What are the pre op physio role in cardiac rehab?
Aims: To reduce post-operative complications, increased oxygen saturation and improved mobilization.
Benefits:
- Improved Functional Capacity: Better physical fitness prior to surgery reduces the strain on the body during recovery.
- Reduced Postoperative Complications: Enhanced lung function and education on coughing techniques lower the risk of respiratory issues.
- Shorter Hospital Stays: Patients with better preoperative conditioning tend to recover more quickly.
- Increased Confidence: Knowledge about the surgical and recovery process helps reduce fear and promote compliance with postoperative care.
What are the roles?
Enhance cardiopulmonary function to reduce surgical risks
- Endurance exercise (low-resistance but high repetition). Eg: treadmill walking or stationary
Frequency: 3–5 times per week
Duration: 20–60 minutes per session
Intensity: Moderate (50–70% of maximum heart rate) to vigorous (70–85% of maximum heart rate), depending on fitness levels.
2. Resistance training
Exercises: Resistance bands, light weights, or bodyweight exercises like squats or wall push-ups.
Frequency:2–3 times per week with gradual progression.
Intensity: 8 reps, 3sets (first session). Progressively increase the reps.
Duration: 20 minutes
3. Breathing Exercises
Aims: To improve respiratory muscle strength and lung capacity by improving chest wall motion, arterial oxygen saturation to reduce postoperative complications like atelectasis and pneumonia.
Exercises: Diaphragmatic breathing, pursed lip breathing, incentive spirometry
Diaphragmatic breathing: Place one hand on the abdomen. Inhale deeply through the nose, focusing on moving the abdomen outward, and exhale slowly through pursed lips
Pursed lip breathing: Inhale through the nose for 2 counts and exhale slowly through pursed lips for 4 counts.
Incentive spirometry: Inhale slowly and deeply through the mouthpiece, raising the piston or ball in the spirometer to the target level. Then,hold your breath for 3–5 seconds.Remove the mouthpiece and exhale slowly. Repeat the process 10 times per hour.
Education and Self-Management Training
- Coughing and Deep Breathing Post-Surgery
Teach controlled coughing techniques with minimum pain to prevent complications like pneumonia.
2. Way to manage breathlessness
Explain to the patients it might be inadequate lung expansion after the surgery, then have to apply the breathing exercises and train the respiratory muscles by using the incentive spirometer.
3. Bed Mobility and Transfers
Train patients in safe methods of getting out of bed and moving without straining the chest.
4. Postoperative Exercise Plan
Discuss the gradual return to physical activity after surgery.
Risk factor modification
- Provide guidance on reducing modifiable risk factors such as Smoking cessation to improve oxygenation and wound healing.
- Limit Alcohol: Reduces strain on the cardiovascular system.
Prepared by
Yuki Lim Hui Chi
Your Physio Kota Kemuning