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.

Result:

After 6 weeks of Structured Exercise training program a 6 Minute Walk test was done in which patient covered 380 metres of distance without any dyspnea. She had become independent in all her Functional Activities of Daily Living (ADL) and had no other symptoms.

Conclusion:

Physiotherapy plays an important role in management of patient with Left Ventricular failure. Chest Physiotherapy and Customized Exercise training programme helps in improving the overall Quality of Life (QOL) and thus makes the patient Functionally Independent.