopulmonary physical therapy journal

Pub Date : 2023-04-01 DOI: 10.1097/CPT.0000000000000221

J. Rodrigues, George J. Beneck

Purpose: The purpose of this study was to determine whether sternal displacement occurs, decreases over time, and varies with adherence to sternal precautions during functional activities after median sternotomy. Methods: Seventeen subjects had ultrasound images taken at two and then six to eight weeks after median sternotomy to measure the sternal gap and displacement during five activities commonly limited by sternal precautions. The subjects were divided into two groups based on self-reported compliance with sternal precautions. Results: At the upper sternal site, displacement occurred with all activities in both sessions and decreased over time. At the lower sternal site, displacement only occurred during dynamic activities and decreased over time. Subjects who fully complied with sternal precautions had less upper sternal displacement during stand-to-sit (P = .043; ES = −1.076) and trend toward reduced displacement during sit-to-stand and horizontal abduction with large effect sizes, −.893 and −.975, respectively. Conclusion: Sternal displacement may vary with the task performed and between sternal sites. Reduced sternal displacement identified over time indicates sternal healing. Pectoralis major tension seems to be a primary mechanism of sternal displacement during common functional activities. Our findings suggest that full compliance with sternal precautions may promote sternal healing.

目的:本研究的目的是确定胸骨移位是否发生，随着时间的推移而减少，以及在胸骨正中切开术后的功能活动中是否遵守胸骨预防措施而变化。方法:17例患者分别于胸骨正中切开术后2周和6 ~ 8周拍摄超声图像，测量胸骨间隙和移位，并进行5种常见胸骨预防措施限制的活动。受试者根据自我报告的胸骨预防措施依从性分为两组。结果:在上胸骨部位，移位在两组活动中均发生，并随时间减少。在胸骨下部，移位仅在动态活动时发生，并随着时间的推移而减少。完全遵守胸骨预防措施的受试者在站坐过程中胸骨上移位较少(P = 0.043;ES =−1.076)，并且在坐立和水平外展过程中有减少位移的趋势，且效应量大，−。893和−。975年,分别。结论:胸骨移位可能因手术任务和不同胸骨部位而异。随着时间的推移，胸骨移位减少表明胸骨愈合。胸大肌张力似乎是常见功能活动中胸骨移位的主要机制。我们的研究结果表明，完全遵守胸骨预防措施可以促进胸骨愈合。

