Respiratory Therapy Commons^™

Physiotherapy Rehabilitation In Bilateral Lower Limbs Amputations Following Dry Gangrene: A Case Report, Pranali R. Gaikwad, Manish P. Shukla, Santosh P. Dobhal

Internet Journal of Allied Health Sciences and Practice

Background: Bilateral lower limb amputation is becoming more frequent in recent years. This case report will outline the pre-operative and post-operative physiotherapy protocol for bilateral lower limb amputations following dry gangrene. Additionally, this case was evaluated to see if postoperative physiotherapy treatment consisting of prevention of complications, patient education, independent self-care, and functional mobility improved outcome. Case: A 76-year-old man came to the hospital with clinical features of dry gangrene of both feet. Preoperatively he was given education on care for his limbs along with the therapy plan following surgery. Pain on VAS scales were taken prior to surgery and …

Therapeutic Strategies Targeting Respiratory Recovery After Spinal Cord Injury: From Preclinical Development To Clinical Translation, Pauline Michel-Flutot, Michael A. Lane, Angelo C. Lepore, Stéphane Vinit

Farber Institute for Neuroscience Faculty Papers

High spinal cord injuries (SCIs) lead to permanent functional deficits, including respiratory dysfunction. Patients living with such conditions often rely on ventilatory assistance to survive, and even those that can be weaned continue to suffer life-threatening impairments. There is currently no treatment for SCI that is capable of providing complete recovery of diaphragm activity and respiratory function. The diaphragm is the main inspiratory muscle, and its activity is controlled by phrenic motoneurons (phMNs) located in the cervical (C3–C5) spinal cord. Preserving and/or restoring phMN activity following a high SCI is essential for achieving voluntary control of breathing. In this review, …

Respiratory Therapy Staff Retention: A Systems Thinking Approach, Jerin G. Juby

Full-Text Theses & Dissertations

Respiratory therapists are an integral part of the healthcare workforce in the United States. The healthcare workforce shortage accelerated by the COVID global pandemic has impacted respiratory therapy departments across the nation, with organizations struggling to hire and retain staff. The prevailing approaches in combating this is linear in nature and does not consider the complexity of the system. The purpose of this dissertation is to address retention issues in respiratory therapy departments from a systems thinking approach and to develop a prototype utilizing systems thinking methodologies and tools.

Mouthpiece For Patients With Neuromuscular Disorders, Rebekah Starkey, Carissa Thompson, Michael Dickens, Andrew Pero

Williams Honors College, Honors Research Projects

Neuromuscular Disorders (NMDs) impact people throughout the world. An early hallmark of these disorders includes some degree of facial muscle weakness. Respiratory testing is important to evaluate the progression of these patients’ NMDs. However, these tests require that the patient purses their lips around a mouthpiece to create a tight seal. This is a difficult task for one with facial muscle degeneration. This often leads to results that fail to reflect the patient’s true respiratory ability and prevents their physician from providing the appropriate degree of care. The objective of this project was to develop a face mask or mouthpiece …

The Accuracy Of Recreational Athletes In Self Detecting Ventilation Threshold During A Maximal Exercise Test, Andrew Biegner

Williams Honors College, Honors Research Projects

INTRODUCTION: Ventilatory threshold (VT) is where minute ventilation (VE) increases nonlinearly with increasing exercise intensity. Prior studies have shown that subjects can recognize VT by changes in breathing during exercise. Teaching recreational athletes to use VT as a training method could result in better quality training. PURPOSE: Determine if recreational athletes can accurately perceive changes in ventilation associated with VT during maximal exercise testing. METHODS: Subjects were recruited (n=20, age= 20.5 ± 1.7 yrs.) to participate in the study. Subjects performed a modified maximal treadmill protocol with gas analysis. Subjects indicated when they noticed a considerable change …

Efficacy Of Early Inpatient Rehabilitation Of Post-Covid-19 Survivors: Single-Center Retrospective Analysis, Ning Cao, Jaclyn Barcikowski, Franklin Womble, Bianca Martinez, Yevgeniya Sergeyenko, Jacob H. Koffer, Michael Kwasniewski, Thomas Watanabe, Rui Xiao, Alberto Esquenazi

Moss Rehabilitation Papers

OBJECTIVE: The aim of this study was to understand the demographic, clinical characteristics, and effectiveness of early inpatient rehabilitation of post-COVID survivors.

DESIGN: A single-center retrospective chart review analysis of 100 patients admitted to a newly created acute COVID rehabilitation unit (CORE+) from April to December 2020 was conducted.

