Learning Objectives
- identify common cardiorespiratory (CR) PT problems using the ICF framework
- identify appropriate outcome measures for evaluating CR PT problems and the effectiveness of CR PT interventions
3 main problems
- getting air into lungs
- problem w/ exchanging the oxygen/carbon dioxide in lungs
- problem w/ transportation of oxygen rich blood
CR PT Problem List
impaired ventilation (reduced air entry)/ reduced lung volume
impaired airway clearance (impaired secretion clearance, inability to clear secretions)
dyspnea (shortness of breath)
decreased exercise tolerance
airflow limitation (obstruction)
reduced chest expansion
impaired gas exchange
respiratory muscle dysfunction
pain
deep vein thrombosis (from reduced mobility)
problem and definition - impaired ventilation
decreased movement of air into and out of lungs; could lead to less oxygen intake or carbon dioxide removal
problem and definition - impaired airway clearance
ineffective removal of mucus or secretions from airways
problem and definition - dyspnea
subjective sensation of breathing difficulty or discomfort
problem and definition - decreased exercise tolerance
inability to sustain physical activity due to CR or muscular limitation
problem and definition - airflow limitation (obstruction)
reduced airflow, especially during expiration, from narrowed or obstructed airways
problem and definition - reduced chest expansion
limited movement of the thoracic cage during inspiration
problem and definition - impaired gas exchange
reduced transfer of oxygen and/or carbon dioxide b/w alveoli and blood
problem and definition - respiratory muscle dysfunction
weakness or fatigue of the muscles involved in breathing
problem and definition - pain
pain restricting normal respiratory movements or effort or secondary to pulmonary emboli
problem and definition - risk of deep vein thrombosis
increased likelihood of blood clot formation in deep veins, typically of the lower limbs
problem and outcome measures - reduced ventilation
auscultation
palpation
chest x-ray
spirometry
arterial blood gases
problem and outcome measures - impaired secretion clearance
auscultation
sputum and cough assessment
tactile fremitus
chest x-ray
subjective report
problem and outcome measures - dyspnea
inspection
dyspnea measure/scales-> e.g. Borg
patient report (part of subjective report)
problem and outcome measures - decreased endurance
subjective patient report of fatigue
exercise tests - e.g. timed up and go
Borg rating of perceived exertion (rpe ) scale
problem and outcome measures - airflow limitation
spirometry (reduced FEV1/FVC ratio)
inspection (e.g. barrel chest. pursed lip breathing)
wheeze on ausculation
x-ray (e.g. horizontal ribs)
problem and outcome measures - reduced chest expansion
chest expansion
problem and outcome measures - impaired gas exchange
pulsed oximetry
arterial blood gases
inspection (cyanosis)
problem and outcome measures - respiratory muscle dysfunction
maximal inspiratory pressure measurement
surrogate measures e.g. spirometry
problem and outcome measures - pain
subjective report
inspection - facial grimacing, withdrawal
visual analogue scale (VAS)
problem and outcome measures - MSK dysfunction
inspection
chest expansion
problem and outcome measures - dysfunctional breathing
inspection
breathing pattern - respiratory rate, and depth
