Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Functional Status in Post-CABG Patients Following Physiotherapy- A Retrospective Analysis


Affiliations
1 K. M. Patel Institute of Physiotherapy, Karamsad, Anand, Gujarat, India
     

   Subscribe/Renew Journal


Background of objectives: Following CABG, various pulmonary complications may result with significant affection of functional recovery of the patients. This adds into the cost of treatment, prolonged length of stay in the hospital, increased morbidity and mortality . Therefore present study was undertaken to determine the efficacy of physiotherapy treatment in functional recovery of the patients following Coronary artery bypass grafting surgery.

Materials & Method: This was a retrospective study, total 65 participants' data were considered for the analysis, which was retrieved from the medical record department of Shree Krishna hospital. The demographic status, physiotherapy treatment program, functional recovery, average walking distance and length of stay in the hospital were analyzed.

Results: In the present study, the medical record of 65 subjects (84% male and 16% female) were analyzed and average of walking distance, flight of stairs and length of stay was recorded. All the subjects were given preoperative physiotherapy which included chest physiotherapy in the form of deep breathing exercise, thoracic mobility exercise, forced expiratory technique and incentive spirometry as well as post operative physiotherapy regimen taught. Out of 65 subjects, 90% (n=58) had no post operative complications and 10% (n=7) had eventful CABG with associated complications like cardiac arrhythmias in 3 patients, uncontrolled diabetes in 1 patients, long term ionotropic support in 2 patients and pleural effusion in 1 patient etc. The average length of stay of the subjects in hospital following uncomplicated CABG was 6 PODs and 90% of the subjects were discharged by 6th POD.

Conclusion: It had been concluded that all the subjects with uneventful CABG (80%) following physiotherapy became functionally independent on 6th POD, whereas subjects with eventful CABG (10%) on 11th POD.


Keywords

CABG, Functional Status, Post-operative Day, Length of Stay
Subscription Login to verify subscription
User
Notifications
Font Size


  • Vibhuti N Singh et al., Cardiac Rehabilitation, American College Of Cardiology, September 19, 200.
  • Huffman MD, Prabhakaran D., Heart Failure: Epidemiology and Prevention in India.
  • Eagle, KA, Guyton RA, Davidoff R et al (October 5, 2004), “ ACC/AHA 2004 guideline update for CABG : a report of ACC/AHA.
  • Gary J. balady et al., Core components of cardiac rehabilitation/secondary prevention programs, AHA/AACVPR Scientific statement(May 2000).
  • Randal J. Thomas et al., Performance Measures on Cardiac Rehabilitation for Referral to and Delivery of Cardiac Rehabilitation/secondary prevention services, AACVPR/ACC/AHA Performance Measure.
  • Randal J. Thomas et al., Performance Measures on Cardiac Rehabilitation for Referral to and Delivery of Cardiac Rehabilitation/secondary prevention services, AACVPR/ACC/AHA Performance Measure.
  • Indians at Risk, Nivh Chennai.2010
  • Definition of functional status .http:// jech.bmj.com/content/55/7/452.full.
  • Inge D. van der Peijl et al., exercise therapy after CABG, October 28, 2003.
  • Barry L. zaret M.D, cardiac rehabilitation, chapter 28, pg no. 351.
  • Best practice evidence based guideline, cardiac rehabilitation, august 2002, chapter 2, pg no. 5.
  • Victor F. Froelicher, Exercise and Heart, 5th edition, pg no. 464.
  • Moholdt T T et al., department of circulation and medical imaging, Trondheim, Norway, aerobic interval training versus continuous moderate exercise after CABG: a randomized study of cardiovascular effects and quality of life, a m heart journal 2009 december:158(6):1031-7.
  • Hansen D. et al., rehabilitation and health care, Belgium, reduction of cardiovascular event rate: different effects of cardiac rehabilitation in CABG and PCI patients, Acta cardial 2009 October; 64(5): 639-44.
  • Urell c et al., department of physiotherapy, Uppsala, Sweden, deep breathing exercises with positive expiratory pressure at a higher rate improve oxygenation in the early period after cardiac surgery- a randomized controlled trail, Eur J cardiothorac surg. 2010 december
  • Elisabeth Westerdahl et al., department of physiotherapy and thoracic surgery, Uppsala, Sweden, chest physiotherapy after CABG- a comparision of three different deep breathing techniques, J Rehab Med 2001; 33:79-84.
  • Tzani P et al., cardiopulmonary department, Italy,patient assessment and prevention of pulmonary side effects in surgery,Carropin Anaesthesiol,2011 Feb;24(1):2-7.
  • Craven JL, Evan GA, Davenport PJ,Williams RHP.The evaluation of the incentive spirometer in the management of post operative complications,Br J Surg. 1974;61:793-797.
  • Erik H. J. Hulzebos et al.,Americal medical association, Netherland,evaluation of the prophylactic efficacy of preoperative inspiratory muscle training on the incidence of post operative pulmonary complications in high risk patients scheduled for elective CABG surgery, JAMA 2011.
  • Elisabeth Westerdahl et al., department of physiotherapy, Sweden, deep breathing exercises reduce atelectasis and improve pulmonary function after CABG, june 2005, vol. 128 no. 5 3482-3488.
  • Mehta Y et al., department of anesthesia and critical care, physiotherapy and cardiac surgery, New delhi, incidence and management of diaphragmatic palsy in patients after cardiac surgery; Indian J crit care Med. 2008 july: 12(3) 91-5.
  • Proposal and validation of a new functional ambulation classification scale for clinical use II mediterranean congress of physical medicine and rehabilitation,May 2000,spain.
  • William L. Haskell et al.,physical activity and public health:updated recommendation for adults from American college of sports medicine and American heart association. Med.sci.sports Exerc.,vol.39,No.8,pp.1423-1434,2007.
  • Serruys P.W. et al., PCI versus CABG for severe CAD, N Engl J Med 360(10): 961-72, march 2009.
  • Heart attack and cardiac arrest in men, men’s health, april 2011.
  • Women and coronary artery disease, heart disease health center, may 2009.
  • Sansone GR.et al., newyork, analysis of FIM instrument scores for patients admitted to an inpatient cardiac rehabilitation program. Arch, phys Med Rehabil 2002, apr,83(4): 506-12.
  • KongKH et al., department of physical medicine and rehabilitation, usa, functional outcome of patients on a rehabilitation unit after open heart surgery, J Cardiopulm Rehabil. 1996, nov-dec; 16(6): 413-8.
  • Convertino VA: effect of orthostatic stress on exercise performance after bed rest: relation to in- hospital rehabilitation: J cardiopulm rehabil 1983;3:660-663.

