Physical therapy in the intensive care unit in a patient with biventricular assist device.

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.

Haemodynamic effects of physiotherapy programme in intensive care unit after liver transplantation.

OBJECTIVE: To determine the haemodynamic effects of intensive care physiotherapy after liver transplantation. PATIENTS AND METHODS: Thirteen patients were included in the study after liver transplantation. The following physiotherapy programme were applied to the patients in intensive care unit: Respiratory physiotherapy, active joint movements, sitting in bed (first task), sitting at the edge of bed (second task), standing (third task), sitting out of bed (fourth task) and walking (fifth task). Heart rate (HR), mean, systolic and diastolic blood pressures (MBP, SBP, DBP), peripheral oxygen saturation (SpO(2)), respiration rate (RR) were recorded before treatment, after each task, after treatment and at the fifth minute of recovery. Pain level was assessed with Visual Analogue Scale (0-10). RESULTS: When compared with supine position before treatment, all of the parameters except RR increased after the first task whereas HR, SBP, MBP and pain increased after the second task. After the third task only HR and pain increased. There was no significant difference between the fourth task and pre-treatment values while HR, DBP and pain increased after the fifth task. When measurements of pre-treatment, immediately after treatment and the fifth minute of recovery were compared HR, MBP and pain increased after treatment whereas HR, RR and pain decreased after recovery. There was no significant difference between pre-treatment values and fifth minute of recovery measurements. CONCLUSION: Returning to initial values after a 5-min period shows that cardiopulmonary changes caused by intensive care physiotherapy after liver transplantation are responded at physiological limits.

Reference accuracy in four rehabilitation journals.

OBJECTIVE: To investigate the incidence of reference errors in major peer-reviewed general physical therapy and rehabilitation journals (American Journal of Physical Medicine and Rehabilitation (AJPMR), Archives of Physical Medicine and Rehabilitation (APMR), Clinical Rehabilitation (CR) and Physical Therapy (PT)). DESIGN: Descriptive, comparative. MAIN OUTCOME MEASURES: All issues of the AJPMR, APMR, CR and PT between 2003 and 2007 were studied. For each journal, references from articles were consecutively numbered, and using a random number generator, 100 references were selected from each journal. For each reference, ease of retrieval on MEDLINE and the presence of citation errors were noted. If discrepancies were identified, the reference was compared with the original publication. Two observers independently evaluated each reference for citation errors. RESULTS: The total number of citations with errors among all published journals was 123 (30.7%). The reference error rates by journal ranged from 23% to 44%. Most errors (48.0%) occurred in the author element, followed by the title (31.7%), journal (8.9%), page (5.7%), year (4.1%), and volume (1.6%). Only 8 (2%) were likely to make retrieval of the reference difficult. CONCLUSIONS: Errors in references still appear in current physical therapy and rehabilitation literature, but most are not severe.