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Blood pressure monitoring in outpatient physical therapy clinics: should it be performed routinely?

(1) Kasinskas, Christine; (1) Wood, Rosemary D.; (1) Koch, Marie L. (1) Quinnipiac University, Hamden, CT, United States.

Purpose/Hypothesis: The Guide to Physical Therapist Practice recommends that all patients who are seen for physical therapy intervention receive a cardiopulmonary screening. This involves the measurement of vital signs including heart rate, respiratory rate, and blood pressure. Physical Therapy faculty at Quinnipiac University has received reports from students on clinical affiliations that clinicians in many outpatient settings do not follow this recommendation. The purpose of this study was to identify whether there is a population of hypertensive patients, either undiagnosed or poorly controlled on antihypertensive medications, who regularly come to physical therapists for treatment. Number of Subjects: One hundred-fourteen patients were screened for hypertension at eleven participating outpatient clinics located in New York, New Jersey, and Connecticut. Materials/Methods: Eleven 3rd and 4th year physical therapy students volunteered to collect data for the study and permission was obtained from the clinical sites where they were affiliating. The patient sample was randomly recruited from the clinics who agreed to participate. Students took regular blood pressure measurements using the Omron HEM-780 automatic blood pressure cuff. They were instructed in use of the blood pressure monitors and data collection by the investigators. Students screened ten to fifteen new patients each on initial and follow up visits for a minimum of three blood pressure readings per patient. Demographic information, physical therapy diagnosis, a brief medical history, and a list of medications were collected. Results: Patients were classified as normal, prehypertensive, or hypertensive using the blood pressure standards of the American Heart Association. Patients who did not have at least 3 values for blood pressures over the course of their therapy were not classified. Twenty seven patients or 23.6% were classified as hypertensive. Twenty seven subjects or 23.6% of the population was classified as prehypertensive. Thirty three of the patients were normotensive. Data from twenty seven of our patients could not be used as they did not have at least three readings. Conclusions: Random blood pressure measurement of physical therapy patients seen on an outpatient basis identified 54 patients out of 87 who had either pre-hypertension or hypertension. Uncontrolled hypertension is a primary risk factor for many other conditions but many individuals are unaware they have hypertension. Direct access is now a reality in many states and patients come to the physical therapist without having seen a primary care physician. Clinical Relevance: Monitoring blood pressure is important before initiating a physical therapy intervention as hypertension may be a contraindication to treatment. Identifying these patients allows the physical therapist to make appropriate referrals for medical intervention.
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Publication:Cardiopulmonary Physical Therapy Journal
Date:Dec 1, 2011
Previous Article:Is home-based pulmonary rehabilitation as effective as hospital-based for patients with chronic obstructive pulmonary disease? A systematic review.
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