Long gone are the days when patients with heart failure were discouraged from any kind of physical exertion for fear that it would aggravate their condition. Countless studies have concluded that physical therapy helps most heart failure patients to not only maintain but also modestly improve their cardiac function. Although it's pretty much a case of use it or lose it, a physiotherapist can help pinpoint the level of "use it" that is right for you.
What Is Heart Failure?
The American Heart Association defines heart failure as the heart's inability to meet all the demands of the body's tissues. Heart failure is common in men and women who have suffered a heart attack---an interruption of blood flow to the heart muscle. Such damage reduces the heart's efficiency. Other patients may develop heart failure due to advancing age. The early signs of heart failure include fatigue and shortness of breath triggered by exertion. Over time, these symptoms may appear whether the patient has exerted himself or not.
A Word of Caution
The benefits of physical therapy for heart failure patients have been endorsed by a number of highly regarded authorities on cardiac health, including the AHA's Committee on Exercise, Rehabilitation and Prevention. However, like every good rule, this one has its exceptions. Consult with your cardiologist and/or a physiotherapist to see whether you're a candidate for a program of physical therapy. Most heart failure patients are, but it's important to check first.
Find a Licensed Physiotherapist
In the same way that you would insist on a medical doctor with top-notch credentials, you'll want to find a physiotherapist who's fully equipped to handle your needs. The American Physical Therapy Association (APTA) suggests that you always seek a physiotherapist who is licensed, even if it's therapy that will be carried out in facilities maintained by your doctor. APTA's website has a PT locator service that allows you to plug in your zip code and generate a list of credentialed physiotherapists within a specified number of miles of your home.
Physical Therapy Works
A large-scale study, the findings of which were published in the April 8, 2009, issue of the Journal of the American Medical Association (JAMA), concluded that a program of physical therapy for heart failure patients was not only safe but produced modest benefits. The study, called HF-ACTION (Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training), involved "a randomized controlled trial of 2,331 medically stable outpatients with heart failure and reduced ejection fraction," according to JAMA.
Physiotherapy for ICU Patients?
While the benefits of physiotherapy in an outpatient setting are widely accepted, the APTA in November 2007 released a study that it said supports physiotherapeutic intervention while patients are recovering in a medical intensive care unit (ICU). The association claimed that getting heart failure patients involved in simple breathing and range-of-motion exercises helped shorten their stay in the ICU, compared with others who did not participate in the physiotherapy sessions.
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