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引用次数: 0

CSM 2023 Cardiovascular and Pulmonary Platform Abstracts CSM 2023心血管和肺部平台摘要

Cardiopulmonary physical therapy journal

Pub Date : 2023-01-01 DOI: 10.1097/cpt.0000000000000219

J. Wulke, K. Brown, J. Teel, M. Reynolds, T. Gilliland, E. McShan, J. Gillespie, S. Driver

BACKGROUND AND PURPOSE: Firefighting is a demanding and hazardous profession requiring optimal physical and cognitive health. Occupational risk factors associated with firefighting (contact with the public, pulmonary damage from repeated exposure to fire) may place firefighters at an increased risk of contracting SARSCoV-2 as well as for suffering complications resulting from fulminant COVID-191, which can result in impaired physical2 and cognitive3 performance. Current recommendations for rehabilitation following COVID-19 may be insufficient to address the unique physical and cognitive demands required to perform fire suppression tasks.4 The purpose of this case report is to describe the efficacy of a high-intensity, occupation-specific physical therapy (HIOS-PT)5 program to improve aerobic capacity, muscular strength, and cognitive performance sufficient to return a firefighter to full duty within 6 months following hospital discharge for critical COVID-19. CASE DESCRIPTION: A 36-year-old firefighter completed 30 sessions of HIOS-PT with hopes of returning to his strenuous occupation as a firefighter following a 70-day complicated hospitalization for critical COVID-19 pneumonia and acute respiratory distress syndrome requiring invasive mechanical ventilation. Initial evaluation revealed impaired aerobic capacity of less than the first percentile for age and sex on cardiopulmonary exercise testing6, impaired muscular strength on isokinetic testing, and impaired cognitive performance as assessed by an app-based information processing task (reaction time and accuracy). The HIOS-PT program was symptom-limited simulated real work activities based on previous literature describing the effect of similar programming with first responders in cardiac rehabilitation5, while improving strength, cognition, and aerobic capacity sufficient to meet fitness standards required to return to work. Additionally, the patient performed 3 simulated candidate physical ability tests each increasing in intensity which consisted of 9 fire suppression activities required by his department7. Followup assessments were performed after completion of 30 HIOS-PT sessions. OUTCOME(S): Aerobic capacity increased 54% from a VO2=25.4 mL/kg/min (7.3 METs) to VO2=39.2 mL/kg/min (11.2 METs). Muscular strength increased from 59% to >96% body weight. Cognitive performance on an information processing test increased 175% from a score of 556 to 1530. Upon discharge from the HIOS-PT program, the patient returned to full duty as a firefighter. DISCUSSION: HIOS-PT was well tolerated and effective in rehabilitating a firefighter to return to work following a prolonged hospitalization for critical COVID-19. Rehabilitation guidelines for occupational athletes, such as firefighters, following critical COVID-19 is limited and may be insufficient to adequately prepare these individuals for return to strenuous work duties. This case supports the exploration into using HIOS-PT for individuals require

背景和目的:消防是一项要求高且危险的职业，需要最佳的身体和认知健康。与消防相关的职业风险因素(与公众接触、反复暴露于火中造成肺部损伤)可能会增加消防员感染sars -2的风险，以及遭受暴发性COVID-191引起的并发症的风险，这可能导致身体和认知能力受损。目前关于COVID-19后康复的建议可能不足以满足执行灭火任务所需的独特身体和认知需求本病例报告的目的是描述高强度，职业特异性物理治疗(HIOS-PT)5计划的有效性，以提高有氧能力，肌肉力量和认知能力，足以使消防员在COVID-19重症出院后6个月内恢复全面工作。病例描述:一名36岁的消防员因重症COVID-19肺炎和急性呼吸窘迫综合征住院70天，需要有创机械通气，他完成了30次HIOS-PT，希望能回到他艰苦的消防员职业。初步评估显示，在心肺运动测试中，年龄和性别的有氧能力受损小于第一个百分位数，在等速运动测试中，肌肉力量受损，在基于应用程序的信息处理任务(反应时间和准确性)中，认知能力受损。HIOS-PT方案是一种症状受限的模拟真实工作活动，基于先前的文献描述了类似方案对心脏康复第一反应者的影响5，同时提高了力量、认知和有氧能力，足以满足重返工作岗位所需的健康标准。此外，患者进行了3次模拟候选体能测试，每次测试的强度都在增加，其中包括他所在科室要求的9次灭火活动7。在完成30次HIOS-PT治疗后进行随访评估。结果(S):有氧能力从VO2=25.4 mL/kg/min (7.3 METs)增加到VO2=39.2 mL/kg/min (11.2 METs)，增加了54%。肌肉力量从体重的59%增加到体重的60%。在一项信息处理测试中，认知表现从556分提高到1530分，提高了175%。在HIOS-PT项目出院后，患者作为一名消防员重返岗位。讨论:HIOS-PT耐受性良好，可有效帮助因严重COVID-19而长期住院治疗的消防员恢复工作。针对职业运动员(如消防员)在COVID-19严重感染后的康复指南是有限的，可能不足以使这些人为重返繁重的工作岗位做好充分准备。本案例支持探索在COVID-19严重疫情后需要执行繁重工作的个人使用HIOS-PT。

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引用次数: 0

Welcome to a New Era 欢迎来到新时代

Cardiopulmonary physical therapy journal

Pub Date : 2023-01-01 DOI: 10.1097/cpt.0000000000000218

A. Gurovich

引用次数: 0

Exercise Progression Protocol for Lung Transplant GO: A Multicomponent Telerehab Exercise Intervention for Patients After Lung Transplantation. 肺移植手术后的运动进展方案》（Exercise Progression Protocol for Lung Transplant GO：针对肺移植术后患者的多成分远程康复运动干预。

