Cardiorespiratory Physiotherapy - Techniques and Benefits

Introduction:

Many cardiorespiratory conditions can be prevented through regular exercise. Cardiorespiratory physiotherapy focuses on bringing heart and lung health to a better condition after sustaining an injury or damage or after an illness. Cardiorespiratory physiotherapy also helps in preventing many cardiovascular and respiratory conditions. People affected with cardiorespiratory problems have issues like a persistent cough, shortness of breath, reduced ability to exercise, and increased breathing.

Who Can Benefit From This?

Individuals with the following conditions can benefit from it:

• Angina: Angina is characterized by chest pain caused due to interruption in blood supply to the heart.

• Asthma: Asthma is characterized by the narrowing of the airway with the accumulation of mucus, which makes the affected individual difficult to breathe.

• Bronchitis: It is characterized by inflammation of the airways (bronchi and trachea), and the affected individual coughs with thickened mucus and has shortness of breath.

• Bronchiectasis: Chronic condition in which the airway is damaged due to prior infection or other medical conditions.

• Congestive Cardiac Failure: It is a condition in which the ability of the heart to pump blood is impaired.

• Chronic Obstructive Pulmonary Disease (COPD): It refers to a group of conditions that cause narrowing of the airway, retention of pulmonary secretions, and deterioration of alveoli (air sacs in the lung).

• Emphysema: A lung condition due to damage to the alveoli. There will eventually be shortness of breath.

• Heart Attack: A heart attack is caused due to blockage of supply to the heart muscle.

• Hypertension: Hypertension simply refers to high blood pressure.

• Peripheral Vascular Disease: This is a progressive slow circulatory disorder in which there is reduced blood circulation to the limbs due to narrowed blood vessels.

• Pneumonia and Other Respiratory Infections: Pneumonia is an infection of the lung causing fluid buildup or pus accumulation.

• Surgeries of Heart or Lung: Post heart and lung surgeries, physiotherapy is done to promote faster recovery.

What Are the Physiotherapeutic Interventions Done in Hospitals?

Patients may be admitted due to minor respiratory or cardiac problems. They can even be there for major life-threatening situations. Patients are assessed on their abilities to the exercises prescribed by the therapist. Physiotherapy is also done to prevent complications of the existing cardiorespiratory problems and to keep them active for a quicker recovery. Depending on the condition, various strategies are followed. Some of them are:

1. Coughing and Breathing Strategies: Patients are taught these exercises to help them cough without difficulty and to manage shortness of breath.

2. Deep Breathing Exercises: Deep breathing techniques are taught to the patient to expand the lung volume.

3. Breathing and Circulation Exercises: Breathing and circulation exercises are done by the patients to improve blood circulation and regular breathing of the individual. They help prevent complications such as deep vein thrombosis.

4. Breathing Facilitation Exercises: Certain hands-on breathing exercises are performed to facilitate the expansion of lung capacity.

5. Percussion and Vibrations: Percussion and vibration are done to enable easy coughing and loosen any secretions that are present. Chest vibrations are given by the physiotherapist to suction out the secretions from the breathing tube.

6. Mobility Aids: Patients are advised, prescribed, and instructed on the usage of walking aids such as canes, sticks, and walking frames.

7. Mobility Assistance: Patients are taught how to safely move in the bed, sit up, and stand and walk without assistance.

8. Individually Tailored Exercises: For improving general well-being and overall health, certain exercises are designed for the patient to control their breathing pattern, increase endurance, and build muscle strength.

9. Neonatal Intensive Care Unit: Children in intensive care who are on a ventilator should be repositioned to help improve breathing. Gravity will also allow the draining of an abscess in the lungs if repositioned often. The physiotherapist does certain movements that can help to move the secretions close to the windpipe through a specialized bag by giving deep breaths.

10. Mobilization: The patient is asked to move often during their time in the hospital. Early mobilization will shorten the recovery time. Certain exercises are recommended to the patients based on their tolerance level.

Physiotherapy Techniques for Cardiorespiratory Disorders:

1. COPD: Diseases like chronic bronchitis, emphysema, asthma, and bronchiectasis are some examples of obstructive lung disease. Patients suffering from COPD usually have symptoms like dyspnea, accumulation of secretions, and decreased exercise tolerance. Physiotherapy aims to relieve dyspnea (shortness of breath), remove secretions, and improve exercise tolerance in such patients.

• Dyspnea Relief: Relief from dyspnea can be brought about by the following methods: The patient is asked to sit in a relaxed position to promote breathing. Breathing retraining exercises like pursed lip breathing are taught to the patients to aid in breathing. Pursed lips breathing exercise prevents collapse of airways during expiration. Breathing control techniques encourage deep breathing and control dyspnea (shallow rapid breathing). Keeping track of breathing time works very well when walking or climbing stairs. Biological feedback helps the patients to learn self-control over physiological function (breathing).

• Secretion Clearance: Secretion clearance can be done through coughing and regular chest physiotherapy. Patients are trained to cough, which will clear secretions effectively. Huffing is done to make it more effective. It consists of a slow inspiration to the maximum lung capacity, followed by huffs. Multiple huffs can minimize small airway collapse, fatigue, and bronchospasm. Chest physiotherapy is done by postural drainage, percussion, and chest wall vibration.

• Exercise Therapy: In COPD patients, there will be a weakness in the skeletal and ventilatory muscles. Strength training for these specific muscle groups is trained for the patients. It will enable them to perform daily activities comfortably and more confidently. They can also be included with endurance training for improving cardiorespiratory health. Flexibility and stretching exercises are prescribed for both upper and lower limbs. Aerobic exercises are encouraged for the patients for at least 30 to 40 minutes.

2. Restrictive Lung Disease: They are a group of diseases with different causative factors characterized by a decrease in pulmonary ventilation, decreased volume of air moving in and out of lungs, decreased lung expansion, and deep breathing. Symptoms of the disease include dyspnea, cough, weight loss, and muscle wasting. The goal of physiotherapy, in this case, will be to relieve dyspnea, increase chest expansion and mobility, correct postural defects, relieve pain, and improve exercise tolerance. This is achieved through the following:

• Respiratory Exercises: Localized and deep breathing exercises are taught to the patients, and the exercises connected with respiration are also taught.

• Mobilizing Exercise: The patient is asked to move freely with a full range of motion. They are instilled in the patients by encouraging them to do activities like swinging, using parallel bars, and asking them to perform a certain range of motion exercises.

• Stretching Exercises: Patients are asked to stretch their muscles well through certain stretching exercises. The pectoralis muscle and hip flexors are especially concentrated in training.

• Pain Relief: Moist heat, massage, and transcutaneous electric nerve stimulation (TENS) are some of the physiotherapeutic modalities used to achieve pain relief.

• Endurance Improvement: Walking, bicycle riding, and swimming are encouraged to improve endurance.

Conclusion:

Physiotherapy helps in meeting the individual needs of the patient by optimizing their overall health and physical performance. Patients with cardiorespiratory problems are at increased risk of poor quality of life. They also have decreased endurance and should be trained through physiotherapy. The physiological response to exercise is improved in patients undergoing cardiorespiratory rehabilitation.