We are upgrading the repository! A content freeze is in effect until December 6, 2024. New submissions or changes to existing items will not be allowed during this period. All content already published will remain publicly available for searching and downloading. Updates will be posted in the Website Upgrade 2024 FAQ in the sidebar Help menu. Reach out to escholarship@umassmed.edu with any questions.

Show simple item record

dc.contributor.authorBaima, Jennifer
dc.contributor.authorMaxfield, Mark W.
dc.contributor.authorPowers, Maggie
dc.contributor.authorVarlotto, John M.
dc.contributor.authorUy, Karl
dc.date2022-08-11T08:10:08.000
dc.date.accessioned2022-08-23T16:56:49Z
dc.date.available2022-08-23T16:56:49Z
dc.date.issued2020-03-08
dc.date.submitted2020-03-11
dc.identifier.doi10.13028/w0dm-t567
dc.identifier.urihttp://hdl.handle.net/20.500.14038/43012
dc.description<p>Poster presentation at the 2020 International Society of Physical and Rehabilitation Medicine World Congress, Orlando, FL, March 8, 2020.</p>
dc.description.abstractCase Diagnosis: 67 year-old man was found down with dysarthria, dysphagia, and right lower limb weakness. He was diagnosed with left anterior cerebral artery ischemic stroke, acute renal failure, atrial fibrillation, and deep venous thrombosis. He remained hospitalized for months as he did not have insurance for inpatient rehabilitation care and could not be safely discharged home. Case Description: During that time, he got physical therapy 5 times per week and then 2 times per week. While hospitalized, he was subsequently diagnosed with left upper lobe nodule from T2aN0M0 lung adenocarcinoma. Physical therapy was increased back to 5 times per week for at least two weeks prior to left upper lobectomy and mediastinal lymphadenectomy by video-assisted thorascopic surgery 2.5 months after admission. Hospital course was complicated by anticoagulation and postoperative hemothorax, which responded to evacuation. He was discharged to subacute care after rate negotiation and then home. Discussions: We present the case of a patient who got physical therapy five times weekly in the 14 days prior to thoracic surgery. Although it is well established that exercise improves aerobic parameters and outcomes, the typical outpatient insurance benefit is under 120 minutes or only twice per week. 150 minutes a week is the current recommended amount of exercise for cancer patients. Since this patient could not be discharged due to lack of insurance for acute rehabilitation or outpatient care, he remained inpatient and received physical therapy five times weekly prior to surgery. Despite risk factors, he was safely discharged and recovered well. Conclusions: Our patient got a greater frequency and higher dose of exercise than most presurgical thoracic patients; this may be why he was able to tolerate thoracic surgery with multiple serious risk factors.
dc.language.isoen_US
dc.rightsCopyright 2020 the Authors
dc.subjectcase study
dc.subjecthealth insurance
dc.subjectphysical therapy
dc.subjectinpatient
dc.subjectexercise
dc.subjectthoracic surgery
dc.subjectCardiovascular Diseases
dc.subjectHealth Services Administration
dc.subjectInsurance
dc.subjectOrthopedics
dc.subjectPhysical Therapy
dc.subjectSurgery
dc.titleAccidental Prehabilitation: a case of increased exercise frequency before thoracic surgery
dc.typePoster
dc.identifier.legacyfulltexthttps://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=1215&amp;context=ortho_pp&amp;unstamped=1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/ortho_pp/213
dc.identifier.contextkey16769390
refterms.dateFOA2022-08-23T16:56:50Z
html.description.abstract<p>Case Diagnosis: 67 year-old man was found down with dysarthria, dysphagia, and right lower limb weakness. He was diagnosed with left anterior cerebral artery ischemic stroke, acute renal failure, atrial fibrillation, and deep venous thrombosis. He remained hospitalized for months as he did not have insurance for inpatient rehabilitation care and could not be safely discharged home. <strong></strong></p> <p>Case Description: During that time, he got physical therapy 5 times per week and then 2 times per week. While hospitalized, he was subsequently diagnosed with left upper lobe nodule from T2aN0M0 lung adenocarcinoma. Physical therapy was increased back to 5 times per week for at least two weeks prior to left upper lobectomy and mediastinal lymphadenectomy by video-assisted thorascopic surgery 2.5 months after admission. Hospital course was complicated by anticoagulation and postoperative hemothorax, which responded to evacuation. He was discharged to subacute care after rate negotiation and then home. <strong></strong></p> <p>Discussions: We present the case of a patient who got physical therapy five times weekly in the 14 days prior to thoracic surgery. Although it is well established that exercise improves aerobic parameters and outcomes, the typical outpatient insurance benefit is under 120 minutes or only twice per week. 150 minutes a week is the current recommended amount of exercise for cancer patients. Since this patient could not be discharged due to lack of insurance for acute rehabilitation or outpatient care, he remained inpatient and received physical therapy five times weekly prior to surgery. Despite risk factors, he was safely discharged and recovered well. <strong></strong></p> <p>Conclusions: Our patient got a greater frequency and higher dose of exercise than most presurgical thoracic patients; this may be why he was able to tolerate thoracic surgery with multiple serious risk factors.</p>
dc.identifier.submissionpathortho_pp/213
dc.contributor.departmentDepartment of Radiation Oncology
dc.contributor.departmentDepartment of Surgery
dc.contributor.departmentDepartment of Orthopedics and Physical Rehabilitation


Files in this item

Thumbnail
Name:
accidental_prehab_____2020jbed ...
Size:
552.1Kb
Format:
PDF

This item appears in the following Collection(s)

Show simple item record