Cardiopulmonary physical therapy journal

Pub Date : 2023-01-01 Epub Date: 2022-03-23 DOI: 10.1097/CPT.0000000000000203

Andrea L Hergenroeder, Bryan Willey, Melissa Vendetti, Annette DeVito Dabbs

引用次数: 2

Cardiorespiratory Insufficiency and Performance Fatigability in Women with Systemic Lupus Erythematosus. 系统性红斑狼疮女性患者的心肺功能不全和运动疲劳。

Cardiopulmonary physical therapy journal

Pub Date : 2023-01-01 Epub Date: 2022-07-13 DOI: 10.1097/cpt.0000000000000210

Liana C Wooten, Sarfaraz Hasni, Jamal A Mikdashi, Randall E Keyser

Purpose: Patients with systemic lupus erythematosus (SLE) experience excessive, debilitating fatigue with previously reported evidence of etiologically mediated cardiorespiratory impairments. Performance fatigability provides a precise characterization of fatigue as it can be quantified objectively as a function of time, frequency, and/or duration. Nevertheless, little consideration has been given to understanding performance fatigability and its physiological determinants in those with SLE. The purpose of this study was to characterize performance fatigability in patients with SLE, utilizing measures surrounding the anaerobic threshold, with emphasis on cardiorespiratory impairment as a potential mediating factor.

Methods: This was a case-control study design. 44 physically inactive women, 26 with SLE and 18 controls, completed a treadmill cardiopulmonary exercise test to volitional exhaustion.

Results: There were no significant differences in age (SLE 34.8(9.0) vs Control 36.9(7.3) yrs; p=0.422) between groups. BMI (SLE 27.1(5.4) vs Control 23.8(5.2) kg/m²; p=0.045) was significantly higher in the SLE vs Control group. Resting heart rate (SLE 68(16) vs Control 78(15) bpm; p=0.040) was significantly lower in the SLE compared to the Control group. The VO₂ corresponding to the anaerobic threshold (AT-VO₂), used to identify the onset of exercise-induced fatigue, was significantly lower in women with SLE than in controls (SLE 12.4(3.1) vs Control 16.4(2.2) ml/kg/min; p<0.001), as was AT-stage (SLE 2.5(0.90) vs Control 3.4(0.78); p=0.002). Additionally, Fatigue Severity Score (FSS) was highly and inversely correlated with AT-VO₂ (rho=-0.615; p<0.001) and FSS was highly correlated with Functional Aerobic Impairment Index (FAI; rho=0.663; p<0.001).

Conclusion: This study underscores severe performance fatigability in patients with SLE and its link to cardiorespiratory insufficiency. Physiological presentation of performance fatigability was observed during very low intensities of exercise, emphasizing the negative impact it may have on physical function in this population.

目的：系统性红斑狼疮（SLE）患者会出现过度疲劳、衰弱的症状，以前曾有报道称有病因介导的心肺功能损害的证据。表现性疲劳是对疲劳的精确描述，因为它可以作为时间、频率和/或持续时间的函数进行客观量化。然而，人们很少考虑了解系统性红斑狼疮患者的表现疲劳性及其生理决定因素。本研究的目的是利用围绕无氧阈值的测量方法来描述系统性红斑狼疮患者运动表现疲劳性的特征，并将重点放在作为潜在中介因素的心肺功能损伤上：这是一项病例对照研究设计。方法：这是一项病例对照研究设计，44 名不运动的女性（26 名系统性红斑狼疮患者和 18 名对照组患者）完成了跑步机心肺运动测试，达到自愿力竭：各组间的年龄（系统性红斑狼疮 34.8(9.0) 岁 vs 对照组 36.9(7.3) 岁；P=0.422）无明显差异。系统性红斑狼疮组比对照组的体重指数（系统性红斑狼疮 27.1(5.4) vs 对照组 23.8(5.2) kg/m2；p=0.045）明显更高。系统性红斑狼疮组的静息心率（系统性红斑狼疮组 68(16) bpm vs 对照组 78(15) bpm; p=0.040）明显低于对照组。系统性红斑狼疮女性患者的无氧阈值（AT-VO2）明显低于对照组（系统性红斑狼疮 12.4(3.1) vs 对照组 16.4(2.2) ml/kg/min；p2 (rho=-0.615; p结论：这项研究强调了系统性红斑狼疮患者严重的运动疲劳及其与心肺功能不全的关系。在极低强度的运动中也能观察到表现疲劳的生理表现，这强调了它可能对这一人群的身体功能产生的负面影响。

