Practices of Physical Therapist Regarding Chest Physiotherapy for Patients Undergoing Open Heart Surgery in Karachi

Main Article Content

Hina Al Fatimah Siddiqui
Muhammad Asif
Sana Iqbal Sheikh
Arooj Raza
Hira Islam Rajput
Shahneela Rafiq Rai
Muhammad Atif Siddiqui

Abstract

Background: Despite the critical role of chest physiotherapy in the recovery process post open-heart surgery, there is a paucity of data on the practices of physical therapists in Karachi. With the high incidence of cardiovascular surgeries and the significant burden of postoperative complications, understanding current physiotherapy practices is essential for improving patient outcomes.


Objective: The objective of this study was to evaluate the current practices of physical therapists regarding chest physiotherapy for patients undergoing open-heart surgery in Karachi and to identify potential areas for standardization and improvement.


Methods: A cross-sectional study was conducted using a questionnaire survey among 40 physiotherapists working in cardiothoracic units across six major hospitals in Karachi. Participants were selected through non-probability convenient sampling, and data on preoperative and postoperative physiotherapy practices were collected. The survey included both open-ended and close-ended questions, with an emphasis on the types of treatments administered during the first five postoperative days. Statistical analysis was performed using SPSS version 25.


Results: The mean age of the physiotherapists was 31.20 (SD = 6.8) years with an average working experience of 7.592 (SD = 6.7) years. On the day of surgery, physiotherapy was provided routinely by 7.5%, as needed by 62.5%, and was never provided by 30% of the respondents. From the first to the fifth postoperative day, routine physiotherapy was administered by an increasing majority, peaking at 100% on the second day. Written guidelines for the management of extubated and intubated patients were accessible to 35% and 10% of participants, respectively.


Conclusion: There is a substantial engagement in chest physiotherapy post open-heart surgery among physiotherapists in Karachi. However, the variability in practice and the lack of standardized guidelines point towards a need for the development and implementation of standardized protocols to ensure consistent and evidence-based care.

Article Details

How to Cite
Siddiqui , H. A. F., Asif, M., Sheikh, S. I., Raza, A., Rajput , H. I., Rai, S. R., & Siddiqui, M. A. (2023). Practices of Physical Therapist Regarding Chest Physiotherapy for Patients Undergoing Open Heart Surgery in Karachi. Journal of Health and Rehabilitation Research, 3(2), 1234–1239. https://doi.org/10.61919/jhrr.v3i2.329
Section
Articles
Author Biographies

Hina Al Fatimah Siddiqui , Nazeer Hussain University Karachi.

Assistant Professor, Department of Rehabilitation and Health Sciences.

Muhammad Asif, Nazeer Hussain University Karachi.

Director, Department of Rehabilitation and Health Sciences.

Sana Iqbal Sheikh, Nazeer Hussain University Karachi.

Department of Rehabilitation and Health Sciences.

Arooj Raza, Rabia Moon Memorial Institute of Neurosciences Trust Karachi.

Physiotherapist.

Hira Islam Rajput , Nazeer Hussain University Karachi.

Assistant Professor, Department of Rehabilitation and Health Sciences.

Shahneela Rafiq Rai, Dynamic Physiotherapy Clinic And institute Karachi.

Senior Physiotherapist.

Muhammad Atif Siddiqui, Dow International Dental College Karachi.

Lecturer

References

Afxonidis G, Moysidis DV, Papazoglou AS, Tsagkaris C, Loudovikou A, Tagarakis G, et al. Efficacy of Early and Enhanced Respiratory Physiotherapy and Mobilization after On-Pump Cardiac Surgery: A Prospective Randomized Controlled Trial. Healthcare (Basel, Switzerland). 2021;9(12):1735.

Chakravarthy M. Modifying risks to improve outcome in cardiac surgery: An anesthesiologist's perspective. Ann Card Anaesth. 2017;20(2):226-33.

Cook A, Smith L, Anderson C, Ewing N, Gammack A, Pecover M, et al. The effect of Preoperative threshold inspiratory muscle training in adults undergoing cardiac surgery on postoperative hospital stay: a systematic review. Physiotherapy Theory and Practice. 2022;39(4):690-703.

Farheen H, Khalid Z, Tariq M, Sadiq T, Amjad I, Ramzan T. Combined Effect of Aerobic and Resistance Interval Training on Ejection Fraction in Myocardial Infarction. Journal of the College of Physicians and Surgeons Pakistan. 2019;29(3):290-2.

