Clinical Case Study Guide to Accompany Principles and Practice of Cardiopulmonary Physical Therapy PDF
Preview Clinical Case Study Guide to Accompany Principles and Practice of Cardiopulmonary Physical Therapy
Copyrighted Material Copyrighted Material Copyrighted Material (cid:1)(cid:2) ... Mosby DeditcaPotu ebdl ishing Excellence ..,. A Times Mirror ... Company PublishDeorn: L adig EditoMra:r thSaa sser DevelopmenEtdailt orKse:l lWihei teA,m y Dubin ProjeMcatn ageDre:b oraLh.V ogel ProductEidoint oMra:m ataR eddy DesignPera:tP iy e ManufactuSruipnegr visLionrd:Ia e rardi 1996 Copyrig©h t byM osby-YeBaoro kI,n c. Allr ighrtess ervNeod p.a rotf t hipsu blicamtaiyob ne r eproducsetdo,r ienda retriesvyaslt eomr,t ransmitted, ina nyf ormo rb ya nym eanse,l ectronic, mechanical,r ecpohrodtioonrcog ot,ph yeirwnigs,we i,t hopurti or writtpeenr missfiroonm t hep ublisher. Permisstioop nh otocoopryr eproduscoel efloyr i nternoarlp ersonuaslei sp ermitftoerdl ibraroiroe tsh er $4.00 userrse gistewrietdht h eC opyrigChlte aranCceen teprr,o vidtehda tth eb asfe eeo f perc haptpelru s $.10 27 01970. perp agei sp aiddi recttolt yh eC opyrigChlte aranCceen ter,C ongreSstsr eeSta,l emM,A This consednote sn ote xtentdoo thekri ndosf c opyinsgu,c ha sc opyinfgo rg enerdails tribuftoirao dnv,e rtiosri ng promotiopnuarlp osfeosr,c reatinnegwc ollecwtoerdk so,r f orr esale. Printiendt heU niteSdt atoefsA merica CompositbiyoG nr aphiWco rldI,n c. Editing/prmoajneacgte mebnytG raphiWco rlPdu blishSienrgv ices PrintinglbbiynP dliunCsgo mmunications Mosby-YeBaoro kI,n c. 11830 WestliInned ustDrriiavle 63146 St.L ouisM,O InternatiSotnaanld aBrodo kN umber 0-8151-2243-8 969 79 89 90 0 9 8 7 4 6 3 2 / 5 I Copyrighted Material THEE VOLUTIOOFNT HIBSO OK Thibso oki sa c ompanivoonl umteo P rinciapnldPe rsa ctoifCc aer diopulPmfzoynsairyTc haelr apy, whicihs t het hiredd itioofCn hePshty siTchaelr aapnydP ulmonRaeryh abilietdiattoeirdoi gni,n ally byD onnaF rownfelitn1e 9r7 a8n dr evisiend1 987B.a seodn a nu nprecedennutmebde orf c opiseosl d andi tosv eraslulc cestsh,il sa ttbeoro kc learfliyl lae sdi gnificvaonitdi nt het extbomoakr keitn cardiopulmopnhayrsyi ctahle rapTyh.e b odyo fk nowledgteh,a its ,p hysioloagnidcs cientific literautnudreer,l ycianrgd iopulmopnhayrsyi ctahle raphya,sn ecessitastiegdn ififcuarntthr eerv ision oft hitse xwth ichi sr eflecitnei dt rse visneadm e,P rinciapnldPe rsa ctoifCc aer diopulmonary PhysiTchaelr aTphyir,Ed d itioann,di tcso nceptfuraalm ewornka,m eloyx ygetnr anspIotri tsc. l ear thaetf ficacciaorudsi opulmopnhayrsyi ctahle rampuys tb ep rinciple-abnadps reeds cripatnidtv hea,t specitfrieca tmceannto nlyb ed iscusisentd h ec onteoxfta specipfaitci eTnhte.r efotrheiu sn ique companivoonl umoen c liniccaaslse t udiiensc ardiopulmopnhayrsyi ctahle rawpays b orn. Becausoeft hei ncreassipnegc ifiocfic tayr diopulmopnhayrsyi ctahle raapnyd t hem ovet oward treatmpernets cripntoiteo vne,r cyo nditcioounl bde i ncludientd h itse xWte. havet herefsoerlee cted caseosfc ommonp rimacrayr diopulmodnyasrfyu nctainodcn o,mm on, yoeftt enno tf ullayp preciated, caseosf s econdacrayr diopulmodnyasrfyu nctCioonns.i stweinttha ni ncreaseimnpgh asoinso ut comesd,e finitnrge atmoeunttc omcer itearnidsa e lectoipntgi moault commee asuraersee mphasized. Thato ptimtarle atmpernets cripsthioounlb der esponse-depreantdhetenhrta