Physical therapy enhances patient care in post-congenital heart surgery clinic

Following paediatric and congenital heart surgery, recognition of rehabilitation needs is variable. This study aims to identify rehabilitation needs and gaps in care for patients in a post-operative congenital heart clinic.

Retrospective review of all patients following congenital heart surgery requiring sternotomy attending their first post-operative clinic appointment between 1/21/2022 and 8/18/2023. Physical therapy evaluation included assessment of posture, mobility, and pain. Patient demographics and clinical data were reviewed. Descriptive and univariate statistics were applied.

Two hundred seventeen patients were identified: 88 (40%) infants (<12 months), 34 (16%) toddlers (1-3 years), 43 (20%) school aged children (4-12 years), and 52 (24%) teens/adults (13+ years). Twenty-one (10%) demonstrated no additional physical therapy needs. Eighty-two (28%) needed clarification of sternal precautions. Teens and adults had significantly higher incidence of impaired posture, difficulty sleeping, and pain. Seventy (32%) patients were referred to physical therapy at time of discharge. Among the 147 not referred, 89 (60%) were identified as needing outpatient physical therapy. Physical therapy assessment discovered previously undiagnosed developmental delay in 9 (4%) patients.

Significant physical therapy needs were identified in a congenital heart post-operative clinic, including needs not identified while inpatient. Integrating physical therapy in clinic improves timely access to rehabilitation care in the subacute phase of recovery.