Date Presented 04/03/2025
This retrospective study explores the role of OT in activities of daily living (ADL) participation after cardiothoracic surgery in acute care by examining changes in clinical outcome measures from postoperative OT evaluation to hospital discharge.
Primary Author and Speaker: Stephanie Tsai
Additional Authors and Speakers: Elyse Peterson
PURPOSE: Heart disease is the leading cause of death and disability, accounting for 17.9 million global deaths in 2019 alone (WHO, 2021). Heart disease conditions can cause shortness of breath, fatigue, and angina that impact ADL and quality of life, with open-heart cardiothoracic surgery often being necessary to treat these conditions (CDC, 2023; Bojar 2020). Patients face immediate postoperative challenges to their physical and psychosocial recovery that affect their ADL participation; however, there is minimal research in this area (LaPier et al., 2008). This study examines OT’s role in patients’ ADL participation while recovering from open-heart surgery in acute care.
DESIGN: Retrospective design using electronic medical records from an academic medical center for 37 patients who underwent open-heart surgery within the study period.
METHOD: Changes in Functional Independence Measure (FIM) and Post-Acute Care ‘6-Clicks’ Daily Activity Inpatient Short Form (AM-PAC Daily Activity) scores at postoperative OT evaluation and hospital discharge were compared using Wilcoxon signed-rank tests and paired t-tests.
RESULTS: Patients showed statistically significant improvements in both the FIM and AM-PAC Daily Activity sum scores between OT evaluation and hospital discharge. The FIM categories with the most improvement were lower body dressing (Mean difference, M = 1.92, p<0.001), toileting (M = 1.78, p <0.001), and bed mobility (M = 1.73, p <0.001). Linear regression analyses revealed that neither the number of OT sessions or hospital length of stay were predictive of changes in AM-PAC Daily Activity scores.
CONCLUSION: Patients who received inpatient OT while recovering from open heart surgery experienced improvements in their ADL participation.
IMPACT: This study generated evidence supporting OT’s role in ADL participation following open-heart surgery, and may serve as an example for future research examining OT’s impact on clinical outcomes in acute care.
References
Bojar, R. M. (2020). Manual of perioperative care in adult cardiac surgery (6th ed.). Wiley-Blackwell Publishing. https://doi.org/10.1002/9781119582557
Centers for Disease Control and Prevention (CDC) (2023) About heart disease. Available at: https://www.cdc.gov/heartdisease/about.htm (accessed 2 July 2023)
LaPier, T. K., Wintz, G., Holmes, W., Cartmell, E., Hartl, S., Kostoff, N., & Rice, D. (2008). Analysis of activities of daily living performance in patients recovering from coronary artery bypass surgery. Physical & Occupational Therapy in Geriatrics, 27(1), 16–35. https://doi.org/10.1080/02703180802206215
World Health Organization (WHO). (2021). Cardiovascular diseases (CVDs). Available at: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) (accessed 6 June 2023)
