Physical therapy and matters of the heart

Pain and limited mobility are generally what brings patients in for physical therapy, though what they don’t feel can be just as important.

Gary Fuschini who works as a physical therapy assistant at Performance Spine and Sports Medicine said some of the common ailments they see in patients are various types of hypertension, which limit sensation in the body. The other side effects of hyper or hypotension can’t be seen with the eye, but still need to be monitored.

“Most patients with diagnosed hypertension come to PT with their blood pressure controlled by medications,” said Fuschini. “If at risk, we will check BP before the start of treatment to ensure it is at a safe level to exercise. If necessary, throughout the PT session we will check the patients BP periodically to make sure it does not exceed a level deemed safe to exercise.”

One type of hypertension which requires special attention is peripheral vascular disease (PVD). Fuschini said those with PVD can have altered and decreased sensations, particularly in their legs and feet. He said he gives extra attention to these areas to identify cuts or bruises.

He said another consideration of PVD is intermittent claudicating, a symptom caused by decreased blood flow.

“It causes aching, burning pain and fatigue with walking. Physical therapy gradually works on increasing tolerance for ambulation,” said Fuschini.

Another type of hypertension he must pay particular attention to is orthostatic hypotension. It is characterized by a rapid drop in blood pressure when a patient changes position, such as standing up from lying or sitting. He said he helps patients alleviate the symptoms of orthostatic hypotension by instructing them to move more slowly.

“It is helpful to have something nearby the patient can hold onto for support as they stand up and to take a minute before initiating walking,” said Fuschini.

Fuschini said the best exercise to maintain cardiovascular health is walking briskly for 30 to 40 minutes per day four days a week.

“There are numerous studies indicating that raised blood pressure, which is a risk factor for heart attack and stroke can be controlled through exercise,” said Fuschini. “Other controllable factors include eating a balanced diet and maintaining a healthy weight, not smoking and having regular checkups by your physician especially if your family has a history of any of these diseases.”

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