5. how did the dallas bed-rest study influence post-surgery rehab procedures?

by Stewart Armstrong Published 1 year ago Updated 1 year ago

When was the Dallas bed rest study published?

Mar 09, 2014 · Fortunately, the scientists didn't stop there. Instead, they put the men on an 8-week exercise program. Exercise did more than reverse the deterioration brought on by bed rest, since some measurements were better than ever after the training. The Dallas study was a dramatic demonstration of the harmful consequences of bed rest.

What happens during cardiac rehabilitation follow-up?

Jul 31, 2021 · Placing a patient on a bedpan requires a special technique and is reserved for those that are on bed rest per a health care provider order or discretion. Follow any preset institutional policies on the use of a bedpan in a clinical setting. ... According to a 2003 study, ... thus poor outcomes at 3 months post-stroke as a result of the added ...

Should supervised cardiac rehabilitation be abstinence for 6 weeks post sternotomy?

Mar 01, 2018 · The Dallas bed rest studies demonstrated that 3 weeks of total inactivity had a more profound impact on exercise capacity than 30 years of ageing.14 15 Cardiac muscle mass has also been shown to decrease by 8% after 6 weeks of bed rest.15 Additionally, inactivity of 10–12 days is sufficient to lead to a loss of skeletal muscle mass of 0.5%–0.6% per day.16 …

How has Cardiac Rehabilitation evolved over the years?

The aim of this study was to investigate the influence of postoperative complications and patient comorbidities on variance in extended length of hospital stay after lumbar spine surgery. Methods: Data from the American College of Surgeons National Surgical Quality Improvement Program were analyzed from January 1, 2008, through December 31, 2014.

What was the primary finding of the Dallas Bed Rest and Training Study and the long term follow up of its research participants addressed in lecture?

The primary findings from the 30-year follow-up were that the average decline in maximal oxygen uptake (VO2max) from age 20 to 50 was less than that observed after 3 weeks of bed rest when the participants were 20 years old and was reversible with endurance exercise training (2,3).

What is the Dallas bed rest Study?

In 1966, a seminal study in exercise science was conducted: the Dallas Bed Rest and Training Study. With the primary results published as a 78-page supplement to Circulation in 1968, it reported the changes in cardiorespiratory performance from extreme changes in physical activity.Oct 14, 2019

What is the meaning of oxygen uptake?

Oxygen uptake (or consumption) is a measure of a person's ability to take in oxygen and deliver it to the working tissues, and the ability of working tissues to use oxygen.

What is PPI in CR?

Patient and public involvement (PPI) has shaped the study design. Our patient forum endorsed the acceptability of early CR exercise training after surgery and stressed the importance of returning to work/activities of daily living as soon as possible. Our PPI coinvestigator, with lived experience of cardiac surgery, met with several surgical patients, each of whom was sent an overview of the early research protocol. The feedback helped researchers select outcome measures that were relevant to patients’ daily experiences and, that crucially, would not unduly inconvenience participants. Multiple, time-consuming, invasive outcome measures were considered unethical so early after major surgery.

How long is the SCAR study?

Participants will be randomly allocated to 8 weeks of CR exercise training commencing at either 2 weeks (early CR) or 6 weeks (usual care CR) post-surgery. Outcomes will be measured at baseline (within 7 days of surgery), start of CR (2 or 6 weeks), end of CR (10 or 14 weeks) and at 12 months. Assessors will be blinded to group allocation. The trial protocol adheres to the Standard Protocol Items: Recommendations for Clinical Trials guidelines. 26

Is CR exercise training important?

Compliance and adherence is an important outcome in patients commencing CR exercise training early post-surgery. Attendance at CR exercise sessions will be closely monitored along with compliance to the prescribed exercise regimen. The number of sessions attended will be documented, as will the number of sessions successfully completed. Detailed reasons for incomplete sessions and dropout will be recorded where the participant is happy to provide this information.

What is the SF-12?

Furthermore, they are routinely recorded in the CR population as part of standard clinical practice with the results reported in the NACR. 38 The 12-Item Short Form Survey (SF-12) will be used to evaluate HR-QoL. 39 The 12 items of the questionnaire are summarised in two weighted summary scales; mental health score and physical health score, where lower scores indicate more severe disability.

How many people undergo CABG surgery?

Every year, approximately 35 000 patients undergo coronary artery bypass graft (CABG) or aortic/mitral valve replacement surgery in the UK. 1 Functional limitation is common and persistent after surgery, mediated by chest wall pain, respiratory complications, fatigue and anxiety concerning the resumption of daily activities. 2–4 At 12 months, previous studies have reported sternal wound pain in nearly 50% of patients 2 and ‘unsatisfactory’ functional status and quality of life in a third of patients. 5 These issues can delay return to work, particularly for those with physically demanding jobs, and the financial consequences can be significant. 6 7

Where is the SCAR trial?

