Cardiopulmonary Physical Therapy

W. Darlene Reid, BMR(PT), PhD is a Professor in the Department of Physical Therapy at the University of British Columbia, Vancouver, British Columbia, Canada. She earned her physical therapy degree from the University of Manitoba in Winnipeg, Manitoba in 1979. She went on to complete graduate studies in pathology at the University of British Columbia and obtained her PhD in 1988. Dr. Reid performs graduate professional entry-level and graduate research teaching related to physical therapy respiratory care and muscle injury, and she supervises research by graduate and undergraduate students in the Rehabilitation Sciences, Kinesiology, and the Experimental Medicine programs at the University of British Columbia. Physical therapy teaching is focused on research design, exercise physiology, and physical therapy management of patients with cardiopulmonary conditions. Research graduate teaching is related to exercise physiology, advanced techniques in the management of cardiovascular and respiratory patients, and research design. In addition, Dr. Reid is involved in continuing education related to these areas. Dr. Reid has held scholarship salary awards from the B.C. Health Research Foundation and the Killam Foundation. Her areas of research interests include muscle injury, muscle performance, and pulmonary rehabilitation. Clinically, she has specialized in physiotherapeutic treatment for patients with chronic pulmonary disease. Her clinical research has focused on the understanding of mechanisms contributing to poor muscle performance and noninvasive measures of muscle dysfunction in people with chronic disease. Dr. Reid has published more than 90 peer-reviewed manuscripts in addition to abstracts, review papers, and chapters. She has been an invited speaker at a number of national and international conferences related to physical therapy, intensive care, and pulmonary medicine in Canada, the United States, Japan, Belgium, and Mexico. Dr. Reid has served on several national and local committees related to cardiorespiratory physical therapy and research including the Cardiorespiratory Division Executive of the Canadian Physiotherapy Association, the Executive of the Canadian Physiotherapy Cardiorespiratory Society of Lung Association, and Co-chair of the Scientific Program for the Canadian Respiratory Conference. She is also Associate Editor of the Cardiopulmonary Physical Therapy Journal. Frank Chung, BSc(PT), MSc graduated with a BSc (Physical Therapy) degree from McGill University in Montreal, Quebec, Canada in 1981 and obtained an MSc degree in interdisciplinary studies (respiratory and exercise physiology) from the University of British Columbia in 1989. He has taught at the School of Rehabilitation Sciences at the University of British Columbia, instructed postgraduate physical therapy courses, engaged in research and knowledge transfer, contributed as manuscript reviewer for Physiotherapy Canada, and published more than 20 papers in peer-reviewed journals in areas related to physical therapy practice. Frank was a member of the national examination test construction and implementation subcommittee of the Canadian Alliance of Physiotherapy Regulatory Boards. He is also an examiner of the Canadian Physical Therapy National Examination. He works as a physical therapist at Burnaby Hospital in British Columbia, Canada. Kylie Hill, BSc(Physiotherapy), PhD is an Associate Professor at the School of Physiotherapy and Exercise Science, Curtin University in Perth, Western Australia. She graduated from Curtin University with a BSc (Physiotherapy) degree in 1994 (with distinction). She has more than 10 years of clinical experience and has worked as a senior physiotherapist across 3 states in Australia. Her main areas of clinical experience include the management of patients admitted to the intensive care unit as well as following cardiothoracic and major abdominal surgery. In 2006, Dr. Hill completed a PhD (with commendation from the chancellor) in the area of pulmonary rehabilitation. In 2009, she completed 3.5 years of ­postdoctoral study at the University of Toronto, with Professor Dina Brooks and Roger Goldstein. She is currently involved in teaching undergraduate and graduate entry master's physical therapy students at Curtin University. She is also heavily involved in the supervision of masters by research and doctoral students at Curtin University. She is a member of the Australian Physiotherapy Association and the European Respiratory Society and was the national convenor of the Physiotherapy Special Interest Group for the Thoracic Society of Australia and New Zealand. She has presented at several national and international scientific meetings and has published more than 50 papers in peer-reviewed journals in areas related to physical therapy practice.

