February 2019

February 2019

Personalized Physical Therapy Can Help You Rebound After a Cardiac Event

Suffering from chronic obstructive pulmonary disease (COPD) for a few years, Mary Gilman has had to limit her favorite activities. When her shortness of breath and lack of energy became worse recently and medication wasn't helping her improve, she needed an alternative.

For Gilman, there was one other complication: She also has atrial fibrillation - an irregular heartbeat.
"I love to garden but I've been curtailed from it because of not being able to breathe," the Kingston resident says.

Physical therapist Rob Sprague with Kitsap Physical Therapy explains that cardiac disease often causes similar problems as lung disease, in particular lack of endurance and stamina. And in both cases, patients often don't realize that physical therapy can help improve their function.

"With COPD, people think they're stuck and can't make any changes," Sprague says. "But you can improve endurance through breathing techniques and exercise. Similarly, after a cardiac event, you become deconditioned and exercise can build strength without aggravating other problems."

Gilman was pleased that her doctor referred her to physical therapy because it's helped her in the past with osteoarthritis and post-hip replacement rehabilitation.

"I'm fond of physical therapy because I'm not a good exerciser and it helps to have someone direct me," she says.
Typical cardiac rehab treatment includes a holistic regimen that addresses not only the systemic problem but also any associated physical conditions. For Gilman, that included knee pain and neck problems.

"When Mary first came here, even walking to the office, she was fatigued and out of breath," Sprague says. "Our main goal was to improve endurance, but we also worked out quite a few other things. Whether it's cardiac rehab or chronic disease like COPD, we try to look at the bigger picture."

During her sessions, Gilman had her blood pressure and heart rate monitored.

"We're reading those numbers to make sure the patient is relating them to how their body is responding," Sprague explains. "The idea is to get them to carry that over into their home exercise so they learn how to listen to their body."

In addition to exercises, the program includes patient education and discussion of other factors, such as diet and lifestyle.

"We take them through a series of questions to discuss their risks and the benefits of exercise for improving their function," Sprague says. "We also talk about reasons to stop exercise and slow down, and what's acceptable intensity and duration."

Gilman appreciated the "very controlled and observed" structure of the sessions and says she had a great experience overall.

"I got better and improved my ability to walk distances, and I was able to breathe better," she says. "I was very happy with the atmosphere at the Kitsap Physical Therapy office, and having everyone tell me they were glad to see me doing better. I think more people would benefit from physical therapy for various things."

Sprague notes that oftentimes, programs like cardiac rehab entail group sessions scheduled at specific times and locations. That can be a challenge for some patients, especially when they can't drive.

The individualized sessions like Gilman's provide the same type of treatment and approach, but they're more convenient, as well as easier to personalize to the specific individual.

"We have flexibility with an open schedule during the week, and we have a cardiac specialist at every location," he says. "The individualization of the program allows us to better address other issues one-on-one, and we can treat more holistically."

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