{"title":"Cardiorespiratory Insufficiency and Performance Fatigability in Women with Systemic Lupus Erythematosus.","authors":"Liana C Wooten, Sarfaraz Hasni, Jamal A Mikdashi, Randall E Keyser","doi":"10.1097/cpt.0000000000000210","DOIUrl":"10.1097/cpt.0000000000000210","url":null,"abstract":"Purpose: Patients with systemic lupus erythematosus (SLE) experience excessive, debilitating fatigue with previously reported evidence of etiologically mediated cardiorespiratory impairments. Performance fatigability provides a precise characterization of fatigue as it can be quantified objectively as a function of time, frequency, and/or duration. Nevertheless, little consideration has been given to understanding performance fatigability and its physiological determinants in those with SLE. The purpose of this study was to characterize performance fatigability in patients with SLE, utilizing measures surrounding the anaerobic threshold, with emphasis on cardiorespiratory impairment as a potential mediating factor.Methods: This was a case-control study design. 44 physically inactive women, 26 with SLE and 18 controls, completed a treadmill cardiopulmonary exercise test to volitional exhaustion.Results: There were no significant differences in age (SLE 34.8(9.0) vs Control 36.9(7.3) yrs; p=0.422) between groups. BMI (SLE 27.1(5.4) vs Control 23.8(5.2) kg/m2; p=0.045) was significantly higher in the SLE vs Control group. Resting heart rate (SLE 68(16) vs Control 78(15) bpm; p=0.040) was significantly lower in the SLE compared to the Control group. The VO2 corresponding to the anaerobic threshold (AT-VO2), used to identify the onset of exercise-induced fatigue, was significantly lower in women with SLE than in controls (SLE 12.4(3.1) vs Control 16.4(2.2) ml/kg/min; p<0.001), as was AT-stage (SLE 2.5(0.90) vs Control 3.4(0.78); p=0.002). Additionally, Fatigue Severity Score (FSS) was highly and inversely correlated with AT-VO2 (rho=-0.615; p<0.001) and FSS was highly correlated with Functional Aerobic Impairment Index (FAI; rho=0.663; p<0.001).Conclusion: This study underscores severe performance fatigability in patients with SLE and its link to cardiorespiratory insufficiency. Physiological presentation of performance fatigability was observed during very low intensities of exercise, emphasizing the negative impact it may have on physical function in this population.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"34 1","pages":"51-60"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9897569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9214118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Quantification of Tissue Oxygen Saturation in the Vastus Lateralis Muscle of Chronic Stroke Survivors during a Graded Exercise Test. 在分级运动测试中量化慢性中风存活者腹外侧肌的组织氧饱和度

Cardiopulmonary physical therapy journal

Pub Date : 2023-01-01 Epub Date: 2022-11-07 DOI: 10.1097/cpt.0000000000000208

Allison S Hyngstrom, Jennifer N Nguyen, Toni D Uhrich, Michael T Wright, David D Gutterman, Brian D Schmit, Matthew J Durand

Purpose: This study examined tissue oxygen saturation (StO₂) of the vastus lateralis (VL) muscles of chronic stroke survivors during a graded exercise test (GXT). We hypothesized the reduction in StO₂ will be blunted in the paretic vs. non-paretic VL during a maximum-effort GXT.

