Ponencia Raquel García Tarrazo: Fisioterapia en enfermedad arterial periférica

Summary

Raquel, a physiotherapist with over a decade of experience, discusses the role of physiotherapy in managing Peripheral Arterial Disease (PAD) during an international congress. She emphasizes the importance of identifying symptoms like intermittent claudication and understanding when to refer patients to vascular specialists. Raquel shares her approach to treatment, focusing on lifestyle changes, exercise, and therapeutic techniques like electrostimulation and massage. She highlights the benefits of combining aerobic and strength exercises to improve mobility and reduce disability. Raquel also addresses the challenges of patient adherence to treatment and the role of a multidisciplinary approach in achieving successful outcomes.

Takeaways

• 😀 Raquel is a physiotherapist since 2012, practicing in both clinical and online settings, with a focus on social media education.
• 😀 The presentation's topic is about the role of physiotherapy in managing peripheral artery disease (PAD), emphasizing the importance of early diagnosis and intervention.
• 😀 PAD is often seen in men over 60, who complain of calf pain while walking, which may temporarily impede movement and improve with rest.
• 😀 Key diagnostic tools include the Ankle-Brachial Index (ABI), which helps identify PAD through the ratio of systolic blood pressure in the ankle and arm.
• 😀 The physical examination for PAD may reveal signs like pulse loss, muscle atrophy, pale skin, and hair loss on the legs.
• 😀 The treatment approach includes lifestyle changes like weight loss, smoking cessation, and regular physical activity, in addition to electrostimulation and massage, depending on pain levels.
• 😀 Exercise is crucial for improving walking capacity and reducing disability in PAD patients. Aerobic exercise and strength training should be combined for best results.
• 😀 Electrotherapy is used as a complementary therapy, showing positive effects on flow-mediated stress and adaptation to exercise, especially for patients with low mobility.
• 😀 A significant challenge in PAD management is patient adherence to exercise programs, which can be improved through education and motivation.
• 😀 The physiotherapist’s role extends beyond direct treatment to include educating patients on lifestyle changes and collaborating with a multidisciplinary team for comprehensive care.
• 😀 The presentation concludes by offering resources for ongoing professional education in physiotherapy and encouraging further discussion and collaboration.

Q & A

What is the primary focus of Raquel's presentation?

Raquel's presentation primarily focuses on the role of physiotherapy in managing peripheral arterial disease (PAD). She emphasizes the importance of recognizing the symptoms and providing appropriate interventions.

Who are the typical patients Raquel encounters in her practice for PAD management?

Raquel typically encounters male patients, usually over 60 years old, who report calf pain while walking. These patients often have underlying conditions such as hypertension, diabetes, smoking habits, and central obesity.

What diagnostic tests does Raquel mention for identifying PAD?

Raquel mentions the Ankle-Brachial Index (ABI) test, where blood pressure is measured at the arms and ankles, and a ratio is calculated to assess if PAD is present. She also mentions the Six-Minute Walk Test and physical examination to identify symptoms.

What does the Ankle-Brachial Index (ABI) test reveal?

The ABI test compares the highest systolic blood pressure in the arms and ankles. If the ankle-to-arm ratio is less than 0.9, it indicates the presence of peripheral arterial disease with high sensitivity and specificity.

How does Raquel's approach to treating PAD differ from her initial treatment methods?

Initially, Raquel treated PAD patients with circulatory massages and electrostimulation aimed at improving circulation. However, now she emphasizes exercise therapy, including aerobic and strength exercises, as a more effective approach.

What role does exercise play in the management of PAD according to Raquel?

Exercise plays a crucial role in improving walking capacity, reducing disability, and preventing cardiovascular events in PAD patients. A combination of aerobic and strength exercises is recommended to improve overall muscle function and prevent further deterioration.

What is the significance of strength training in PAD rehabilitation?

Strength training is vital for PAD patients because it helps combat muscle loss and weakness, which is common in these patients. Aerobic exercise alone cannot rebuild muscle mass, so combining both types of exercise is essential for better overall outcomes.

What are the key challenges Raquel faces when treating PAD patients?

Key challenges include the logistics of treatment (e.g., patient time, mobility, and availability of resources), lack of medical referrals, and the need for strong patient motivation and adherence to exercise programs.

What additional treatments does Raquel use alongside exercise for PAD patients?

Raquel still uses electrostimulation in consultation for some patients, especially those with low activity levels, to simulate muscle contractions and enhance blood flow. She also considers massage for pain relief if it helps the patient feel better.

How does Raquel recommend addressing the barriers to exercise in PAD patients?

Raquel suggests addressing issues like ulcerations or wounds, lack of time, and dependence on others for transportation. She also emphasizes the importance of developing community-based programs and offering personalized support to help patients stick to their exercise routines.