Dedication Acknowledgments About the Editors Contributing Authors Introduction Abbreviations SECTION ICARDIOPULMONARY ASSESSMENT AND MANAGEMENT PATHOPHYSIOLOGY OF THE RESPIRATORY AND CARDIOVASCULAR SYSTEMS Chapter 1Anatomy and Physiology of the Respiratory and Cardiovascular Systems Cristiane Yamabayashi, BSc(PT), PhD and W. Darlene Reid, BMR(PT), PhD Chapter 2Respiratory Conditions Patricia G. Camp, PhD, PT; W. Darlene Reid, BMR(PT), PhD; Frank Chung, BSc(PT), MSc; and Kylie Hill, BSc(Physiotherapy), PhD Chapter 3Cardiovascular Conditions Frank Chung, BSc(PT), MSc and Lori Roy, BSc(PT) Chapter 4Surgical Interventions Frank Chung, BSc(PT), MSc and Lori Roy, BSc(PT) Chapter 5Conditions That Can Compromise the Respiratory System W. Darlene Reid, BMR(PT), PhD and Frank Chung, BSc(PT), MSc CARDIOPULMONARY ASSESSMENT Chapter 6Clinical Decision Making Kylie Hill, BSc(Physiotherapy), PhD and W. Darlene Reid, BMR(PT), PhD Chapter 7Chart Review and Patient Interview Kylie Hill, BSc(Physiotherapy), PhD and W. Darlene Reid, BMR(PT), PhD Chapter 8Arterial Blood Gas Interpretation W. Darlene Reid, BMR(PT), PhD and Frank Chung, BSc(PT), MSc Chapter 9Chest Imaging W. Darlene Reid, BMR(PT), PhD Chapter 10Pulmonary Function Testing W. Darlene Reid, BMR(PT), PhD Chapter 11Laboratory Investigations Frank Chung, BSc(PT), MSc Chapter 12Electrocardiogram Interpretation Sandy Gilmour, BSc, RN and W. Darlene Reid, BMR(PT), PhD Chapter 13Physical Examination187 Kylie Hill, BSc(Physiotherapy), PhD; Frank Chung, BSc(PT), MSc; Lori Roy, BSc(PT); and W. Darlene Reid, BMR(PT), PhD Chapter 14Surface Anatomy and Auscultation W. Darlene Reid, BMR(PT), PhD and Mireille Landry, BSc(PT), MSc Chapter 15Screening and Exercise, Strength, and Functional Performance Tests W. Darlene Reid, BMR(PT), PhD and Kylie Hill, BSc(Physiotherapy), PhD Chapter 16Oxygen Therapy, Noninvasive Ventilation, and Mechanical Ventilation Shane Patman, BAppSc(Physiotherapy), MSc, PhD and Kylie Hill, BSc(Physiotherapy), PhD CARDIOPULMONARY MANAGEMENT Chapter 17Adult and Patient Education Judy King, PhD, MHSc, BHSc(PT) Chapter 18Breathing Strategies and Exercises Kylie Hill, BSc(Physiotherapy), PhD; Frank Chung, BSc(PT), MSc; and W. Darlene Reid, BMR(PT), PhD Chapter 19Positioning Kylie Hill, BSc(Physiotherapy), PhD; Frank Chung, BSc(PT), MSc; and W. Darlene Reid, BMR(PT), PhD Chapter 20Airway Clearance Techniques Jamie Wood, BSc(Physiotherapy); Frank Chung, BSc(PT), MSc; and Nola Cecins, BAppSc, MSc Chapter 21Mobilization and Exercise for Hospitalized Patients Megan Harrold, BSc(Physiotherapy); Frank Chung, BSc(PT), MSc; and Kylie Hill, BSc(Physiotherapy), PhD Chapter 22Exercise Training in Cardiac Rehabilitation Mireille Landry, BSc(PT), MSc and Andrew Maiorana, BSc, MSc, PhD Chapter 23Exercise Training in Pulmonary Rehabilitation Sunita Mathur, BSc(PT), MSc, PhD and Dina Brooks, BSc(PT), MSc, PhD SECTION IICARDIOPULMONARY CASES Preamble