Methods: Chronic stroke survivors performed a GXT and StO₂ of the VL in each leg was measured using near infrared spectroscopy. Twenty-six stroke survivors performed a GXT.

Results: At rest, there was no difference in StO₂ between the paretic and non-paretic VL (65±9% vs. 68±7%, respectively, p=0.32). The maximum change in StO₂ from rest during the GXT was greater in the non-paretic vs. the paretic VL (-16±14% vs. -9±10%, respectively, p<0.001). The magnitude of the oxygen resaturation response was also greater in the non-paretic vs. the paretic VL (29±23% vs. 18±15%, respectively, p<0.001). VO₂ Peak was associated with the magnitude of the VL StO₂ change during (r²=0.54, p<0.0001) and after (r²=0.56, p<0.001) the GXT.

Conclusions: During a GXT there is a blunted oxygen desaturation response in the paretic vs. the non-paretic VL of chronic stroke survivors. In the paretic VL there was a positive correlation between the oxygen desaturation response during the GXT and VO₂ Peak.

目的：本研究考察了慢性中风幸存者在分级运动测试（GXT）中的侧阔肌（VL）组织氧饱和度（StO2）。我们假设，在最大负荷 GXT 过程中，瘫痪 VL 与非瘫痪 VL 相比，StO2 的降低幅度会减弱：方法：慢性中风幸存者进行 GXT，并使用近红外光谱测量每条腿 VL 的 StO2。26 名中风幸存者进行了 GXT：静息时，瘫痪和非瘫痪 VL 的 StO2 没有差异（分别为 65±9% 对 68±7%，P=0.32）。在 GXT 期间，非瘫痪 VL 与瘫痪 VL 的 StO2 与静息时相比的最大变化更大（分别为-16±14% vs. -9±10%，p2 峰值与 GXT 期间 VL StO2 变化的幅度相关（r2=0.54，p2=0.56，p结论：在 GXT 期间，慢性中风幸存者的瘫痪 VL 与非瘫痪 VL 相比，氧饱和度降低的反应较弱。在瘫痪的 VL 中，GXT 期间的氧饱和度下降反应与 VO2 峰值呈正相关。

{"title":"Quantification of Tissue Oxygen Saturation in the Vastus Lateralis Muscle of Chronic Stroke Survivors during a Graded Exercise Test.","authors":"Allison S Hyngstrom, Jennifer N Nguyen, Toni D Uhrich, Michael T Wright, David D Gutterman, Brian D Schmit, Matthew J Durand","doi":"10.1097/cpt.0000000000000208","DOIUrl":"10.1097/cpt.0000000000000208","url":null,"abstract":"Purpose: This study examined tissue oxygen saturation (StO2) of the vastus lateralis (VL) muscles of chronic stroke survivors during a graded exercise test (GXT). We hypothesized the reduction in StO2 will be blunted in the paretic vs. non-paretic VL during a maximum-effort GXT.Methods: Chronic stroke survivors performed a GXT and StO2 of the VL in each leg was measured using near infrared spectroscopy. Twenty-six stroke survivors performed a GXT.Results: At rest, there was no difference in StO2 between the paretic and non-paretic VL (65±9% vs. 68±7%, respectively, p=0.32). The maximum change in StO2 from rest during the GXT was greater in the non-paretic vs. the paretic VL (-16±14% vs. -9±10%, respectively, p<0.001). The magnitude of the oxygen resaturation response was also greater in the non-paretic vs. the paretic VL (29±23% vs. 18±15%, respectively, p<0.001). VO2 Peak was associated with the magnitude of the VL StO2 change during (r2=0.54, p<0.0001) and after (r2=0.56, p<0.001) the GXT.Conclusions: During a GXT there is a blunted oxygen desaturation response in the paretic vs. the non-paretic VL of chronic stroke survivors. In the paretic VL there was a positive correlation between the oxygen desaturation response during the GXT and VO2 Peak.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"34 1","pages":"39-50"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9937433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10856916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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