Primary respiratory muscles during normal quiet breathing include the diaphragm and external intercostals. Accessory muscles of respiration assist the primary muscles when the chest is not expanding or contracting effectively to meet ventilation demands. Increased age, stress, poor posture, COPD, pneumonia, and illness are conditions that negatively impact proper oxygen and carbon dioxide exchange in the lungs.
Individuals who present with a compromised pulmonary system, are acutely ill, or hospitalized for extended periods may become deconditioned or develop hospital-acquired muscle weakness, among other deleterious effects. Even healthy individuals may become deconditioned and frail if they decrease their activity level due to social distancing and limiting time outside their room or home.
Infection control and patient safety are top priorities in healthcare. This document reviews low-level and intermediate-level infection control procedures for use with ACP technology to ensure the safety of healthcare providers and patients.
Topics: Clinical Tip
Approximately 6.5 million adults in the United States have heart failure. Heart failure (previously referred to as chronic heart failure or CHF) occurs when the heart cannot pump enough blood throughout the body to meet the requirements of other organs and muscles. This results in a wide variety of symptoms and functional impairments which may result in hospitalization, re-hospitalization, and death. In 2017, heart failure contributed to 1 in 8 deaths. (CDC, 2020)
Over the past several years, the body of evidence on the effectiveness of virtual reality (VR) in rehabilitation has significantly expanded. VR has been studied for a variety of diagnoses including stroke, Parkinson’s disease, multiple sclerosis, dementia, burns, pain, and total knee arthroplasty. VR helps enhance patient involvement and motivation while increasing the repetitions and duration of exercise. Benefits addressing ADL performance, balance, gait, pain, and cognition have been reported.
Hypertonia is defined as excessive muscle tone which leads to stiffness with movement or inability to move a joint and often occurs with neurological conditions such as upper motor neuron lesions (CP, CVA, TBI, SCI, MS) and basal ganglia disorders (PD, Huntington
disease, Dystonia). While the terms spasticity and hypertonia are often used interchangeably, spasticity is actually a subtype of hypertonia in which muscle tone is increased by the speed of joint movement. (NIH, 2019)
Range of motion (ROM) deficits may affect an individual’s ability to move, care for themselves, or perform typical daily activities including self-feeding, walking, and dressing. Decreased ROM is a common deficit addressed regularly by rehab professionals in all settings. Contractures arise from shortened muscle or other joint structure restrictions, leading to reduction in mobility and deformity with resultant reduced function.
• Prevalence of contractures in nursing homes is estimated at 55% with significant functional and medical consequences. (Offenbächer, 2014)
• Patients who are immobilized for a prolonged period are at risk of developing joint contractures, which often affect functional outcomes. (Born, 2017)
The use of outcome measures has become the standard of care to objectively assess changes in function, quantify clinical observations, enhance interdisciplinary communication, and examine intervention effectiveness at the patient and practice levels. Inconsistent use of outcome measures remains an issue due to difficulty identifying the most suitable measures based on patient diagnosis, acuity of condition, or practice setting.
Per the American Physical Therapy Association’s (APTA) “Defensible Documentation Tips” resource¹, the top 10 payer complaints about documentation (reasons for denials) include:
Topics: Clinical Tip
It is estimated that over 30 million individuals (9.4%) in the US population has diabetes, while more than one in four do not know they have the disease. A staggering 84.1 million adults have pre-diabetes and, of these individuals, 9 out of 10 are unaware of the condition. Diabetes affects multiple parts of the body and causes many complications such as heart disease, stroke, kidney dysfunction, diabetic neuropathy, orthopedic problems, gum disease, and eye disease. Managing blood glucose levels, a healthy lifestyle and physical activity can help prevent these complications.¹