Role of Physiotherapy in Left Ventricular Failure

Role of Physiotherapy in Left Ventricular Failure

Background: 

A 79 year old female was admitted in Saifee hospital with Grade IV dyspnea on New York heart Association (NYHA) scale and cough with mucoid expectoration. She was in tachycardia, tachypnea with a low Oxygen saturation (SpO2) level of 84%. Investigation were done which diagnosed her to be in acute Left Ventricular Failure (LVF). She was started with 2L/min of oxygen along with medications and was referred for Chest Physiotherapy.

Method:

Chest Physiotherapy consisting of Chest wall Manipulations and Breathing exercises (Diaphragmatic Breathing exercise, Segmental breathing exercise and Pursed Lip Breathing exercise) were given to the patient thrice a day. After 5 days of treatment there was significant reduction in the Crepts in Lungs and the symptoms and the patient maintained SpO2 level of 95% on room air. 

After Discharge patient was breathless even after walking only for 5-6 steps in the home. Low intensity Calisthenics exercise of 1.5-2 Metabolic Equivalent (METs) along with walking program was started for the patient. In the beginning patient was made to walk 10 steps with a rest pause in between and gradually the duration of walk was increased and intensity was decided on the basis of Karnovens formula. It was performed 3 times a day with a Rate of perceived exertion (RPE) of less than 3 on a scale of 10.