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Arzu Genc Seher Ozyurek Ugur Koca Ali Gunerli 《Cardiopulmonary Physical Therapy Journal》2012,23(1):14-18
Purpose
The aim of this study was to investigate the effects of mobilization on respiratory and hemodynamic parameters in critically ill obese patients.Methods
Critically ill obese patients (n = 31) were included in this retrospective study. Data were collected from patients’ files and physiotherapy records of mobilization sessions. Heart rate (HR), systolic/diastolic/mean blood pressure, respiratory rate (RR), and percutaneous oxygen saturation (SpO2) were recorded. Cardiorespiratory parameters were collected just prior to the mobilization, just after the completion of the mobilization and after 5 minutes recovery period. Respiratory reserve was calculated before and after the mobilization.Results
A total of 37 mobilization sessions in 31 obese patients (mean age: 63.3 years, mean BMI: 32.2 kg/m2) who received physiotherapy were analyzed. Respiratory rate increased significantly after the completion of the mobilization compared to initial values (p < 0.05). SpO2 significantly increased (p < 0.05) and all other parameters remained similar (p > 0.05) compared to initial values after the recovery period. Mobilization resulted in a significant increase in respiratory reserve (p < 0.05).Conclusion
Early mobilization in intensive care unit promotes respiratory reserve in obese patients. We found that mobilization can be performed safely in critically ill obese patients if cardiorespiratory parameters are continuously monitored.Key Words: obesity, mobilization, critically ill patients, physiotherapy 相似文献2.
Purpose
The purpose of this review is to evaluate the literature related to mobilization of the critically ill patient with an emphasis on functional outcomes and patient safety.Methods
We searched the electronic databases of PubMed, CINAHL, Medline (Ovid), and The Cochrane Library for a period spanning 2000–2011. Articles used in this review included randomized and nonrandomized clinical trials, prospective and retrospective analyses, and case series in peer-reviewed journals. Sackett''s Levels of Evidence were used to classify the current literature to evaluate the strength of the outcomes reported.Results
Fifteen studies met inclusion criteria and were reviewed. According to Sackett''s Levels of Evidence, 9 studies were level 4 evidence, one study was level 3, 4 studies were level 2, and one study was level one evidence. Ten studies pertained to patient safety/feasibility and 10 studies pertained to functional outcomes with 5 fitting into both categories.Conclusion
A search of the scientific literature revealed a limited number of studies that examined the mobilization of critically ill patients in the intensive care unit. However, literature that does exist supports early mobilization and physical therapy as a safe and effective intervention that can have a significant impact on functional outcomes.Key Words: mobilization, exercise, intensive care unit, critical illness, physical therapy 相似文献3.
I Anne Leditschke Margot Green Joelie Irvine Bernie Bissett Imogen A. Mitchell 《Cardiopulmonary Physical Therapy Journal》2012,23(1):26-29
Purpose
Recently there has been increased interest in early mobilization of critically ill patients. Proposed benefits include improvements in respiratory function, muscle wasting, intensive care unit (ICU), and hospital length of stay. We studied the frequency of early mobilization in our intensive care unit in order to identify barriers to early mobilization.Methods
A 4-week prospective audit of 106 patients admitted to a mixed medical-surgical tertiary ICU (mean age 60 ± 20 years, mean APACHE II score 14.7 ± 7.8) was performed. Outcome measures included number of patient days mobilized, type of mobilization, adverse events, and reasons for inability to mobilize.Results
Patients were mobilized on 176 (54%) of 327 patient days. Adverse events occurred in 2 of 176 mobilization episodes (1.1%). In 71 (47%) of the 151 patient days where mobilization did not occur, potentially avoidable factors were identified, including vascular access devices sited in the femoral region, timing of procedures and agitation or reduced level of consciousness.Conclusions
Critically ill patients can be safely mobilized for much of their ICU stay. Interventions that may allow more patients to mobilize include: changing the site of vascular catheters, careful scheduling of procedures, and improved sedation management.Key Words: intensive care units, mobility, physical therapy 相似文献4.
