Physiotherapy for Respiratory and Cardiac Problems

This book is intended for physiotherapy students/new graduates and postgraduate physiotherapists with an interest in patients with respiratory and cardiac problems.

Assessment of the patient should reveal the patient’s problems. If some or all of these problems can be influenced by physical means, physiotherapy is indicated. Physiotherapy is also indicated when potential problems have been

identified and preventative measures should be taken. The role of the physiotherapist as an educator in both the prevention and treatment of problems is another important aspect.

Diagnoses will continue to provide usefulmedical categories, but treatment can become prescriptive and inappropriate or ineffective if given in response to a diagnosis alone. The pathology behind the problem provides the key as to whether it is a physiotherapy problem or a medical problem.

It is by accurate assessment of the patient that short- and long-term patient goals can be identified and agreed, and an effective treatment plan outlined. Continuous reassessment of the patient and the treatment outcomes will identify the need for continuation or modification of treatment.

This book begins with assessment of the patient and the interpretation of medical investigations. This is followed by a section on mechanical support and cardiopulmonary resuscitation.

An important part of our role is communication, counselling and health education. The skills available to the cardiorespiratory physiotherapist are many and varied. Practical skills have been outlined and referenced where possible. All skills are not yet supported by rigorous clinical studies, but it is important that we continue to

use them if outcome measures support their place in clinical practice. In the future measurement tools could validate their use. Research should be an integral part of the practice of physiotherapy.

Patients’ problems and their management are outlined in the context of differing pathologies.

One pathological process may present as several patient problems. Pneumothorax, for example, appears under the problems of both pain and breathlessness. The characteristic problems of some patient groups and diagnostic categories are then discussed detailing the pathology, medical management physiotherapy and evaluation

of treatment.

This book should be read in conjunction with specialized texts on anatomy, physiology and pathology. Further reading is indicated within each chapter. Throughout the text, for simplicity, the patient is referred to as he/him and the physiotherapist as she/her, but it is not intended to imply that all patients are male or that all

physiotherapists are female.

It is hoped that the problem orientated approach to physiotherapy practice will facilitate the learning process for the physiotherapist and improve the quality of the care we provide.