Abstract Views: 1055

PDF Views: 0




  • Functional Status in Post-CABG Patients Following Physiotherapy- A Retrospective Analysis

Abstract Views: 1055  |  PDF Views: 0

Authors

Vinod K. Ravaliya
K. M. Patel Institute of Physiotherapy, Karamsad, Anand, Gujarat, India

Abstract


Background of objectives: Following CABG, various pulmonary complications may result with significant affection of functional recovery of the patients. This adds into the cost of treatment, prolonged length of stay in the hospital, increased morbidity and mortality . Therefore present study was undertaken to determine the efficacy of physiotherapy treatment in functional recovery of the patients following Coronary artery bypass grafting surgery.

Materials & Method: This was a retrospective study, total 65 participants' data were considered for the analysis, which was retrieved from the medical record department of Shree Krishna hospital. The demographic status, physiotherapy treatment program, functional recovery, average walking distance and length of stay in the hospital were analyzed.

Results: In the present study, the medical record of 65 subjects (84% male and 16% female) were analyzed and average of walking distance, flight of stairs and length of stay was recorded. All the subjects were given preoperative physiotherapy which included chest physiotherapy in the form of deep breathing exercise, thoracic mobility exercise, forced expiratory technique and incentive spirometry as well as post operative physiotherapy regimen taught. Out of 65 subjects, 90% (n=58) had no post operative complications and 10% (n=7) had eventful CABG with associated complications like cardiac arrhythmias in 3 patients, uncontrolled diabetes in 1 patients, long term ionotropic support in 2 patients and pleural effusion in 1 patient etc. The average length of stay of the subjects in hospital following uncomplicated CABG was 6 PODs and 90% of the subjects were discharged by 6th POD.

Conclusion: It had been concluded that all the subjects with uneventful CABG (80%) following physiotherapy became functionally independent on 6th POD, whereas subjects with eventful CABG (10%) on 11th POD.


Keywords


CABG, Functional Status, Post-operative Day, Length of Stay

References