tni me-depenidsae lnsto emphasized. THEM ISSIOOFNT HIBSO OK CliniCcaaslSe t udGyu idteoA ccompany PrainndPc riapcltoeifscC ea rdiopulPmhoynsairyc al TherapTyhi,r Edd itihoans,b eend esignteobd ea learninga ndt eachitnogof lo rs tudenetdsu,c ators, andp hysictahle rapprya ctitioners. Students Studenntese dt oe stablai ssohl igdr oundiinntg h ep hysioloofgo yx ygetnr ansptohretf ,a ctotrhsa t contribtuodt yes functiinoo xny getnr anspaonrdtt ,h ei ntervenutsieotdn osa ddretshsev ariotuysp es ofd eficiinto sx ygetnr anspoSrttu.d enctasn t henp ractirceel attihnegs fea ctotrost hes election, prioritizaantdia opnp,l icaotfit orne atmeinntt erventiinao cntsu acla ses cenariPorso.f icieinnc y relattirnega tmteont th eu nderlypiantgh ophysiorleoqguyir persa ctiTchee.p rogressoifto hne t ext fromb asitcoa dvancceads ewsi leln ablset udenttors e fitnhee cilri nipcraolb lesmo lvianngdd ecision makinsgk ilclosmm ensurawtiet ht hei ncreascionmgp lexoiftt yh ec ases. v Copyrighted Material vi Preface Educators Educatocrasnu set hibso oka sa s ourcofev ariceads set udifeosre xaminatpiuornp osaesss,i gnments, andc lassrodoims cussEiaocnh.c aseh asb eenh and-pictkoed de monstraa vtaer ieotfyo xygen transport daenfidic liltuss ttrhaest tee pisn c linical decision mwaikliblne gu sewfhutiloct hh e educationtr e achitnhgep rinciapnldep sr actoifcc ea rdiopulmopnhayrsyi ctahle raTphye.p rogressive complexiotfcy o ndititohnrso ughtohuetb ookp aralltehleps r ogressoifoc no nditicoonmsm only studiiendc ardiopulmopnhayrsyi ctahle racpoyu rses. PractiPchiynsgi Tchearla pists Physical thweirtahpoisusittg sn ificbaanctk grouinncd a rdiopulmopnhayrsyi ctahle rawpiyl filn dt his booku sefiunlu pdatitnhge mselivnet sh em ostr eceandtv ancienst hes peciaalntdyr elatceldi nical decision-maskkiinlgTl sho.s ep hysical thertahpeis sptesc iaiwlnit lybl e comem orep roficieantt identifyipnrgi oarnidt oixzyignegtn r ansport deficits, retloat thien gu ntdreeraltymiennagtn sdd e ficits, providian rga tionfaolrte r eatmseenlte ction. THEI NTENDAEUDD IENCE Physictahle raipnyt ervensttiroentsshs ec ardiopulmosnyasrtyeI mn.t hicso nteexvte,r pya tiecnatn bec onsidear "ecda rdiopulmopnaatriye nRte.g"a rdloefsw sh ethetrh eayr eb eintgr eatfeodrs oft tissiunej uroirer se,c overfirnogma strokhee,a ratt tacokrs, u rgeprhyy,s ictahle rasptyr esosxeysg en transppohryts iologiTchaecl ulmyu.l atiimvpea cotfa ltlh esfea ctoirnas d dittiooa ng e-relcahtaendg es ino xygetnr anspionrfltu encterse atmoeunttc omTeh.u sp hysictahle rapiinse tvse ry speacrieaal ty beneffirto mu nderstanodxiyngge tnr anspaonrdtt ,h em anifestaatnidio mnp acotfd eficiinot xsy gen transptoort tr,e tahte piart ieonpttsi maltlhya,t wiistt,hh em aximable nefiatn dl earsits Mka.x imizing theb enefit-tor-artiiosofkp hysictahle rapprya ctiicspe a rticuliamrployr tantto daayn di nt he2 1st century beocfat uhsede e manfdo re vidence-bparsaecdt iccoes,et ff ectivenqeusasl,ic tayr ee,t hical consideratainodtn hse,i ncreased osfcp ohpyes ictahle rapprya ctiec.eg,.d ,i reacctc esFsu.r ther, cardiopulmopnhayrsyi cal thhaesar davpayn caesda u niqusep eciatlhtuyts,h ibso oki sd irected toward physictahle rapirsetssp onsifbolrbe a siacn da dvancelde velosf p ractiacned,t owarpdh ysical therapiinso ttsh esrp ecialties. THES PECIFGIOCA LOSF T HITSE XT 1.T o proviadnea ppliteedx otn clinipcraolb