RESULTS: The demographic and clinical characteristics and complications of 100 post-COVID patients were reviewed. Functional outcomes of GG Self-care and Mobility Activities Items (Section GG0130 and GG0170) of the Centers for Medicare & Medicaid Services of the Inpatient Rehabilitation Facility Patient Assessment Instrument (Version 3.0) at admission and discharge, prevalence of …

Icu Liberation Bundle: A Multidisciplinary Approach, Julie Anne Snyder Amoroso

Student Scholarly Projects

Practice Problem: Patients with increased ventilator days see dramatic increases in their chances of developing healthcare-related conditions (HAC). Extended ICU stays increase the potential for problematic issues in patients' physical, mental and spiritual health with short-and-long-term consequences.

PICOT: The PICOT question that guided this project was looking at adult ventilated patients in a medical ICU (P) and what is the effect of initiating interdisciplinary ABCDEF-ICU liberation bundle rounding as (I) compared to no ICU liberation bundle rounding (C) has on the length of ventilator days (O) over eight weeks (T).

Evidence: Evidence from quality studies and backing from the …

The Feasibility And Efficacy Of Telespirometry For Pulmonary Monitoring Of Cystic Fibrosis: A Systematic Review, Tessa Yap, Anne Jones

Internet Journal of Allied Health Sciences and Practice

Background: Spirometry via telehealth (telespirometry) involves remote monitoring of lung function, which is useful to detect pulmonary changes and increase continuity of care for patients with cystic fibrosis (CF). Purpose: This systematic review aims to evaluate the feasibility and efficacy of telespirometry assessments for paediatric and adult CF patients. Method: A comprehensive search of health-related databases (CINAHL, Emcare (Ovid), Medline (Ovid), PEDRo and Scopus) was conducted. For inclusion, patients had to be clinically diagnosed with CF and studies could be of any study design or level according to the National Health and Medical Research Council (NHMRC) evidence hierarchy, had to …

Efektifitas Acbt Dalam Meningkatkan Ekspansi Dada Pada Kasus Bronchiectasis : Studi Kasus, Riza Pahlawi, Aditya Denny Pratama, Mita Noviana, Anastasia Viastuti Iskandar

Jurnal Fisioterapi Terapan Indonesia or Indonesian Journal of Applied Physiotherapy

Bronchiectasis is a major chronic disease characterized by infection, inflammation, and permanent dilation of the bronchial walls. Interaction of chronic infection, exacerbation, and inflammation resulting in lung injury. Patients with bronchiectasis have several clinical manifestations of primary bronchiectasis, which is the occurrence of recurrent, chronic infections. In patients with bronchiectasis, mechanical efficiency of breathing leads to decreased rib movement and increased abdominal movement leading to a paradoxical breathing pattern. Treatment goals include achieving symptom control, preventing or reducing exacerbations. Various alternative airway techniques have been used in the physiotherapeutic management of patients with bronchiectasis. Techniques are considered the way to …

Duchenne’S Muscular Dystrophy & Occupational Therapy, Vanessa Sagredo, Meagan C. Romero

Client Educational Handouts

No abstract provided.

Quantifying The Effect Of Monitor Wear Time And Monitor Type On The Estimate Of Sedentary Time In People With Copd: Systematic Review And Meta-Analysis, Fiona Coll, Vinicius Cavalheri, Daniel F. Gucciardi, Sheldon Wulff, Kylie Hill

Research outputs 2022 to 2026

In studies that have reported device-based measures of sedentary time (ST) in people with chronic obstructive pulmonary disease (COPD), we explored if the monitor type and monitor wear time moderated the estimate of this measure. Five electronic databases were searched in January 2021. Studies were included if >70% of participants had stable COPD, and measures of ST (min/day) were collected using wearable technology. Meta-regression was used to examine the influence of moderators on ST, monitor type, and wear time. The studies identified were a total of 1153, and 36 had usable data for meta-analyses. The overall pooled estimate of ST …

Patient And Therapist Perceptions Of Respiratory Functioning Due To Spinal Cord Injury: Implications For Music Therapists, A'Marie Dotson

Theses and Dissertations--Music

Decreased respiratory functioning is a common symptom of spinal cord injury (SCI) and can impact individuals’ personal, professional, and social lives. In spite of this, researchers have not explored the use of music in the lives of individuals with SCIs or music’s role in their healthcare professionals’ treatment plans to improve respiratory functioning. The purpose of this qualitative study was to better understand how decreased respiratory functioning affects individuals with SCIs and healthcare professionals through a multiple case study design. Participants were two individuals with SCIs and three healthcare professionals (physical therapist, recreational therapist, and music therapist) who worked with …

Pressure Injury As Insidious Comorbidity In Ventilator-Dependent Respiratory Failure (Vdrf) Secondary To Covid-19: A Case Report, Carlos Rodriguez, Karyn R. Doddy, Napatkamon Ayutyanont

Physical Medicine & Rehabilitation

Research Objectives: To highlight opportunities to decrease adverse outcomes in the acute management of COVID-19 infection.

Design: Descriptive single-subject study

Setting: Inpatient/Acute rehabilitation

Participants: A 47-year-old female with Ventilator-Dependent Respiratory Failure (VDRF) secondary to COVID-19.

