The Pulse

This 77-year-old woman was admitted to Raleigh Court Health & Rehabilitation Center in Roanoke, VA  due to weakness and inability to care for herself. She was hospitalized after a stroke where she was also diagnosed with COVID-19. Before the stroke, she was undergoing treatment for metastatic lymphoma (cancer in the lymph system that has spread to the lungs). Prior to hospitalization, she lived alone and was independent with self-care and mobility.

Champions Corner

This 74-year-old woman was referred to a skilled nursing facility for rehabilitation services with severe debility, decreased functional mobility, increased urinary frequency, and anxiety following hospitalization for acute cystitis (inflammation of the bladder). She has a long standing history of COPD and emphysema with requirement of oxygen supplementation of 4L/min. Prior to hospitalization, she lived independently. This woman’s goal is to be able to get to the bathroom on her own again.

Breathing impacts everything we do from bed mobility, transfers and gait to ADLs and IADLs. Incorporating patient-specific breathing strategies into a comprehensive rehab program not only addresses breathing impairment due to cardiopulmonary compromise, but also positively impacts pain, balance, function, and ADL performance.

According to the CDC, coronary artery disease (CAD) is the most common type of heart disease in the US. It is caused by plaque build-up in the coronary arteries which slows blood flow. The most common symptom of CAD is chest pain. However, many people don’t have symptoms and only find out they have CAD after they suffer a heart attack.

This 71-year-old gentleman was admitted to a skilled nursing facility following hospitalization due to COVID-19 with pneumonia, chronic respiratory failure, and exacerbation of asthma. He was weak and required 5 liters per minute of supplemental oxygen. Prior to hospitalization, he lived at home, was independent with all self-care and mobility, and did not use supplemental oxygen.

According to the CDC, 78% of adults over 55 in the U.S. have one or more chronic conditions. The ability to perform activities of daily living (ADLs) such as transfers, dressing, and bathing along with instrumental activities of daily living (IADLs) such as shopping, cooking, and cleaning informs healthcare professionals regarding the individual’s level of independence. With chronic conditions such as COPD, chronic heart failure, stroke, and diabetes, individuals may have dyspnea, weakness, and poor aerobic capacity which in turn may lead to impaired ability to perform ADLs and IADLs.

This 66-year-old gentleman was admitted to a skilled nursing facility following a two-month hospitalization due to COVID-19 with pneumonia. He was weak and required 6 liters per minute of supplemental oxygen. Prior to hospitalization, he lived at home and was independent with all self-care and mobility.

Aging results in a loss of muscle mass (sarcopenia) and a decrease in muscle strength, which can lead to functional impairment and frailty. Research highlights the impact of frailty on individuals and how exercise and rehab technology may counteract this decline.

Individuals with cardiopulmonary conditions often present with dyspnea, severe weakness, poor endurance, limited mobility, and decreased activity tolerance. As their disease state progresses, their ability to perform activities of daily living (ADLs) declines, ultimately leading to a loss of independence. A therapy plan of care that includes breathing exercises, energy conservation techniques (e.g., paced activity, assistive device, task planning), and ventilatory strategies may improve the individual’s breathing and functional performance as well as help maintain independence.