Research Anchors Care Planning
Research Anchors Care Planning
Adams says that three research studies conducted by Cardiac Rehab took center stage in 2016 .
“ Use of Inclinometry in Cardiac Rehabilitation to Assess Shoulder Abduction After Sternotomy ,” was a pilot study where an inclinometer was used to measure right and left shoulder abduction in 36 cardiac rehabilitation patients ( 12 women and 24 men , ranging in age from 25 to 86 ). Sternotomy and non-sternotomy patients were included in the study . A t-test was used to evaluate the difference in shoulder abduction between the two groups of patients .
The results of the study showed that sternotomy patients had fewer degrees of abduction than non-sternotomy patients in both the right and left shoulders , but the differences were not significant . Sternotomy patients also showed fewer degree of abduction in the right shoulder than in the left . Those leading the study concluded that variables such as patient age and arm dominance may be relevant and deserve further investigation .
Inclinometer testing in the cardiac rehabilitation setting was found to be a quick , effective and well-tolerated way to document flexibility abnormalities in patients . This information can provide pre- and post-rehabilitation outcomes for the program and it can help motivate patients to continue their flexibility exercise training after they complete cardiac rehabilitation .
“ Comparison of Activity Forces Between Patients Who Follow Traditional Sternal Precautions Versus Those Who Use A Unique Post-Sternotomy Discharge Education Model : ‘ Keep Your Move in the Tube™ ’,” involved ten sternotomy patients in a prospective pilot study where force dynamometry data were collected as they performed activities of daily living while practicing “ Keep Your Move In The Tube .” The patients were enrolled in cardiac rehabilitation ( seven men and three women , ages 41 to 78 years ).
Adams ’ work focused on patients who had undergone coronary artery bypass grafting ( CABG ) and other procedures involving median sternotomy , splitting the sternum to provide access to the heart during surgery . The study looked at the forces required to lift ten pounds – the upper limit suggested by current sternal precautions – with the forces exerted by study participants using “ Keep Your Move In The Tube ” techniques .
Results showed that these patients , while practicing “ Keep Your Move In The Tube ” were able to lift , pull and push with substantially more force than would be required for the tenpound restriction recommended by current sternal precautions .
In addition , the study participants were able to perform these activities on average of three weeks and three days after surgery , far sooner than the usual ten to 12 week restriction .
“ Continuous Blood Pressure Monitoring During High- Intensity Resistance Training in a Cardiac Rehabilitation Setting ,” involved five male patients , 18 to 80 years of age , who had a current diagnosis of stable angina , MI or PTCA with or without stent . Study participants performed a 1-RM test on the leg press resistance training equipment while the finometer finger cuff recorded continuous finger arterial pressure . During the next five sessions , the participants performed four sets of six repetitions at 85 percent of their 1-RM with one minute of rest between . This process was repeated for a total of 18 sessions . A one-sample t-test was used to compare the average RPP for each leg press movement with the safety threshold suggest by current guidelines .
The results of using the finometer to measure continuous blood pressure during high-intensity leg press resistance training indicate that the patients reached an RPP that was substantially less than the currently recommended safety threshold ( 15,379.4 , plus or minus 2.626.7 ).
Based on these results , medical professionals could more accurately prescribe high-intensity resistance training in order to help patients reach desirable strength and endurance increases more closely related to the activity they will be required to perform through their athletic pursuits as well as their occupations .
We ’ ve taken a proactive approach with our cardiac rehab patients . Our goal is to have each patient leave the program in a healthier state than when he or she first came to us .
Jenny Adams , PhD Senior Research Associate
Baylor Jack and Jane Hamilton Heart and Vascular Hospital
OUTCOMES 2016
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