The Effect of an Exercise Prescription on Physical Fitness in Physical Therapy Underclassmen

A new trend tOl-1ard health activation is emerging in the United States which emphasizes self-care and self-help to enhance health. The traditional sick role paradigm formulated by Parsons (cited in Harston, 1970) views the individual as passive, not held responsible for becoming ill, and expected to lay aside his usual activities and be taken care of. This is being transformed into relying on active, informed participants in health promotion. Health activation is an educational approach to health care that focuses on what individuals can appropriately do for themselves (Shirreffs, 1978). A belief in individuals is fostered which asserts that health behavior can and should be self-directed (Alderman, 1980; Shirreffs, 1978). People can understand more about . health and thereby take more responsibility for pursuing positive behavior change

Perspective Paper: Assessing Air Quality as Part of a Physical Therapy Plan of Care

Purpose: The purposes of this clinical perspective paper are (1) to expand physical therapists’ awareness to the topic of air quality as a health priority when providing professional services; and (2) to provide templates for screening the indoor clinical environments and patient profiles to avert respiratory exacerbations, especially in persons with asthma. Summary of Key Points: The location where a physical therapist practices determines the air quality indices to which a person is exposed. Poor indoor air quality can expose a person to even greater compromise of respiration (ie, Sick Building Syndrome) than outdoor air quality secondary to an array of factors like building materials, the ventilation exchange rate of an enclosed space, chemicals used in cleaning, and humidity. Statement of Conclusions: Extrinsic (ie, environmental) and intrinsic (eg, pre-disposition to airway hypersensitivity) factors must be accounted for by physical therapists to safeguard their patients and themselves from experiencing respiratory compromise and/or distress as a result of a treatment session or their place of employment. Recommendations: Efforts to screen indoor environments for potential triggers and patient risk profiles for abnormal airway reactivity should routinely be undertaken. Individualized Action Plans should be prospectively prepared and readied for implementation when warranted

Functional and oximetric assessment of patients after lung reduction surgery

AbstractObjective: The goal of this study was to clarify the issue of functional oxygen requirement by regimented exercise oximetry in patients undergoing lung reduction surgery.Methods: Thirty-seven patients underwent lung reduction surgery and were followed up for at least 3 months. Patients routinely completed a 6-week program of cardiopulmonary rehabilitation. Preoperative and postoperative spirometry, dyspnea scores, 6-minute walk distances, respiratory mechanics, and exercise oximetry were recorded.Results: After the operation, patients had a 37% increase in forced vital capacity and a 59% increase in forced expiratory volume in 1 second. Six-minute walk distance increased from 913 ± 310 feet before the lung reduction operation to 1202 ± 274 feet 6 months after the operation (p < 0.001). Maximal inspiratory and expiratory pressures were significantly increased in 16 patients after lung reduction surgery. Perceived dyspnea was significantly improved. Exercise pulse oximetry demonstrated that 83% of patients met American Thoracic Society criteria for supplemental oxygen use before lung reduction surgery. After the operation, 70% of patients continued to meet American Thoracic Society criteria for supplemental oxygen use. Notably, 10 patients with exertional desaturation while breathing room air discontinued supplemental oxygen use because of a reduction in dyspnea.Conclusions: These findings demonstrate significant subjective and functional improvements related to lung reduction surgery. Exercise-induced hypoxia was not reversed by lung reduction surgery. Discontinuance of supplemental oxygen use owing to reduction in dyspnea and improved physical performance may not be warranted in lieu of continued exertional desaturation. (J Thorac Cardiovasc Surg 1997;113:675-82