Westerdahl Elisabeth, Möller Margareta
Department of Physiotherapy, Orebro University Hospital, 701 85 Orebro, Sweden.
J Cardiothorac Surg. 2010 Aug 25;5:67. doi: 10.1186/1749-8090-5-67.
Limited published data are available on how patients are mobilized and exercised during the postoperative hospital stay following cardiac surgery. The aim of this survey was to determine current practice of physiotherapy-supervised mobilization and exercise following cardiac surgery in Sweden.
A prospective survey was carried out among physiotherapists treating adult cardiac surgery patients. A total population sample was identified and postal questionnaires were sent to the 33 physiotherapists currently working at the departments of thoracic surgery in Sweden. In total, 29 physiotherapists (response rate 88%) from eight hospitals completed the survey.
The majority (90%) of the physiotherapists offered preoperative information. The main rationale of physiotherapy treatment after cardiac surgery was to prevent and treat postoperative complications, improve pulmonary function and promote physical activity. In general, one to three treatment sessions were given by a physiotherapist on postoperative day 1 and one to two treatment sessions were given during postoperative days 2 and 3. During weekends, physiotherapy was given to a lesser degree (59% on Saturdays and 31% on Sundays to patients on postoperative day 1). No physiotherapy treatment was given in the evenings. The routine use of early mobilization and shoulder range of motion exercises was common during the first postoperative days, but the choice of exercises and duration of treatment varied. Patients were reminded to adhere to sternal precautions. There were great variations of instructions to the patients concerning weight bearing and exercises involving the sternotomy. All respondents considered physiotherapy necessary after cardiac surgery, but only half of them considered the physiotherapy treatment offered as optimal.
The results of this survey show that there are small variations in physiotherapy-supervised mobilization and exercise following cardiac surgery in Sweden. However, the frequency and duration of exercises and recommendations for sternal precautions reinforced for the healing period differ between physiotherapists. This survey provides an initial insight into physiotherapy management in Sweden. Comparison with surveys in other countries is warranted to improve the physiotherapy management and postoperative recovery of the cardiac surgery patient.
关于心脏手术后患者在住院期间如何进行活动和锻炼的已发表数据有限。本次调查的目的是确定瑞典心脏手术后由物理治疗师监督的活动和锻炼的当前实践情况。
对治疗成年心脏手术患者的物理治疗师进行了一项前瞻性调查。确定了总体样本，并向瑞典胸外科目前工作的33名物理治疗师发送了邮政问卷。总共有来自八家医院的29名物理治疗师（回复率88%）完成了调查。
大多数（90%）物理治疗师提供术前信息。心脏手术后物理治疗的主要理由是预防和治疗术后并发症、改善肺功能以及促进身体活动。一般来说，物理治疗师在术后第1天进行1至3次治疗，在术后第2天和第3天进行1至2次治疗。在周末，物理治疗的程度较低（术后第1天的患者在周六接受治疗的比例为59%，在周日为31%）。晚上不进行物理治疗。术后早期常规进行活动和肩部活动度锻炼很常见，但锻炼的选择和治疗持续时间各不相同。会提醒患者遵守胸骨保护措施。关于负重和涉及胸骨切开术的锻炼，对患者的指导存在很大差异。所有受访者都认为心脏手术后物理治疗是必要的，但只有一半的人认为所提供的物理治疗是最佳的。
本次调查结果表明，瑞典心脏手术后由物理治疗师监督的活动和锻炼存在细微差异。然而，物理治疗师之间在锻炼的频率和持续时间以及愈合期胸骨保护措施的建议方面存在差异。本次调查为瑞典的物理治疗管理提供了初步见解。有必要与其他国家的调查进行比较，以改善心脏手术患者的物理治疗管理和术后恢复情况。
