Cardiovascular Considerations in Orthopedic Rehabilitation

With the increased prevalence of rehab professionals functioning in direct access scenarios, as a potential first entry point into the healthcare system, medical screening is a vital component of the clinical examination. This may be especially true in settings, such as in outpatient orthopedics, where patients are least likely to have close physiologic monitoring and may not be referred directly from a physician. Screening for cardiovascular stability and differential diagnosis is warranted for patient safety, appropriate referral, selection of interventions and timely medical management.

Cardiovascular disease (CVD) remains the leading cause of mortality in the United States, with other vascular related diseases included in the top 10. Studies have demonstrated that of the comorbidities present in patients referred to outpatient rehabilitation, heart disease and risk factors for heart disease are the most common. Epidemiological studies have also demonstrated that risk factors for the development of low back pain and osteoarthritis, the most common diagnoses treated by outpatient physical therapists, are nearly identical to those for heart disease.

Given that common interventions utilized by rehab providers generate a hemodynamic response, and many cardiovascular syndromes may mimic many orthopedic conditions, cardiovascular screening is critical. This course will provide rehab professionals with the most current evidence regarding the cardiovascular disease risk factors present in physical therapy practice, guidelines for effectively screening patients, examination techniques and potential modifications to orthopedic rehabilitation for patients with cardiovascular disease.

Upon completing this course, you’ll be able to:

1. Describe the epidemiology, risk factors, and importance of clinical screening for cardiovascular disease.
2. Understand the pathophysiological mechanisms involved in common cardiovascular conditions that mimic orthopedic syndromes.
3. Collect and interpret clinical examinations used in to screen and stratify for cardiovascular disease and associated risk factors.
4. Interpret clinical patient cases of patients with cardiovascular syndromes mimicking orthopedic conditions.
5. Integrate cardiovascular screening into clinical situations relevant to orthopedic physical therapy practice.
6. Modify orthopedic rehabilitation interventions for patients with cardiovascular disease.