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Although recommended in most treatment guidelines for child/adolescent rehabilitation, there is a lack of standards regarding the amount of exercise therapy that children and adolescents should receive during rehabilitation to ensure effective treatment. First, existing treatment guidelines were examined with regard to data on the frequency, duration, content, and modes of procedure of exercise therapy in the treatment of children and adolescents with asthma, obesity, and atopic dermatitis. Moreover, the actual implementation of exercise therapy in child/adolescent rehabilitative care was analyzed by using standardized data on the classification of therapeutic measures of the years 2007/2008 and comparing different rehabilitation centers. In the context of a nationwide survey, experts and clinicians were asked to describe and define how exercise therapy can be adopted in rehabilitative practice. On this basis, an expert workshop was conducted during which a pilot version of treatment guidelines for child/adolescent rehabilitation was developed and compared with actual medical care practice. Obese children/adolescents receive the highest amount of exercise therapy (4.7 h/week). However, children suffering from atopic dermatitis engage just as long in therapeutic exercises (1.9 h/week) as do children with asthma (1.9 h/week). Exercise therapy modules vary significantly between rehabilitation centers in terms of average frequency and duration. When comparing treatment guidelines and actual medical practice, it becomes apparent that only children up to the age of 7 with atopic dermatitis or asthma are provided to some degree adequately with exercise therapeutic treatment, whereas children aged 8 or older with asthma and/or obesity receive too little exercise therapy. Potential reasons for large variations between rehabilitation centers regarding the use of exercise therapy as well as possible factors that influence discrepancies between actual rehabilitative care practice and therapeutic guidelines are discussed. 相似文献
7.
康复运动处方对青少年支气管哮喘患者呼吸机能的影响 总被引：1，自引：0，他引：1
观察康复运动处方对青少年支气管哮喘患者呼吸机能的影响。支气管哮喘患者31例，随机分成A、B两组，A组11例维持已有的药物治疗；B组20例在已有药物治疗基础上实施康复运动处方。两组的观察时间均为12周，对所有患者试验前后的哮喘症状、肺功能及不良反应进行了随访观察和测定。结果：肺活量、肺功能FEV1、PEF明显改善，提示哮喘症状呈逐步稳定状态。喘息、痰量、哮呜音症状改善有效率分别为A组63．64％、45．45％、54．56％；B组85％、75％、80％。试验所取得的正向效果。证明了康复运动处方对改善和提高青少年支气管哮喘患者的呼吸机能有显著效果． 相似文献
8.
Purpose: To determine the safety and feasibility of early physical therapy in the intensive care unit in a patient with biventricular assist device. Methods: Physical therapy started on the first postoperative day and continued till discharge including airway clearance, lower/upper extremity exercises, and mobilization. Heart rate (HR), respiratory rate (RR), systolic/diastolic/mean arterial pressures, peripheral oxygen saturation, and double product were recorded before treatment, after treatment, and 5 minutes after treatment. Results: In total, 15 sessions of physical therapy were implemented for a 41-year-old male patient during 21 days following implantation of a biventricular assist device. Normal physiological responses were seen in response to treatment. Heart rate increased significantly after treatment in comparison to pretreatment values (p = 0.02) and decreased significantly after 5 minutes (p = 0.03) and approached pretreatment values. Respiratory rate increased nonsignificantly after treatment and decreased significantly after 5 minutes (p = 0.001) and approached pretreatment values. Conclusion: Physical therapy in the intensive care unit in a patient with biventricular assist device resulted in significant increases within HR and RR in physiological limits. Ongoing monitoring of vital signs is recommended in order to observe physiological responses to early physical therapeutic interventions in the intensive care unit.Key Words: biventricular assist device, physical therapy, intensive care unit 相似文献
