Altitude Medicine: Rehab at the Peak

I took a trip to Denver recently and, right around the same time, was consulted regarding the use of a pulse oximeter at high altitudes. It all got me thinking: how different could it really be to practice at 9,000ft? So, I did some work on this and I have to tell you, finding thisContinue reading “Altitude Medicine: Rehab at the Peak”

Blow Out the Candles…

If there is any treatment that I feel like gets used in a cookie-cutter fashion, it’s pursed-lip breathing. As much as I hate seeing this technique used for every single patient that has shortness of breath, it does have clinical usefulness. So let’s talk about how to implement pursed-lip breathing properly based on patient presentationContinue reading “Blow Out the Candles…”

Postural Drainage

We’ve all seen that dreaded picture in our textbooks… All the human figures laying in so many different positions with pillows and tables tilted all over… and I very clearly remember thinking, “How on earth am I supposed to remember all of those?” Well, good news. You really don’t have to. It’s great if youContinue reading “Postural Drainage”

The Counting Talk Test

Time to give you guys another tool. This one is especially important for patients with COVID-19, and it’s not terribly often that we get an objective measure for exertion. I’ve found the counting talk test to be critical in quantifying exertion in my patients with respiratory diagnoses. This measure is phenomenal for taking breathlessness inContinue reading “The Counting Talk Test”

NIV/NIPPV

Already updated since first posting!!! So many acronyms… Non-Invasive Ventilation (NIV) and Non-Invasive Positive Pressure Ventilation (NIPPV) are some of the more advanced respiratory interventions being provided to some patients who experience COVID-related and non-COVID-related ARDS. These interventions are pretty much what they sound like: mechanical ventilation is provided to the patient with or withoutContinue reading “NIV/NIPPV”

Segmental Breathing

Thanks for checking out the next post in the pulmonary rehab toolbox! We’re going to talk about the performance and use of segmental breathing techniques. In relationship to COVID-19, segmental breathing can be utilized to target specific lung segments that have been affected by alveolar collapse or damage, but it can also be utilized toContinue reading “Segmental Breathing”

Glossopharyngeal Breathing

Hi everyone! Thanks for sticking with me on my post series for the pulmonary rehab toolbox! In my post on V/Q matching I talked a little bit about the use of dynamic hyper inflation techniques including glossopharyngeal breathing. This is a technique that we typically utilize for patients who have spinal cord injuries or otherContinue reading “Glossopharyngeal Breathing”

Inspiratory Muscle Training (IMT)

What is an Inspiratory Muscle Trainer (IMT)? A device that strengthens the diaphragm and external intercostal muscles (muscles of inspiration) Provides controlled, graded resistance to inspiration Patients who can benefit from IMT use: COPD Respiratory Failure Recent Mechanical Ventilation Pneumonia Cystic Fibrosis   Congestive Heart Failure Pre/Post CABG     Pre/Post Lung Transplant ALS/GB/SCI Frailty/DebilityContinue reading “Inspiratory Muscle Training (IMT)”

Active Cycle of Breathing (ACBT)

The Active Cycle of Breathing is a critical tool for secretion mobilization. It can also be modified in several ways to address patient-specific needs. But the basic cycle is more than enough for most patients. The goal is to loosen secretions and get air underneath them so they can be mobilized (or coughed) out. IContinue reading “Active Cycle of Breathing (ACBT)”

H.O.M.E.B.O.U.N.D.

Home health care PTs are incredibly familiar with the term “homebound.” It determines whether or not we can provide home-based services to a Medicare patient. Directly from CMS… “Home health services are or were required because the individual is or was confined to the home per the criteria below (as defined in sections 1835(a) andContinue reading “H.O.M.E.B.O.U.N.D.”