The SCAR trial will be conducted at two cardiac rehabilitation venues provided by University Hospitals Coventry and Warwickshire (UHCW) National Health Service (NHS) Trust, (1) Atrium Health, Centre for Exercise and Health, Coventry and (2) Hospital of St Cross, Rugby. Both CR programmes are certified by the British Association of Cardiovascular Prevention and Rehabilitation (BACPR), thus, providing the necessary infrastructure and expertise for the delivery of the SCAR intervention. All cardiac surgery will be performed at University Hospital, Coventry, a national specialist tertiary cardiac centre. One hundred and forty patients will be recruited over a 2-year period, commencing 15 July 2017.

What is EuroQol 5D?

The 5-Item EuroQol (EQ-5D) questionnaire is a commonly used generic measure of health status. A key feature is the availability of ‘value sets’ to weight the EQ-5D health states reported by participants and populations. The UK value set reported by Dolan 40 is recommended by National Institute for Health and Care Excellence for use in its health technology appraisal process. 41 An adapted Client Service Receipt Inventory (CSRI), based on examples in the Database of Instruments for Resource Use Measurement (DIRUM) database 42 will be administered at each time point to capture participant health and social care service use since the last time point. The cost of delivering early CR and usual care CR (ie, staff, equipment, facility) will be recorded throughout the CR programme.

Chapter 1: Introduction

Most patients who have undergone cardiac surgery require rehabilitation as a way of reversing the limitations experienced from adverse pathophysiologic and psychological consequences of the whole process.

Chapter 2: Review of Literature

The need for cardiac rehabilitation for people with heart diseases is to enable them to go back to their usual and fulfilling life and keep away from cardiac events.

Chapter 3: Conceptual Framework

Prolonged cardiac rehab for cardiac patients with the assistance of online support group is going to be used as the model of implementing the current program. In this approach, there is a need to focus on the prevailing conditions that could affect the level of success of any prolonged cardiac rehab activities.

What are the complications of thrombolysis 24 hours after rtPA?

Complications 24 hours after thrombolysis, such as hemorrhagic transformation, bleeding of other origin, infection or deep venous thrombosis (as noted in medical record) were recorded.

How long after thrombolysis is a rtpa recorded?

The time and date of rtPA injection was recorded as well as blood pressure, blood glucose level, heart rate, respiratory rate, oxygen saturation and temperature on admission and 24 hours after thrombolysis. The NIHSS at 24 hours post rtPA was also recorded.

What is the cause of mortality?

Myocardial infarction ( MI) is a major cause of mortality and morbidity in the western world. As MI is a life threatening event it is hardly surprising that it often causes distress and impairment of quality of life for patients and their relatives, especially partners.

What should advice be?

Advice should be realistic, practical, and concrete (that is, specifying exactly what should be done—for example, “eat five portions of fresh fruit or vegetables every day” instead of “try and eat more fruit”). Advice should take account of social and cultural needs.

How long does it take to get a hospital anxiety test?

It takes only minutes to screen patients using the Hospital Anxiety and Depression Scale, and as many patients come back for an exercise test at 6–12 weeks postdischarge, this may be a good time to identify those likely to have long term adjustment problems and to refer them for appropriate counselling/treatment.

Is exercise good for post-MI?

The exercise involved may even be protective as regular moderate exercise has a very significant protective effect in post-MI patients. Some patients interpret the normal or explicable feelings of fatigue or minor symptoms of the anxiety they are suffering as relating to the condition of their heart.

What are the psychological reactions of a patient who is afraid of exercise?

Common psychological reactions that should be mentioned are: low mood; tearfulness; sleep disturbance; irritability; anxiety;

How does cardiac rehabilitation work?

A combination of exercise, psychological interventions, and education appears to be the most effective form of cardiac rehabilitation.

Should family members be included in rehabilitation?

Family members, especially the partner, should be included in the rehabilitation process. The greater part of any verbal interaction is quickly forgotten, and should be backed up with carefully constructed and empirically evaluated written and taped material.

How to use a quad cane?

1. using the quad cane on the left with the longer legs positioned away from the patient. 2. using the quad cane on the right with the longer legs positioned away from the patient. 3. using the quad cane on the left with the longer legs positioned toward the patient.

How to use a handrail on stairs?

stairs the MOST practical method is to: 1 use the handrail with the right hand and place the two canes in the left hand. 2. use the handrail with the left hand and place the two canes in the right hand. 3. place one cane in each hand and avoid using the handrail.

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