The physiotherapy management of patients undergoing coronary artery surgery: A questionnaire survey

Tucker, Beatrice; Jenkins, Sue; Davies, Kim; McGann, Romola; Waddell, Julie; King, Rebecca; Kirby, Vanessa; Lloyd, C.R.

doi:10.1016/s0004-9514(14)60445-1

Cited by 35 publications

(42 citation statements)

References 28 publications

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“…[8]. The educational content of the preoperative information was similar, with early mobilization, post-sternotomy recovery and postoperative pulmonary function being the topics most covered.…”

Section: Discussionmentioning

confidence: 99%

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Physiotherapy-supervised mobilization and exercise following cardiac surgery: a national questionnaire survey in Sweden

Westerdahl

Möller

2010

J Cardiothorac Surg

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BackgroundLimited published data are available on how patients are mobilized and exercised during the postoperative hospital stay following cardiac surgery. The aim of this survey was to determine current practice of physiotherapy-supervised mobilization and exercise following cardiac surgery in Sweden.MethodsA prospective survey was carried out among physiotherapists treating adult cardiac surgery patients. A total population sample was identified and postal questionnaires were sent to the 33 physiotherapists currently working at the departments of thoracic surgery in Sweden. In total, 29 physiotherapists (response rate 88%) from eight hospitals completed the survey.ResultsThe majority (90%) of the physiotherapists offered preoperative information. The main rationale of physiotherapy treatment after cardiac surgery was to prevent and treat postoperative complications, improve pulmonary function and promote physical activity. In general, one to three treatment sessions were given by a physiotherapist on postoperative day 1 and one to two treatment sessions were given during postoperative days 2 and 3. During weekends, physiotherapy was given to a lesser degree (59% on Saturdays and 31% on Sundays to patients on postoperative day 1). No physiotherapy treatment was given in the evenings. The routine use of early mobilization and shoulder range of motion exercises was common during the first postoperative days, but the choice of exercises and duration of treatment varied. Patients were reminded to adhere to sternal precautions. There were great variations of instructions to the patients concerning weight bearing and exercises involving the sternotomy. All respondents considered physiotherapy necessary after cardiac surgery, but only half of them considered the physiotherapy treatment offered as optimal.ConclusionsThe results of this survey show that there are small variations in physiotherapy-supervised mobilization and exercise following cardiac surgery in Sweden. However, the frequency and duration of exercises and recommendations for sternal precautions reinforced for the healing period differ between physiotherapists. This survey provides an initial insight into physiotherapy management in Sweden. Comparison with surveys in other countries is warranted to improve the physiotherapy management and postoperative recovery of the cardiac surgery patient.

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Section: Discussionmentioning

confidence: 99%

“…Physiotherapy management of patients undergoing coronary artery bypass graft (CABG) surgery [8] and thoracic surgery [9] has been examined in Australia and New Zealand. However, we found no such study performed in Europe.…”

Section: Introductionmentioning

confidence: 99%

Physiotherapy-supervised mobilization and exercise following cardiac surgery: a national questionnaire survey in Sweden

Westerdahl

Möller

2010

J Cardiothorac Surg

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“…Using a mailed questionnaire, Tucker et al surveyed senior physiotherapists working with coronary artery surgery patients in 23 public hospitals (22 responses) and 19 private hospitals (13 responses) in Australia and New Zealand; data were gathered in 1995. 16 Similarly, Reeve and Ewan mailed a questionnaire to the senior physiotherapist in each of the 52 cardiothoracic units in the United Kingdom, receiving 40 responses in total; their data collection was completed by 2000. 17 Our telephone survey involved 18 hospitals that conduct cardiac surgery; we asked a designated physical therapist in each hospital to reply on the basis of practice at that hospital.…”

Section: Discussionmentioning

confidence: 99%

“…Surveys on the specific use of incentive spirometry in the United Kingdom indicated usage rates of 44% in 1986 18 and 71% in 1998. 19 Sustained maximal inspirations are used more frequently in New Zealand and Australia (75%) 16 than in the United Kingdom (55%) 17 or in Canada (22%). Deep breathing and coughing were used in the vast majority of hospitals in all three studies, as were both upper-and lowerextremity exercises.…”

Section: Discussionmentioning

confidence: 99%

Physical Therapy Management for Adult Patients Undergoing Cardiac Surgery: A Canadian Practice Survey

Overend¹,

Anderson²,

Jackson³

et al. 2010

Physiotherapy Canada

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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 ¼ 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. RÉ SUMÉObjectif : É tablir en quoi consiste la pratique actuelle en physiothé rapie au Canada pour les patients adultes qui ont besoin de soins intermé diaires à la suite d'une chirurgie cardiaque. Mé thodes : Un sondage té lé phonique a é té ré alisé auprè s d'un é chantillon choisi d'hô pitaux canadiens (n ¼ 18) afin de ré pertorier les soins cardiorespiratoires et pour la mobilité , les exercices et la ré adaptation offerts aux patients qui subissent une chirurgie cardiaque. Ré sultats : En moyenne, 21 chirurgies cardiaques par semaine (entre 6 et 42 interventions) ont é té pratiqué es dans les é tablissements sondé s et ces interventions ont occasionné des sé jours à l'hô pital d'une moyenne de 6,4 jours (de 4,0 à 10,6 jours par é tablissement). Les patients é taient vus de fac¸on proactive dans 7 des 18 hô pitaux sondé s et au premier jour de la pé riode postopé ratoire (JPP-1) dans 16 des 18 hô pitaux. Au JPP-1, 16 é tablissements ont demandé au patient de prendre de grandes respirations et de tousser, 7 ont utilisé des spiromè tres incitatifs, 13 ont procé dé à des exercices des membres supé rieures et 12 à des exercices des membres infé rieurs. Neuf sites ont offert des soins cardiorespiratoires au jour 3. Au jour 1, les patients é taient aidé s à s'asseoir et à se redresser dans 17 hô pitaux, et mobilisé s hors de leur lit dans 13 é tablissements. Au jour 3 aprè s l'intervention, les patients marchaient de 50 à 120 m, de 2 à 5 fois par jour. Les mesures de pré cautions sternales variaient selon les cas, mais la limite de charge dé c...

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“…1 A recent systematic review provided evidence that such interventions were ineffective at preventing PPC in this population, although it was acknowledged that the component studies were often of low quality, and that Heart, Lung and Circulation Supervised exercise improves distance walked following CABG 2008;17:129-138 cise' and 'breathing exercise'. We found no studies of the effect of Phase 1 mobilisation per se on walking ability, respiratory capacity, subjective health or length of hospital stay following CABG.…”

Section: Introductionmentioning

confidence: 99%

Supervised Moderate Intensity Exercise Improves Distance Walked at Hospital Discharge Following Coronary Artery Bypass Graft Surgery—A Randomised Controlled Trial

Hirschhorn

Richards

Mungovan

et al. 2008

Heart, Lung and Circulation

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The physiotherapy management of patients undergoing coronary artery surgery: A questionnaire survey

Cited by 35 publications

References 28 publications

Physiotherapy-supervised mobilization and exercise following cardiac surgery: a national questionnaire survey in Sweden

Physiotherapy-supervised mobilization and exercise following cardiac surgery: a national questionnaire survey in Sweden

Physical Therapy Management for Adult Patients Undergoing Cardiac Surgery: A Canadian Practice Survey

Supervised Moderate Intensity Exercise Improves Distance Walked at Hospital Discharge Following Coronary Artery Bypass Graft Surgery—A Randomised Controlled Trial

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