A Case Report of Physical Therapy Intervention of Acute Myocardial Infarction-Application of International Classification of Functioning, Disability and Health (ICF) Model
李雨軒(Yu-Hsuan Li)；蕭淑芳(Shu-Fang Hsiao)；廖華芳(Hua-Fang Liao)；簡盟月(Meng-Yueh Chien)
急性心肌硬塞 ； 冠狀動脈心臟病 ； 心臟復健 ； 個案處理模式 ； 國際健康功能與身心障礙分類系統 ； Acute myocardial infarction ； Coronary heart disease ； Cardiac rehabilitation ； Patient/Client management model ； ICF
|Volume or Term/Year and Month of Publication||
38卷2期（2013 / 06 / 01）
116 - 125
Acute myocardial infarction (AMI) is the most prevalent fatal heart disease worldwide. The mortality rate of AMI is approximately 10% to 20%. Although the advances in medical technology lower the mortality rate of myocardial infarction, the subsequent functional capacity and quality of life, and secondary prevention of the survivors are the important issues. This article analyzed a case diagnosed with AMI by using the Client Management Model (CMM) and International Classification of Functioning, Disability and Health (ICF). The case is a 43-yearold man diagnosed as AMI. He suffered from sudden severe left chest pain on August 2012, and was then sent to a teaching hospital for treatment. At the emergency room, the electrocardiogram revealed hyperacute T wave over V1-4 and coronary angiography revealed multiple occlusions of three coronary arteries. Under the diagnosis of AMI, the percutaneous balloon obstructive stent plastic surgery (POBAS) was performed. In addition, both extracorporeal membrane oxygenation (ECMO) and intra-aortic balloon pump (IABP) were used to improve cardiac function. Cardiac rehabilitation phase I program was started on the 7th day after onset and he was discharged under stable medical condition after 13-day hospitalization. The patient has started cardiac rehabilitation phase II program in the physical therapy department after discharged from the hospital 27 days. ”The International Classification of Functioning, Disability and Health” (ICF) model was used for comprehensively describing and classifying health status and its related factors of this patient. We found that the key problem of this patient was cardio-vascular dysfunction which led to exercise intolerance, functional impairment, and anxiety. In addition, the patient had several risk factors associated with cardiovascular disease. Physical therapy goal, and intervention were based on strong evidences supported that cardiac rehabilitation phase II program could improve exercise capacity and quality of life of patients after AMI. After two-month physical therapy intervention, the patient got significant improvement of maximal exercise capacity and muscle strength, and decrement of anxiety. The patient also showed high motivation to continue the cardiac rehabilitation program and has returned to work.