Integrating physiological principles into the comprehensive management of cardiopulmonary dysfunction

Impairment of oxygen transport can be conceptualized as a motion disorder based on the framework previously reported by Hislop and Zadai. Extensive literature exists that demonstrates the beneficial effects of body positioning and mobilization on impaired oxygen transport. This article integrates this existing information and attempts to extend the framework of Hislop and Zadai in cardiopulmonary physical therapy. To provide a basis for discussion, we describe the multisystemic consequences of immobility from bed rest. We also discuss the role of body positioning and mobilization as therapeutic interventions that can be used to directly enhance all components of oxygen transport in patients with cardiopulmonary dysfunction. This approach may improve the efficacy of treatment in these patients and thus may address some of the limitations of current methods of practice. Further research is needed, however, to clarify and extend the application of this approach.