to Cases SURGICAL CONDITIONS Case 1Atelectasis—Postoperatively in an Obese Patient—Deep Vein Thrombosis and Pulmonary Embolus Frank Chung, BSc(PT), MSc and Lori Roy, BSc(PT) Case 2Metabolic Syndrome Kylie Hill, BSc(Physiotherapy), PhD Case 3Postoperative Laparotomy in an Older Patient Simone Gruenig, BSc, MSc(PT) and W. Darlene Reid, BMR(PT), PhD Case 4Postoperative Thoracotomy in a Smoker Simone Gruenig, BSc, MSc(PT) and W. Darlene Reid, BMR(PT), PhD Case 5Acute Myocardial Infarction—Coronary Artery Bypass Graft Frank Chung, BSc(PT), MSc Case 6Left-Sided Congestive Heart Failure—Pulmonary Edema Frank Chung, BSc(PT), MSc and W. Darlene Reid, BMR(PT), PhD Case 7Atelectasis—Postoperatively in an Older Patient—Hypotensive and Atrial Fibrillation Frank Chung, BSc(PT), MSc MEDICAL CONDITIONS Case 8Aspiration Pneumonia and Acute Respiratory Distress Syndrome Frank Chung, BSc(PT), MSc and Lori Roy, BSc(PT) Case 9Elderly Patient With a Pleural Condition Simone Gruenig, BSc, MSc(PT); Frank Chung, BSc(PT), MSc; and W. Darlene Reid, BMR(PT), PhD Case 10Amyotrophic Lateral Sclerosis in the Intensive Care Unit Frank Chung, BSc(PT), MSc and Lori Roy, BSc(PT) TRAUMA Case 11Chest Trauma—Pneumothorax/Fractured Ribs3 Frank Chung, BSc(PT), MSc; Kylie Hill, BSc(Physiotherapy), PhD; and W. Darlene Reid, BMR(PT), PhD Case 12Acute Cervical Spinal Cord Injury Kylie Hill, BSc(Physiotherapy) CHRONIC RESPIRATORY CONDITIONS Case 13Restrictive Lung Disease W. Darlene Reid, BMR(PT), PhD and Frank Chung, BSc(PT), MSc Case 14Stable Chronic Obstructive Pulmonary Disease W. Darlene Reid, BMR(PT), PhD; Frank Chung, BSc(PT), MSc; and Kylie Hill, BSc(Physiotherapy), PhD Case 15Cystic Fibrosis and Lung Transplant W. Darlene Reid, BMR(PT), PhD and Sunita Mathur, BSc(PT), MSc, PhD CHRONIC RESPIRATORY CONDITIONS WITH AN ACUTE EXACERBATION Case 16Asthma—Acute Exacerbation W. Darlene Reid, BMR(PT), PhD and Frank Chung, BSc(PT), MSc Case 17Acute Exacerbation of Chronic Obstructive Pulmonary Disease W. Darlene Reid, BMR(PT), PhD and Frank Chung, BSc(PT), MSc CARDIAC CONDITIONS Case 18Acute Myocardial Infarction—Good Recovery Frank Chung, BSc(PT), MSc Case 19Chronic Heart Failure—Post-Myocardial Infarction—Class III/IV Frank Chung, BSc(PT), MSc Case 20Chronic Heart Failure—Cardiomyopathy—Class I/II Frank Chung, BSc(PT), MSc Case 21Peripheral Vascular Disease Frank Chung, BSc(PT), MSc and Lori Roy, BSc(PT) Case 22Exercising Outpatient—Arrhythmia and Hypotension W. Darlene Reid, BMR(PT), PhD RESPIRATORY AND CARDIAC CONDITIONS Case 23Lobar Pneumonia and Angina Frank Chung, BSc(PT), MSc and W. Darlene Reid, BMR(PT), PhD Case 24Pleural Effusion Complicated by Cardiac Effusion and Cardiac Tamponade Frank Chung, BSc(PT), MSc and W. Darlene Reid, BMR(PT), PhD SECTION IIIANSWER GUIDES Answer Guides: Chapters Answer Guides: Cases Appendix: Summary of Common Laboratory Values and Clinical Implications Financial Disclosures Index