Interventions: In the ED, Patient was started on antibiotics (azithromycin, ceftriaxone), nebulizer treatments, intravenous fluids, and intramuscular corticosteroids (methylprednisolone).
On hospital admission, she was initiated on antiviral Remdesivir and received 1 unit of convalescent plasma. Self-proning was encouraged, yet Patient required progressive increase in oxygen (O2) supplementation. She was intubated from Hospital Day (HD) 4 to 7. Wound care assessments began on HD10; wounds to …

Assessing The Clinical Characteristics And Ventilator Parameters Of Covid-19 Mechanically Ventilated Patients At Lehigh Valley Health Network, Andrew Kelly, Kenneth Miller Med, Rrt-Nps

Research Scholars

No abstract provided.

Functional Outcomes Of Infants With Chiari Ii Malformation With Tracheostomy And Home Ventilator Dependence, Abbigayle Carlson

Research Days

Background: Chiari II malformation is relatively common with an incidence of about 1 in 1000 live birth and is associated with reduced life expectancy. Characteristic features are beaked midbrain, downward displacement of the tonsils, and cerebellar vermis, and spinal myelomeningocele that can be associated with hydrocephalus needing ventriculoperitoneal shunt (VP shunt). Mortality is about 50-70% if not recognized early. Survivors have high morbidity and develop neurologic abnormalities and significant developmental delays. Long-term outcome is poorly understood.

Objective: Not much has been published that describes the outcome of infant with Chiari II malformation that received tracheostomy for long-term ventilator support. Our …

Neurally Adjusted Ventilatory Assist: Summation Of The Safety Proofs And Benefits, Landry Carneal

Williams Honors College, Honors Research Projects

Neurally Adjusted Ventilatory Assist (NAVA) is a mode of ventilation that is triggered by neither flow nor pressure but by the electrical activity of the diaphragm (Stein & Firestone, 2018, p. 227). NAVA puts ventilatory control into the hands of the patient and is often used in neonates who are more challenging to ventilate. Medical practitioners, however, are skeptical to put this mode of ventilation into practice with fear that neonates are neither strong enough nor capable to manage their own respiratory efforts without hypoventilation or damage to the lungs (Lubarsky et al., 2020, p. 3). Research shows that despite …

The Successful Rehabilitation Of A Complicated Mva Patient: A Case Report, Mike Hansen, Eric Jonsvold, Stanley Poole, Mark Steinhauer

Physical Medicine & Rehabilitation

No abstract provided.

Increasing Kangaroo Care In A New Small Baby Unit, Dianne Wilderson, Barb Haney, Ashley Mirabile, Beckie Palmer, Jenny Heltzer, Erin Keith-Chancy Bsn,Ccrn, Brooke Smith, Christian Anthony Schneider, Abdebayo Oshodi

Posters

Project Aim: Increase the percent of eligible patients receiving kangaroo care from 19% to 30% by September 2019.

Results:

113 staff completed education

OT consults completed on all SBU patients

20 kangaroo wraps purchased

Kangaroo care rate in NICU increased from 19% (prior to SBU) to 36% (Post SBU opening).

Conclusion: Due to increased multidisciplinary awareness of importance of kangaroo care in the SBU more parents are completing kangaroo care.

The Decision Of Families And Hospice Nurses On Use Of Oxygen Therapy At End Of Life, Mary Gathoni, Janis Schiefelbein

Posters

Minimal research efforts have focused on why family members make the decision to use oxygen therapy for their loved one at end of life, and the thoughts of hospice nurses who recommend the use of oxygen. Many families and nurses believe the use of oxygen therapy in palliative care is a practice endorsed by the medical community. However, this is inconsistent with existing knowledge that oxygen use at end of life contributes to comfort and decreases breathlessness or dyspnea. Dyspnea, the sensation of breathlessness or inadequate breathing, is common for patients with end of life illnesses. Dyspnea occurs when an …

Quickcough: An Instrumentational Proximal Airway Clearance Technique (Act) For Select Patients With Neuromuscular Disease (Nmd), Sean X. Sullivan, Russell K. Catania, Madison K. Plaster, Sydney E. Kandray, Mariah Costa

Williams Honors College, Honors Research Projects

Patients with neuromuscular disease (NMD) requiring tracheostomy and mechanical ventilation secondary to respiratory failure encounter increased difficulty in removing pulmonary secretions from the airways. To combat issues associated with current treatment modalities for insufficient cough efficacy (cost, poor mobility, discomfort, lack of evidence), we have developed an instrumentational proximal airway clearance technique (ACT) which augments a manual proximal ACT developed by a client with NMD. QuickCough is a 3D-printed PLA attachment to the tracheostomy apparatus which has demonstrated its ability to facilitate pressure changes necessary to increase patient’s peak cough flow (PCF) by providing a stronger exsufflation for the patient. …