On “Physical Therapist Clinical Practice Guideline for the Management of Individuals With Heart Failure.” Shoemaker MJ, Dias KJ, Lefebvre KM, Heick JD, Collins SM. Phys Ther. 2020;100:14–43. https://doi.org/10.1093/ptj/pzz127; and on “A Knowledge Translation Framework for Optimizing Physical Therapy in Patients With Heart Failure.” Dias KJ, Shoemaker MJ, Lefebvre KM, Heick JD. Phys Ther. 2021;101:pzab079. https://doi.org/10.1093/ptj/pzab079

Abstract

We read with interest, “Physical Therapist Clinical Practice Guideline for the Management of Individuals with Heart Failure,” by Shoemaker et al,1 and its companion article, “A Knowledge Translation Framework for Optimizing Physical Therapy in Patients with Heart Failure,” by Dias et al.2 In the context of this letter, these 2 companion articles are referred to as the physical therapist CPG (clinical practice guideline) and the KT (knowledge translation) article, respectively. The CPG constituted 9 Key Action Statements; 1 being on education and chronic disease management and 8 related to activity and exercise. How health promotion, in this case a focus on heart health, can be integrated into physical therapy CPGs for heart failure as per the CPG and KT articles, has been reported in a health and lifestyle framework for physical therapist CPGs.3 This evidence-informed framework, which complements the 2 PTJ articles, illustrates how the modification of lifestyle practices can be positioned foremost to augment health and responses to activity/exercise interventions prescribed by physical therapists, as well as for cost-effectiveness. Such a framework focuses on augmenting physical activity, function and exercise capacity through not smoking, quality nutrition, weight reduction, alcohol moderation, optimal sleep, and stress management, as well as activity and exercise prescribed by the physical therapist. With a health and lifestyle focus, the CPG for individuals with heart failure would result in superior patient, physical therapy, and economic outcomes by better reflecting the totality of the literature related to heart health and its evidence-informed priority. A health and lifestyle framework for physical therapist CPGs for individuals with heart failure illustrates an example of grounding physical therapist CPGs within such a framework consistent with the extant literature.