Physical Therapist Clinical Practice Guideline for the Management of Individuals With Heart Failure

Abstract

The American Physical Therapy Association (APTA), in conjunction with the Cardiovascular and Pulmonary Section of APTA, have commissioned the development of this clinical practice guideline to assist physical therapists in their clinical decision making when managing patients with heart failure. Physical therapists treat patients with varying degrees of impairments and limitations in activity and participation associated with heart failure pathology across the continuum of care. This document will guide physical therapist practice in the examination and treatment of patients with a known diagnosis of heart failure. The development of this clinical practice guideline followed a structured process and resulted in 9 key action statements to guide physical therapist practice. The level and quality of available evidence were graded based on specific criteria to determine the strength of each action statement. Clinical algorithms were developed to guide the physical therapist in appropriate clinical decision making. Physical therapists are encouraged to work collaboratively with other members of the health care team in implementing these action statements to improve the activity, participation, and quality of life in individuals with heart failure and reduce the incidence of heart failure-related re-admissions.

Cardiovascular and Pulmonary Research: The Year (2021) in Review

“…If physical therapists recognize signs and symptoms of acute decompensation, such as S3 heart sound, pulmonary crackles, and increase in peripheral edema, it is crucial to recommend prompt medical follow-up. Utilization of the detailed algorithms provided in the article of Dias et al 2 can also be used as a supplement to the algorithms presented in the HF CPG given by Shoemaker et al 3 .…”

An Executive Summary of the Physical Therapist Clinical Practice Guideline for the Management of Individuals With Heart Failure

“…Specific details of the guideline development methodology and literature review can be found in the full guideline published in the Physical Therapy journal. 4…”

“…NYHA classes I-IV represent patient symptoms that vary bidirectionally where there can be progression and regression of symptoms depending on a patient's current state. 4 Reprinted from Phys Ther. 2020; 100(1):14-43, with permission of the American Physical Therapy Association.…”

Association of the quality of life parameters with the indicators of chronic heart failure severity in patients with rheumatoid arthritis

“…Оценка симптомов течения хронической сердечной недостаточности (ХСН), особенно на фоне таких заболеваний, как ревматоидный артрит (РА), сопровождающихся выраженным болевым синдромом и снижением качества жизни пациентов, важна для получения детальной и целостной картины заболевания. У пациентов с ХСН и РА такие первые неспецифические проявления ХСН, как повышенная утомляемость, снижение толерантности к физической нагрузке, спад повседневной активности, могут маскироваться под симптомы РА [1,2]. В свою очередь, снижение физической активности, по мнению ряда исследователей, может быть причиной увеличения риска развития декомпенсации ХСН, ввиду ухудшения кровообращения органов и тканей, в том числе миокарда [3,4].…”