engleski

I am active, therefore I am: physiotherapy interventions in cardiovascular rehabilitation

The procedures performed by the Bachelor of Physiotherapy are an indispensable part of cardiovascular (CV) rehabilitation following the initial workup performed by a cardiologist, physician, Bachelor of Nursing and Occupational Therapy, and, if necessary, by a psychologist. The goals of physiotherapy interventions in patients undergoing the CV rehabilitation are the improvement of the functional capacity and the stabilization of the condition in order to achieve better control of the disease and present comorbidities, social reintegration and recovery of the working abilities. Physiotherapy (FT) program in CV rehabilitation starts with an evaluation of the patient's condition performed by analyzing medical records, taking FT medical history, evaluating the condition by SOAP and ICF classification models, thereby using one-dimensional or multidimensional standardized and non- standardized questionnaires for evaluation of the effects of the FT process: stress test, anthropometric measures - body mass index, the waist to hip ratio, respiratory index measures, VAS pain scale, extremity volume, the Borg Scale of Perceived Exertion, voice test, 36-Item Short Form Health Survey (SF-36), FIM – Functional Indepedance Measure and other tests for the evaluation of comorbidities. After the Bachelor of Nursing has completed the therapeutic education on CV risk factors and proper testing of the heart rate and blood pressure, Bachelor of Physiotherapy will continue with conducting the education on the guidelines and legislation pertaining to applying physical exercise, proper breathing, relaxation techniques and posture improvement. Individual needs (type, duration, frequency, intensity) are identified for FT interventions that are performed by applying the cardiorespiratory and vascular therapy methods. This is followed by the interval CV training consisting of the therapeutic exercises mainly of aerobic type, riding a manual bike, riding on a modern computer controlled pedal bike, where treadmill walking is done in case of present peripheral arterial disease, while we also create some other individual programs if indicated by a physiatrist in case of comorbidities. The cardiology societies recommend 36 CV trainings in duration of up to 60 minutes, while the frequency of coming is 3-5 times a week for 3 months. Stress tolerance, clinical status and vital signs are monitored while doing the training, where the electrocardiogram is monitored by telemetric monitoring for several times (at the beginning, in the middle, at the end, and when changing the intensity of the stress). Subject to the assessment of the importance of subjective discomforts, the team makes a decision on the need to change the FT plan and intervention. The effect of the interventions or the CV treatment plan is modified at follow-up examinations and regular meetings of the CV rehabilitation team. At the end of the program, the discharge is being planned when a final FT assessment and evaluation is made. The Bachelor of Physiotherapy documents all elements of FT interventions performed by using the diagnostic and therapeutic procedure codes in specialist-consulting healthcare prescribed by the Croatian Health Insurance Fund. The timely CV rehabilitation in specialized institutions with modern equipment, such as Institute Srčana has been conducted by a team of continuously educated health professionals since 1982, providing safety and quality of performed outpatient CV rehabilitation for approximately 400 new patients on an annual basis.

cardiovascular rehabilitation ; physiotherapeutic interventions ; multidisciplinary approach

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