Abstract
Objective: To find out the current practice patterns of Physiotherapists in Phase I Cardiac Rehabilitation of patients following Cardiac Surgery (CABG/Valve Surgery).
 Materials and Methods: The cross sectional survey included 600 cardio-pulmonary physiotherapists working in Cardiac Care Unit, who filled questionnaires sent to them through e-mail.
 Results: 252 completed questionnaires were received back, the response rate being of 42 %, with a major portion of responses coming from Maharashtra, Karnataka and Andhra Pradesh. More than 80 % of physiotherapists assess and treat the patient Pre- Operatively. More than 90% of physiotherapists performed Cardiac Rehabilitation Post-Operatively. Cardiac Rehabilitation Treatment Techniques predominantly focused on Breathing Exercises (96.7%), Incentive Spirometry (91.1%), Coughing and Huffing (83.3%), Thoracic Expansion Exercises (82.13%), Positioning (71.16%), Percussion and Vibration (63.6%), Modified Postural Drainage (41.2%), active exercises of the upper limb (89.13%), and lower limb exercises (89.3%). Dangling the lower limb (69%) was started on Post –Operative day 2. Room and corridor mobilisation (73.8%) began on third Post-Operative day. 29.4% Stair case climbing was started on fourth post-operative day. 73.8% of patients practiced 6-minute walk test prior to discharge. Most commonly used sternal precautions were Supported Coughing (96.0%) and Lifting Restrictions (82.5%).
 Conclusion: Phase I cardiac rehabilitation adopted by physiotherapists for cardiac surgery patients involves treatment which mainly focused on cough and huff techniques, breathing exercises and thoracic expansion exercises. On Post-Operative day 2, dangling the lower limb and room ambulation started on third post-Operative day 3. The training for climbing stairs started on fourthpost-operative day. The most commonly used sternal precautions were supported coughing and lifting restrictions whereas 6-minute walk test was use to assess exercise tolerance,prior to discharge.
 Bangladesh Journal of Medical Science Vol.19(2) 2020 p.214-222
Highlights
There are no studies which have been conducted to find optimal chest physiotherapy care given to patient following Cardiac Surgery in India.To our knowledge, there exists no survey’s discussing the Post-Operative Phase I Cardiac Rehabilitation practise following Cardiac Surgery (CABG/valve surgery).The study was aimed at analysing the current practice patterns among physiotherapists in Phase I Cardiac Rehabilitation following Cardiac Surgery (CABG/Valve Surgery)
Content validation: Seven Physiotherapists working in a Cardiac Care Unit, experts in the field of Cardio-Pulmonary Physiotherapy were given the “Current Practice patterns of Physiotherapists in Phase I Cardiac Rehabilitation following Cardiac Surgery (CABG/ Valve Surgery)” questionnaire for content validation and the final questionnaire was prepared basedon their reviews and suggestions
The response rate for the survey was 42 % with the majority of respondents hailing from Maharashtra 92.5(36.5%), Karnataka 88(34.9%) and Andhra Pradesh 29.5(11.5%).Demographic details are mentioned in Shruti chari, Gopala Krishna Alaparthi, Shyam Krishnan k, Ashish prabhakar, Kalyana Chakravarthy Bairapareddy
Summary
The patients are given chest Physiotherapy following cardiac Surgery (CABG/ valve surgery) to decrease or prevent the pulmonary complications after surgery. 1 The treatment is initiated after extubating the patients in ICU and it is continued in the acute wards until the patients get discharged.[2]The physiotherapy treatment given during hospital stay generally consists of exercisesfor relaxation, chest expansion; breathing exercises, cough and huff techniques, postural drainage therapy, walking and stair climbing. 1-4 The progressive ambulation and education to prepare thembefore returning home is part of acute physiotherapy management. 2Although the value of post-operative chest physiotherapy is well established, there is limited information on the efficient and effective practices for mobilizing the patients during the first few days’ after cardiac surgery.[4]There is lack of evidence on the most effective physiotherapy practices for patients following cardiac surgery. In the absence of any such supporting evidence from literature, there were suggestions by experts to use lower grades of evidence..[2] the clinical practice surveys do not provide research evidence, they are useful for accurate description of practice patterns it will be important for the therapists to know if their practicesareaccording to the standard practices in cardiac rehabilitation.[2] Several surveys on chest physical therapy interventions were conductedonpatients undergoing cardiac surgery in Australia, Brazil, Canada, Sweden, New Zealand, the United Kingdom and Greece These studies have shown the variations in the application of treatments techniques among these countries in the pre and postoperative period 1, 5 there are no studies which have been conducted to find optimal chest physiotherapy care given to patient following Cardiac Surgery in India.To our knowledge, there exists no survey’s discussing the Post-Operative Phase I Cardiac Rehabilitation practise following Cardiac Surgery (CABG/valve surgery).The study was aimed at analysing the current practice patterns among physiotherapists in Phase I Cardiac Rehabilitation following Cardiac Surgery (CABG/Valve Surgery)
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