Literature DB >> 21629599

Physical therapy management for adult patients undergoing cardiac surgery: a canadian practice survey.

Tom J Overend1, Cathy M Anderson, Jennifer Jackson, S Deborah Lucy, Monique Prendergast, Susanne Sinclair.   

Abstract

PURPOSE: To determine current Canadian physical therapy practice for adult patients requiring routine care following cardiac surgery.
METHODS: A telephone survey was conducted of a selected sample (n=18) of Canadian hospitals performing cardiac surgery to determine cardiorespiratory care, mobility, exercises, and education provided to patients undergoing cardiac surgery.
RESULTS: An average of 21 cardiac surgeries per week (range: 6-42) were performed, with an average length of stay of 6.4 days (range: 4.0-10.6). Patients were seen preoperatively at 7 of 18 sites and on postoperative day 1 (POD-1) at 16 of 18 sites. On POD-1, 16 sites performed deep breathing and coughing, 7 used incentive spirometers, 13 did upper-extremity exercises, and 12 did lower-extremity exercises. Nine sites provided cardiorespiratory treatment on POD-3. On POD-1, patients were dangled at 17 sites and mobilized out of bed at 13. By POD-3, patients ambulated 50-120 m per session 2-5 times per day. Sternal precautions were variable, but the lifting limit was reported as ranging between 5 lb and 10 lb.
CONCLUSIONS: Canadian physical therapists reported the provision of cardiorespiratory treatment after POD-1. According to current available evidence, this level of care may be unnecessary for uncomplicated patients following cardiac surgery. In addition, some sites provide cardiorespiratory treatment techniques that are not supported by evidence in the literature. Further research is required.

Entities:  

Keywords:  cardiac surgery; cardiorespiratory; clinical practice; physical therapy; survey

Year:  2010        PMID: 21629599      PMCID: PMC2909859          DOI: 10.3138/physio.62.3.215

Source DB:  PubMed          Journal:  Physiother Can        ISSN: 0300-0508            Impact factor:   1.037


  12 in total

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2.  Physiotherapy following cardiac surgery: is it necessary during the intubation period?

Authors:  S Patman; D Sanderson; M Blackmore
Journal:  Aust J Physiother       Date:  2001

Review 3.  The effect of incentive spirometry on postoperative pulmonary complications: a systematic review.

Authors:  T J Overend; C M Anderson; S D Lucy; C Bhatia; B I Jonsson; C Timmermans
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4.  Reducing postoperative pulmonary complications in cardiac surgery patients with the use of the best evidence.

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Review 5.  Applying evidence standards to rehabilitation research.

Authors:  Mark V Johnston; Mark Sherer; John Whyte
Journal:  Am J Phys Med Rehabil       Date:  2006-04       Impact factor: 2.159

6.  Current activity guidelines for CABG patients are too restrictive: comparison of the forces exerted on the median sternotomy during a cough vs. lifting activities combined with valsalva maneuver.

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Review 7.  Is chest physiotherapy necessary after cardiac surgery?

Authors:  D K Thornlow
Journal:  Crit Care Nurse       Date:  1995-06       Impact factor: 1.708

8.  Evidence based medicine: what it is and what it isn't.

Authors:  D L Sackett; W M Rosenberg; J A Gray; R B Haynes; W S Richardson
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9.  Does removal of deep breathing exercises from a physiotherapy program including pre-operative education and early mobilisation after cardiac surgery alter patient outcomes?

Authors:  Phillip A Brasher; Kirstin H McClelland; Linda Denehy; Ian Story
Journal:  Aust J Physiother       Date:  2003

10.  Physiotherapy after coronary artery surgery: are breathing exercises necessary?

Authors:  S C Jenkins; S A Soutar; J M Loukota; L C Johnson; J Moxham
Journal:  Thorax       Date:  1989-08       Impact factor: 9.139

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6.  Inpatient cardiac rehabilitation programs' exercise therapy for patients undergoing cardiac surgery: National Korean Questionnaire Survey.

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7.  Assessment of the Quality of Life in Patients before and after Coronary Artery Bypass Grafting (CABG): A Prospective Study.

Authors:  Stana Pačarić; Tajana Turk; Ivan Erić; Želimir Orkić; Anamarija Petek Erić; Andrea Milostić-Srb; Nikolina Farčić; Ivana Barać; Ana Nemčić
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