lesmo lvianngd c linidceacli simoank inbga seodn oxygetnr anspaonrdtt her emediatoifoo xny getrna nspodretf icits 2.T o s ervaesa s tudgyu idfeo prh ysictahle rasptyu deinntc so njunctwiiotPnhr incipalnde Psr actice ofC ardiopulmoPnhayrsyi cTahle rap3yr,dE dition 3.T o p roviad seo urcoefc asset udifeosrt hee ducatfoorre xaminatpiuornp oses, assiagnndm ents, clasdsi scussion 4.T o p roviad see lf-conttaeixnoten dc linipcraolb lesmo lvianngd d ecisimoank infgo rp racticing physictahle rapists 5.T o proviad ree souracnedr eferebnocoek t op hysictahle rapaicsrtossa sls lp ecialties given that physictahle raipmyp ospehsy siolsotgriecos nso xygen traannsdpt ohraattv asntu mbeorfs ystemic conditihoanvsec ardiopulmomnaanriyf estations 6.T o p roviad ber oasdp ectroufmc aseisn volvai vnagr ieotfoy x ygetnr anspdoerfitc iftosrp hysical therappirsetpsa rfionrgt hec ardiopulmosnpaercyi ablotayr d examinations Copyrighted Material Preface vii THE ORGANIZOAFTT IHOINS BOOK Thibso oki sd esignteobd e u sebdo tihn c onjunctwiiotPnh rinciapnlde sP raoc/tCiacred iopulmonary PhysiTchaelr aTphyir,Ed d itiaonnd,o ni tosw n.Tw o introduccthoarpyt eornse,o nt hee lemenotfs oxygetnr anspaonrdto neo nt hei dentificoaftd ieofinc iitnso xygetnr anspporrotv,i tdhee bafsoirs thee vidence-biansteedr ventthiaoatnc sc ompaenayc cha sset udTyh.e m ajor secitnicolnusmd eed ical casset udiseusr,g iccaaslse t udisepse,c icaals easn,d c riticcaarlce a sset udiTehse.c asset udiaerse orderienda sequentmiaanln esru cthh atth ec omplexoiftt yh eo xygetrna nspodretfi cihtesn,c el,e vel ofp roblesmo lvinign,c reatsherso ughtohuetb ook. Theraer ef ourp arttso e achc ases tudyE.a chc aseb eginwsi tha concise descorfit phtei on pathologciocnadli tTihoinis.s f ollowbeyda d escripotfit ohnep atiewnitt thh es pecicfoincd itiaonnd, as chemasthiocw intgh eo bservaenddp otential idneo fixcyigtesn tranFsipnoarlitln.ya ,ne asy-to-read tabulfaorr matth,ev ariocuasr diopulmopnhayrsyi ctahle radpiya gnosaepsp eairno rdeorfp roiritfoyr thep atieanttt hastp ecisftiacg ien t hec oursoef r ecovearlyo,n wgi tht hea ssociastiegdn asn d symptomFso.re acdhi agnostihsei, n tervenatnidot nhse pirre spctriivpea rametaerrels i staendd,m ost importlaynt,t her ationfaolrte h et reatmiesng ti ve.n Iti s importtoan nott et hatth ec ardiopulmopnhayrsyi ctahle rapdyi agnosaensd t reatment intervenatrieos npse ciffoirec a chi ndividpuaatli eanntd,n ott hec onditpieorns e. Copyrighted Material To DonnaF rownfelftoermr a kinyge ta nothderre amc omet rueY.o urd edicattiooe nx cellence withitnh es peciaalntdcy o ntinuseudp poarrteu nparallTehlaendky. o uf ory oure xample. ToD aniePle rlmaann dD ougF rosfto ry oucro ntinsuuepdp odrutr intgh ee volutainodnc ompletion oft hipsr oject. To my studenatnsdc olleagfuoerys o uri nspiraatnidoi nn quiarnyd,f orm akintgh ivso lumteh e bestth aittc anb e-mys incegrrea titude. To KelliWeh itea ndt heM osbyc rewf ory oure nthusiasm, saunpdpe oxrcte,l leednitt orial capabilities. My sincearpep reciattoiy oonua ll. ElizabDeetha n Thisc asset udbyo okr epreseonutrvs i ewt hatth ec ardiopulmosnyasrtye m nteoeb dest akeinn to accouwnitt ha lpla tienTthse.r apigsetnse raclolnys idtehrec ardiopulmosnyasrtyew mh ent reating patiewnittsph r imacrayr diopulmodnyasrfyu nctsiuocnah s a sthmoar e mphysemyae,ti ti so ftetnh e limitifnagc toirnt hec oursoef r ehabilitoaftp