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Eleni A. Kortianou Ioannis G. Nasis Stavroula T. Spetsioti Andreas M. Daskalakis Ioannis Vogiatzis 《Cardiopulmonary Physical Therapy Journal》2010,21(3):12-19
Physical training is beneficial and should be included in the comprehensive management of all patients with COPD independently of disease severity. Different rehabilitative strategies and training modalities have been proposed to optimize exercise tolerance. Interval exercise training has been used as an effective alternative modality to continuous exercise in patients with moderate and severe COPD.Although in healthy elderly individuals and patients with chronic heart failure there is evidence that this training modality is superior to continuous exercise in terms of physiological training effects, in patients with COPD, there is not such evidence. Nevertheless, in patients with COPD application of interval training has been shown to be equally effective to continuous exercise as it induces equivalent physiological training effects but with less symptoms of dyspnea and leg discomfort during training.The main purpose of this review is to summarize previous studies of the effectiveness of interval training in COPD and also to provide arguments in support of the application of interval training to overcome the respiratory and peripheral muscle limiting factors of exercise capacity. To this end we make recommendations on how best to implement interval training in the COPD population in the rehabilitation setting so as to maximize training effects.Key Words: interval exercise training, chronic obstructive pulmonary disease, exercise tolerance, pulmonary rehabilitation 相似文献
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The purpose of this study was to expand our knowledge and increase our understanding of imagery use by athletes in sport-injury rehabilitation using a qualitative approach. The participants were 10 injured athletes who were receiving physiotherapy at the time they were interviewed. During the interviews, the athletes provided extensive information about their use of imagery during injury rehabilitation and it was clear that they believed imagery served cognitive, motivational and healing purposes in effectively rehabilitating an injury. Cognitive imagery was used to learn and properly perform the rehabilitation exercises. They employed motivational imagery for goal setting (e.g. imagined being fully recovered) and to enhance mental toughness, help maintain concentration and foster a positive attitude. Imagery was used to manage pain. The methods they employed for controlling pain included using imagery to practise dealing with expected pain, using imagery as a distraction, imagining the pain dispersing, and using imagery to block the pain. With respect to what they imaged (i.e. the content of their imagery), they employed both visual and kinaesthetic imagery and their images tended to be positive and accurate. It was concluded that the implementation of imagery alongside physical rehabilitation should enhance the rehabilitation experience and, therefore, facilitate the recovery rates of injured athletes. Moreover, it was recommended that those responsible for the treatment of injured athletes (e.g. medical doctors, physiotherapists) should understand the benefits of imagery in athletic injury rehabilitation, since it is these practitioners who are in the best position to encourage injured athletes to use imagery. 相似文献
