Research shows early physiotherapy intervention is integral to managing PH A study into physiotherapy delivered to patients with PH in the UK has found that early intervention with physiotherapy practice is integral to managing the condition. Here we take a closer look at the findings.
B
ack in the Summer 2015 edition of Emphasis, you may remember that we invited readers to take part in a research programme into physiotherapy and the management of PH, funded by the Chartered Society of Physiotherapy. The programme, which ran over an 18-month period from December 2015, aimed to identify what role physiotherapists play in the care of patients with PH, in specialist centres and in other settings too. The researchers were also interested in what worked well for different groups of patients, and if there were any gaps in services. Three patients volunteered to take part in the study who all described themselves as ‘active’ and regularly exercised independently. One patient had been through a pulmonary rehabilitation programme several years previously, whereas the others had had no physiotherapy involvement. There were two female patients and one male patient aged between 44 and 66 years old. All the patients had stable PH and
had been diagnosed for eight to ten years previously. Interviews were carried out with a physiotherapist at each of the specialist PH centres, and survey data was also gathered from 63 physiotherapists caring for patients with PH in specialist and non-specialist settings.
THE FINDINGS The study showed that physiotherapists would like to do more to achieve better health outcomes for acutely unwell patients at the specialist PH centres through early rehabilitation. This might involve getting patients standing, walking around the ward, and starting to look after themselves physically, as early as possible while they are in hospital. Survey data found that physiotherapists and PH patients see the benefit and potential of increasing physical activity in and out of hospital, to help patients be able to do as much
as they can for themselves, and to become more independent. However, at the moment, physiotherapy only supports the most unwell inpatients and planning for hospital discharge. This means that current procedures differ from what research evidence and clinical guidelines recommend. The research also found that physiotherapists will occasionally refer patients to existing community services, e.g. community pulmonary rehabilitation. However, specialist knowledge of this rare condition can be lacking in these local services which provides a barrier to accessing quality care. The study concluded that physiotherapy should become routine in the management of PH promoting physical activity, functional independence, and self-management. To achieve this, physiotherapists will need to work closely with local services to deliver quality care in line with patient needs throughout the lifespan of their disease.
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Carol Keen is a clinical specialist physiotherapist in pulmonary hypertension at the Royal Hallamshire Hospital. She said:
This study highlights the importance of participating in research to generate outcomes “which can change services. The information we gathered from patients in this research was
vital in helping us put together a picture of what patients need. The data from this study was collected over two years ago now, and since then we are slowly seeing a greater emphasis on the importance of physiotherapy and physical activity in caring for patients with PH, but there is still a long way to go.
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AUTUMN 2018 emphasis 33