iaotni enwtist ha varieotfyn euromuscualnadr musculoskedlyestfauln ctions. ElizabaentdIh h avael waytsa ugohutr s tudetnotts a kteh ee xtrtai mteo e valuaatnedt retahtew hole patieenmtp,h asiztihneig m portaonfct eh ec ardiopulmosnyasrtye Tmh.i sb ookp ulltso gethoeurr thoughatnsds pecifitehsec onsiderawtei mounsstm akei ne valuatainodtn r eatmoefna tl pla tients. Ia m gratetfoum ly studenotvsem ra nyy earfso ry ourq uestiaonndsi nquirtiheahsta vel edu st ot ake thimso deo ft eachitnohg e lypo ufi nda nswerWse. d on'wta ntt og ivyeo ua "cookboomke"t hod oft heraWpey. w anty out ot hinoku tt hee valuatainodtn r eatmpelnatn . Iw antto t hanEkl izabfertohmt heb ottoomfm y hearfto hre rl eadersrhoilipen p ullitnhgit so gether. We havbee ekinn dresdp iraintdsh avdei scusasneddr ehashtehde sceo nsideraotnim oannsyo ccasions persolnlayH.o weveErl,i zabweatsha blteo t akoeu rt houghatnsdw itphh ysiolodgaitpcau ltlo gether thec asewsh icwho uldde monstroautrpe h ilosoTphheyo .u tcomiese xcitainndgo new hicsht udents andt herapwiisltblse a blteo i dentwiiftyrh e.a dialnydu sei mmediately. Ther espontsote h escea sehsa sb eeonv erwhelmipnogsliyt aisva et eachitnogoa ln da na idt or eally understantdhien gr tohlece a rdiopulmosnyasrtyep ml ayisn a lpla tients. Ia m thankftuoml y familfyr,i enadnsd,c olleagwuheosk nowt het oltlh eseen deavoprlsa oyn persontailm aen dr elationasnhdiw phsoh aveg ivesnu ppoarntd e ncouragemneenetd etdoc ontinue. Youa res peciaanlda ppreciaTtheadn.k sIn. e edetdh atIt! h anGko df orc ontinusetdr engatnhdf or youa ll. I am appreciatiMvoes btyfo o rt heiirn sigahntd v isiotnh atth ibso okw asn eedeads a n accompanimteono tu rt extP,r incipalnedsP ractiocfeC ardiopulmoPnhayrys icTahle rapTyh,i rd EditioIan l. stoh antkh emf ort heir leadaenrdcs ohoippe ratiinto hni esf fort. DonnaF rownfelter ix Copyrighted Material PARTI CLINICAPLR OBLEM SOLVI NGIN CARDIOPULMONARY PHYS ICALT HERAPY, 1 Chapte1r OxygeTnr asnporTth:e B asifso rC ardiopulmoPnhayrsyi cTahle rapy3, Chapte2r DeficiitnsO xygeTnr anspoTrhte:B asifso rD iagnosainsdT reatment Prescript1i3o n , PARTI I MEDICAL CASE STUDIE2S5, Chapte3r Pneumonia2,7 Chapte4r ChroniAci rfloLwi mitatio3n6, Chapte5r MyocardiIanlf arcti4o4n , Chapte6r DuchennMeu sculDayrs rtophy,5 1 Chapte7r CerebrPaall sy5,9 Chapte8r SystemLiucp usE ryhtematosu6s6, Chapte9r Crohn'Dsi sease7,3 PART III SURGICALC ASE STUDIES,8 1 Chapte1r0 OrthopeSduircg erPye:l vFirca ctuFriex atio8n3, Chapte1r1 LowerA bdominaSlu rgerPya:r tiHayls terecto9m3y , Chapte1r2 UppeAr bdominaSlu rgerCyh:o leceycsttomy,1 02 Chapte1r3 CardiovalsaTcrh uoracic SuLrugnegrR ye:s ectio1n1,3 Chapte1r4 OpenH eart Surgery: ACrotreorBnyya prays s,1 24 PARTI V SPECIALC ASE STUDIES,1 35 Chapte1r5 InterstPiutlimaoln aFriyb roswiistP he ripheVraaslc ulDairs ease1,3 7 Chapte1r6 CystiFci brosi1s4,4 Chapte1r7 RheumatoAritdh riti1s5,2 Chapte1r8 Strokwei tShl eeApp nea,1 59 Chapte1r9 LatSee queloafeP oliomyeli1t6i8s , Chapte2r0 ChroniRce naFla ilur1e7, 5 xi Copyrighted Material xii Contents PART V CRITICALC ARE CASE STUDIES, 183 Chapte2r1 AdulRte spiratDoirsyt reSsysn drome1,8 5 Chapte2r2 InfaRnets piratDoirsyt reSsysn drome1,9 7 Chapte2r3 CardiopulmoFnaairlyu r2e0,5 Chapte2r4 MultipTlrea uma,2 12 Chapte2r5 HeadI njury2,2 2 BIBLIOGRAPHY,2 33 Copyrighted Material
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