Over the last 10 to 15 years, health care providers have focused more on using evidence-based medicine to determine what works best for their individual patients. This involves basing treatments on objective tests of effectiveness published in scientific literature, rather than on just anecdotal, subjective observations made in the office. While seeking out the appropriate research can be difficult and time consuming, the Internet has greatly increased the ease with which many health care providers can access and rapidly sort up-to-date information.

Physical therapy has likewise moved in the same direction. Because a program that works for one patient may not be effective for another, we incorporate a patient’s information, preference or particular circumstance, along with our clinical expertise and research evidence, to identify an approach that will guide decision making and provide the most benefit for that particular patient.

For instance, if you have injured a joint, such as a shoulder or a knee, before consulting the research literature, we may ask the following medical history questions to identify the specifics of your injury:

  • When did you first experience pain?
  • What caused the pain?
  • Is the pain constant or intermittent?
  • Are there any other circumstances that affect the pain?
  • Are there vocational concerns to be considered?
  • Do you have any other symptoms?
  • Have you tried any home remedies, and what were the results?

We will integrate the answers to these questions and your particular patient or family preferences with findings from systematic research and our own clinical experience. We will then utilize this information to design a physical therapy program of stretching and strengthening exercises that will accomplish the outcome best for you.
Getting Back Into the Swing Following Angioplasty

Coronary angioplasty is a procedure to open clogged heart arteries. First, a catheter, or small tube, is snaked into the artery; then, a balloon on its end is expanded to force the artery open. Often, a stent, or small wire mesh device, is inserted at the site of the clog to keep the artery open and prevent a heart attack.

The procedure usually takes several hours and requires a short hospital stay. Because angioplasty and stenting increase the amount of blood flowing to the heart, many people feel better almost immediately.

How quickly you can return to activities such as tennis or golf is variable and depends on your physical condition and activity level before the angioplasty, the number of blood vessels involved and your response to treatment. Your cardiologist will determine the level of activity appropriate for you.

Physical therapy often begins soon after surgery. Six to eight hours after the angioplasty, patients are generally encouraged to walk around, although they may feel sluggish and weak for a day or two. Lifting more than ten pounds and engaging in vigorous exercise should be avoided for the first week or two, but studies have shown that moderate exercise after stenting does not increase the risk of complications. After a few months, your cardiologist may order an exercise stress test to assess your condition and make sure your arteries remain open.

Not only is exercise safer than it was before your angioplasty but most physicians recommend it because of the benefits it affords. Exercise can

  • prevent the recurrence of the condition that led to the angioplasty in the first place
  • enable you to get a better night’s sleep
  • keep your blood pressure, cholesterol and weight at healthy levels

Regardless of your physical limitations, we can work with you and your physician to set up an exercise program to help you to reach your goals. Using our skills and experience, we can determine the duration and intensity of your exercise program. The good news is that many patients who were physically active before angioplasty are able to return to playing the sports they love.

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