ONLINE PHYSIOTHERAPY FOR EARLY RECOVERY OF PHYSICAL FUNCTION AFTER CARDIAC SURGERY

T. Takahashi¹, T. Morisawa¹, M. Saitoh¹, Y. Kikuchi², M. Mochizuki¹, H. Watanabe², M. Yokoyama³, N. Kagiyama³, T. Kasai³, T. Minamino³, M. Tabata⁴, H. Daida⁵

¹Juntendo University, Department of Physical Therapy, Bunkyo-ku, Tokyo, Japan, ²Juntendo University Hospital, Department of Rehabilitation, Tokyo, Japan, ³Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Bunkyo-ku, Tokyo, Japan, ⁴Juntendo University Graduate School of Medicine, Department of Cardiovascular Surgery, Bunkyo-ku, Tokyo, Japan, ⁵Juntendo University, Faculty of Health Science, Bunkyo-ku, Tokyo, Japan

Background: We reported that older patients discharged from the hospital after cardiac surgery without adequate improvement in physical function during hospitalization have a poor prognosis, suggesting the need for continued physiotherapy after discharge (Morisawa 2021). In recent years, telemedicine is rapidly becoming more common due to the development of information and communication technology, and physiotherapy is no exception.

Purpose: The purpose of this study was to examine the effect of online physiotherapy on physical function recovery in older cardiac patients after early post-discharge.

Methods: Thirty four patients (mean age 78 years) who underwent standby cardiac surgery and underwent cardiac rehabilitation during hospitalization, and whose SPPB 5 times repeated chair rises had not returned to preoperative values by the time of discharge, were offered with online physiotherapy. Changes in frailty-related indicators and the Kihon-checklist were compared with those in the age-matched control group (n=34, mean age 77 years, no PT intervention). Online physiotherapy was conducted by connecting the university and the patient's home via a telecommunication system. After checking the patient's general condition and confirming vital signs, the same SPPB-based exercise function assessment and exercise intervention as during hospitalization were conducted for 30 minutes per session, once a week, for one month after discharge.

Results: Online physiotherapy was completed without incident in all patients. One month after discharge, 29/34 patients in the online physiotherapy group and 25/34 patients in the control group were able to stand up five times in SPPB within 10 seconds. Six months after discharge, more patients in the control group experienced falls (4 cases), and there was a significant difference in the Kihon checklist with 4.0 points in the online physiotherapy group and 5.1 points in the control group (p<0.05).

Conclusions: Online physiotherapy early after discharge promoted recovery of physical functions. It is possible that the early online physiotherapy may have affected the number of falls and post-discharge frailty 6 months after discharge.

Implications: Online physiotherapy for older patients after cardiac surgery is feasible and helps patients restore physical function.

Funding acknowledgements: This work was supported by JSPS KAKENHI Grant Number 20H04055

Keywords:
Online physiotherapy
Cardiac surgery
Older patient

Topics:
Cardiorespiratory
Service delivery/emerging roles
Older people

Did this work require ethics approval? Yes

Institution: Juntendo University

Committee: Juntendo University Hospital Ethics committee

Ethics number: H20-0365