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Article

Therapist Driven Rehabilitation Protocol for Patients with Chronic Heart and Lung Diseases: A Real-Life Study

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Istituti Clinici Scientifici Maugeri IRCCS, Cardiac Rehabilitation of the Institute of Lumezzane, 25065 Lumezzane (BS), Italy
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Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Lumezzane, 25065 Lumezzane (BS), Italy
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Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Montescano, 27040 Montescano (PV), Italy
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(3), 1016; https://doi.org/10.3390/ijerph17031016
Received: 18 December 2019 / Revised: 31 January 2020 / Accepted: 1 February 2020 / Published: 5 February 2020
(This article belongs to the Special Issue Physical Activity and Elder Health)
Therapist driven protocols may help to tailor rehabilitation programs to individual patients. We aimed to test the feasibility, safety, and clinical usefulness of a therapist driven protocol for rehabilitation including exercise training of patients with heart or lung diseases. An internal audit elaborated the Cardio-Respiratory Exercise Maugeri Algorithm (CREMA) based on: (a) standardized baseline assessments, (b) decision-making pathways, and (c) frequency/intensity/time/type (FITT) of prescription for each exercise. Outpatients (n = 620) with chronic heart disease (CHD), recent myocardial revascularization (REVASC), chronic airway (Obstructive), and restrictive lung (Restrictive) diseases underwent exercise training according to CREMA during 4 years. Peripheral muscle strengthening was the most prescribed exercise (83.6%), while arm endurance training was the least frequently (0.75%). Exercise prescription varied widely among the disease groups (interval training 19–47%, balance 35–49%, lower limb muscle training 6–15%). After training, REVASC patients were the best improvers in the 6 min walking distance (+48.7 (56.1) m), maximal inspiratory pressure (+9.6 (15.4) cmH2O), and daily steps (+1087.2 (3297.1) n/day). Quadriceps and biceps strength, maximal expiratory pressure, and balance improved in all groups, without significant differences. Minor side effects were observed in 11.2% of the patients. The CREMA therapist driven protocol was feasible, safe, and useful for prescribing tailored training programs. Exercise prescriptions and training response differed among diseases. View Full-Text
Keywords: cardiac rehabilitation; pulmonary rehabilitation; exercise; training; algorithm; physiotherapist protocol; driven protocols cardiac rehabilitation; pulmonary rehabilitation; exercise; training; algorithm; physiotherapist protocol; driven protocols
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MDPI and ACS Style

Simonelli, C.; Vitacca, M.; Ambrosino, N.; Scalvini, S.; Rivadossi, F.; Saleri, M.; Fokom, A.G.; Speltoni, I.; Ghirardi, R.; Paneroni, M. Therapist Driven Rehabilitation Protocol for Patients with Chronic Heart and Lung Diseases: A Real-Life Study. Int. J. Environ. Res. Public Health 2020, 17, 1016. https://doi.org/10.3390/ijerph17031016

AMA Style

Simonelli C, Vitacca M, Ambrosino N, Scalvini S, Rivadossi F, Saleri M, Fokom AG, Speltoni I, Ghirardi R, Paneroni M. Therapist Driven Rehabilitation Protocol for Patients with Chronic Heart and Lung Diseases: A Real-Life Study. International Journal of Environmental Research and Public Health. 2020; 17(3):1016. https://doi.org/10.3390/ijerph17031016

Chicago/Turabian Style

Simonelli, Carla, Michele Vitacca, Nicolino Ambrosino, Simonetta Scalvini, Francesca Rivadossi, Manuela Saleri, Aubin G. Fokom, Ilaria Speltoni, Riccardo Ghirardi, and Mara Paneroni. 2020. "Therapist Driven Rehabilitation Protocol for Patients with Chronic Heart and Lung Diseases: A Real-Life Study" International Journal of Environmental Research and Public Health 17, no. 3: 1016. https://doi.org/10.3390/ijerph17031016

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