Kashoo FZ, Ahmad M, Sidiq M, Shahood H. Comment on "The effect of preoperative chest physiotherapy on oxygenation and lung function in cardiac surgery patients: a randomized controlled study". Annals of Saudi medicine. 2022;42(4):288-9.

Muhammad K, Shaikh Nabi Bukhsh N, Aftab Ahmed Mirza B. Physiotherapy practices for patients undergoing coronary artery bypass grafting: a cross- sectional study. Journal of the Pakistan Medical Association. 2020:1-11.

Patel P, Amin B, Mehta KG, Gopal R, Raval DA, Kadri AM, et al. Clinical features and outcome of COVID-19 among PLHIV in Gujarat, India: A case series. Journal of family medicine and primary care. 2021;10(10):3925-9.

Nardi P, Pellegrino A, Pisano C, Vacirca SR, Anselmi D, Saulle S, et al. The effect of preoperative respiratory physiotherapy and motor exercise in patients undergoing elective cardiac surgery: short-term results. Kardiochir Torakochirurgia Pol. 2019;16(2):81-7.

Zolfaghari M, Mirhosseini ÙSJ, Baghbeheshti M, Bauer BA. The Effect of Classic Chest Physiotherapy on Postoperative Pain Scores and Hospital Stay in Patients Undergoing Off-Pump Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial. Galen Medical Journal. 2018;7.

Niazi ASK, Bajwa MA, Zahra M, Niazi MUK, Zainab I, Anwer A. EFFICACY OF INTRA-ARTICULAR KETOROLAC AND LIGNOCAINE ON POST-OPERATIVE PAIN RELIEF AFTER ARTHROSCOPIC KNEE SURGERY. Journal of Ayub Medical College Abbottabad. 2022;34(2).

Westerdahl E, Fagevik Olsén M. Chest physiotherapy and breathing exercises for cardiac surgery patients in Sweden - A National survey of practice. Monaldi Archives for Chest Disease. 2015;75(2).

Westerdahl E, Lindmark B, Eriksson T, Friberg ö, Hedenstierna G, Tenling A. Deep-Breathing Exercises Reduce Atelectasis and Improve Pulmonary Function After Coronary Artery Bypass Surgery. Chest. 2005;128(5):3482-8.

Westerdahl E, Möller M. Physiotherapy-supervised mobilization and exercise following cardiac surgery: a national questionnaire survey in Sweden. J Cardiothorac Surg. 2010;5:67-.

Connors C, Betts T, Lawrence S, Walag HB, Buchl J, Kaza V. Implementing Standard Physical Therapy Guidelines With Patients Acutely After Single or Bilateral Lung Transplant: A Quality Improvement Project in the Hospital Setting. Cardiopulmonary Physical Therapy Journal. 2023:10.1097.

Esmealy L, Allahbakhshian A, Gholizadeh L, Khalili AF, Sarbakhsh P. Effects of early mobilization on pulmonary parameters and complications post coronary artery bypass graft surgery. Applied Nursing Research. 2023;69:151653.

Gamal Ahmed Mohammed E, Gaber Mohamed H, Sheta AE-S, Elsayed Ghonaem S. Effect of Evidence Based Nursing Program on Post Thoracic Surgery Patients' Health Outcomes Regarding Pulmonary Care. Journal of Nursing Science Benha University. 2023;4(1):427-43.

Khushnood K, Sultan N, Awan MMA, Altaf S, Mehmood R, Qureshi S. Effects of Pre-Operative Physical Therapy on Functional Capacity, Kinesiophobia, and Post-Operative ICU Stay in Coronary Artery Bypass Grafting Candidates. Iranian Rehabilitation Journal. 2023;21(1):0-.

Labib MA. Effect of Preoperative Respiratory Muscle Training on Respiratory Complications after Median Sternotomy Incision. The Egyptian Journal of Hospital Medicine. 2023;90(1):1510-4.

Shaphe MA. The effects of a structured physiotherapy program on pulmonary function and walking capacity in obese and non-obese adults undergoing cardiac surgery. Isokinetics and Exercise Science. 2023(Preprint):1-10.

Shkurka E, Wray J, Peters MJ, Shannon H. Chest physiotherapy for mechanically ventilated children: a survey of current UK practice. Physiotherapy. 2023;119:17-25.

Daum N, Drewniok N, Bald A, Ulm B, Buyukli A, Grunow JJ, et al. Early mobilisation within 72 hours after admission of critically ill patients in the intensive care unit: A systematic review with network meta-analysis. Intensive and Critical Care Nursing. 2024;80:103573.

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