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韩旭升 《体育科技文献通报》2010,18(9):86-86,104
太极拳是中华智慧的结晶，它融武术、气功、导引为一体，以其独特的养生保健功效，越来越为世人所瞩目。从现代医学的角度看，太极拳对中老年人神经系统和心理状态、运动系统和呼吸系统、心血管系统和消化系统都有良好的调节作用。 相似文献
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目的探讨并评估运动康复锻炼对PCI术后患者心功能、运动耐力、不良心血管事件、生活质量的影响。方法检索运动康复锻炼对PCI术后患者心功能及生活质量的影响的相关研究文献。将运动干预后患者心功能相关指标、不良心血管事件发生情况、生活质量各维度评分与干预前、常规治疗对照组进行对比。结果较多研究显示,参加运动康复锻炼可改善患者心功能状态、降低不良心血管事件发生率、提高运动耐力及生活质量。也有部分研究表明,运动康复锻炼对术后患者部分心功能指标无明显改善,对部分不良心血管事件的发生无明显影响。结论长期规范化的运动康复训练,可显著提高PCI术后患者左心室射血分数、改善NYHA心功能分级、增大6 min步行距离、降低心源性死亡率、再发心绞痛率、血运重建率、冠状动脉造影、再住院风险、提高生活质量各维度评分而对再发心肌梗塞、冠状动脉搭桥术无明显影响。 相似文献
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运动与2型糖尿病治疗的研究述评 总被引：8，自引：0，他引：8
运动被认为是2型糖尿病（非胰岛素依赖型）病人治疗康复的基石，传统认为有氧耐力运动是最适宜的运动模式，目前许多研究发现抵抗性训练对治疗2型糖尿病也有效。因此，提出针对2型糖尿病人个体的最理想的运动方案应当是包括改善心肺功能、肌肉力量和耐力等的有氧耐力训练和抵抗性训练的综合方案，包括各种运动模式的运动方案都能积极地影响病人对运动方案的适应性。2型糖尿病人从事个性化的训练，发生并发症的危险性显著降低。 相似文献
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Ann Knocke 《Cardiopulmonary Physical Therapy Journal》2012,23(3):46-48
Aerobic exercise and resistance training have been proven to be beneficial for patients with heart failure. Current reimbursement guidelines exclude these patients from our traditional cardiac rehabilitation program, so at Newton Wellesley Hospital a clinic model was developed for the disease management and exercise of heart failure patients.Key Words: heart failure, physical therapy, exercise 相似文献
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杜雷 《体育科技文献通报》2007,15(4):82-82,90
对持续进行10个月游泳锻炼的60名大学一年级女学生锻炼前后身体成分和心肺功能进行测试分析。结果显示,长期游泳锻炼可一定程度降低女大学生体脂百分比,减轻体重,减慢安静心率、呼吸频率,降低血压,提高肺活量。提示游泳锻炼有利于保持大学生体型健美,改善其心血管、呼吸系统功能。 相似文献
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In this study, we examine the effect of exercise on the time and flow characteristics of the respiratory cycle profile at the point of volitional exercise termination. Eight males (mean age 29 years, s = 10; body mass 74 kg, s = 7; height 1.75 m, s = 0.04) undertook a cycle test to volitional exhaustion on a cycle ergometer, which allowed peak oxygen uptake (VO(2peak)) to be measured (mean 51 ml x kg(-1) x min(-1), s = 7). At a later date, two sub-maximal tests to volitional exhaustion were completed in a random order at 76% (s = 6) and 86% VO(2peak) (s = 7). As expected, the magnitude of the respiratory flow and time characteristics varied with the three exercise intensities, as did the point of exercise termination and terminal ventilation rates, which varied from 7 to 27 min and 112 to 132 litres x min(-1) respectively. More importantly, however, at exercise termination some of the characteristics were similar, particularly the breathing frequency (at termination 49 breaths x min(-1)), the ratio between inspiration and total breath time (0.5), and the later occurrence of peak inspiratory flow (0.24-0.48 s). The coincident unity of these time and flow profile characteristics at exercise termination illustrates how the integration of timing and flow during breathing influence exercise capacity in non-elite athletes. 相似文献
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以人民健康为中心,主动健康为导向,发挥全民科学健身在健康促进、慢性病预防和康复等方面的积极作用,把健康关口前移到健康维护和疾病防控,推动形成“体医融合”的疾病管理与健康服务模式,是健康中国行动的目标与任务。国家运动处方库建设是在健康中国战略指引下,在借鉴学习国外运动处方研究、推广和应用先进成果的基础上,通过对我国运动处方内容系统、运动处方师培训系统、运动处方应用系统的构建,通过健康人群、疾病风险人群、慢性疾病人群、功能受损人群、发展性障碍人群运动处方的制定及运动处方推广应用路径的选择,将我国运动处方的研究、推广和应用向着科学、严谨、规范、深入推进,让具有科学性、针对性、有效性、可操作性并适合中国人体质特点的运动处方惠及我国亿万民众,为增强国民体质、增进国民健康,实现健康中国目标做出应有贡献,为世界运动处方的理论与实践提供中国经验与借鉴。 相似文献