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2015v1.0
Cardio respirato ry 
Physio therapy
To Barbara, Jennifer and Ammani
Cardio respirato ry 
Physio therapy
ADULTS AND PAEDIATRICS
Fifth Edition
EDITED BY
ELEANOR MAIN BSc BA MSc PhD FCSP
Professor of Physiotherapy and Director of UCL Postgraduate Physiotherapy Programme, 
UCL School of Life and Medical Sciences, University College London, London, UK
LINDA DENEHY BAppSc(Phty) 
GradDipPhysio(Cardiothoracic Phty) PhD
Professor and Head, Department of Physiotherapy, Melbourne School of Health Sciences, Faculty 
of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
FOREWORD BY
BARBARA A WEBBER FCSP DSc(Hons)
Formerly Head of Physiotherapy, Royal Brompton Hospital, London, UK
JENNIFER A PRYOR PhD MBA MSc FNZSP MCSP
Formerly Senior Research Fellow in Physiotherapy, Royal Brompton & Hare  eld NHS Trust; Honorary Lecturer, 
University College London and Imperial College London, London, UK
S AMMANI PRASAD GradDipPhys FCSP
Cystic Fibrosis Manager, Respiratory Unit, Great Ormond Street Hospital for Children NHS Trust, London, UK
Edinburgh  London  New York  Oxford  Philadelphia  St Louis  Sydney  Toronto  2016
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CONTENTS
Foreword ............................................................. ix  6 OUTCOMME  EASUREMENT 
IN CARDIORESPIRATORY 
About the Editors................................................ xi
PHYSIOTHERAPY PRACTICE .................195
Preface ................................................................xiii
SELINA M PARRY  LINDA DENEHY
■
WITH CONTRIBUTIONS FROM CLAIRE E BALDWIN,  
Acknowledgements .............................................xv
BRONWEN CONNOLLY, ELIZABETH H SKINNER,  
SALLY J SINGH, SARAH RAND, CRAIG A WILLIAMS
Contributors ..................................................... xvii
 7 PHYSIOTHERAPIY NTERVENTION.S .....248
ELEANOR MAIN
 1 ANATOMAY NDP HYSIOLOGOY F 
WITH CONTRIBUTIONS FROM SUE BERNEY, LINDA DENEHY, 
THE RESPIRATORY AND CARDIAC  MICHELLE CHATWIN, MARK R ELKINS, DANIEL FLUNT,  
AMANDA J PIPER, ANNEMARIE L LEE, BREDGE MCCARREN, 
SYSTEMS ..................................................1
HARRIET SHANNON, SARAH RAND, ROSEMARY MOORE, 
MANDY JONES ■ ALEX HARVEY ■ ELEANOR MAIN BARBARA A WEBBER, MARIE T WILLIAMS
 2 CLINICAAL SSESSMEN.T ........................47
 8 OPTIMIZINGE NGAGEMENAT ND 
Adults ................................................................48 ADHERENCE WITH THERAPEUTIC 
AMANDA THOMAS  LYNDAL J MAXWELL INTERVENTIONS ..................................402
■
Infant and Child ................................................74 MANDY BRYON
ELEANOR MAIN
 9 ADULIT NTENSIVCE AR..E ....................415
The Acutely Ill or Deteriorating Patient ...............77
JENNIFER PARATZ  GEORGE NTOUMENOPOULOS   
■ ■
SARAH KEILTY
ALICE Y M JONES  CLAIRE FITZGERALD
■
 3 THORACICI MAGIN.G. ...........................83
10 PAEDIATRICI NTENSIVEC AR.E ............455
Adults ................................................................84
Paediatric Mechanical Support ......................... 456
CONOR D COLLINS   SUSAN J COPLEY
■
STEWART REID   MARK J PETERS
■
Paediatrics ....................................................... 108
Physiotherapy Management of Ventilated  
JOY L BARBER  CHRISTOPHER D GEORGE
■
Infants and Children ........................................ 473
 4 CARDIACA NDC ARDIOVASCULAR  ELEANOR MAIN ■ ALICIA J SPITTLE
DISEASES .............................................125
11 UPPERA BDOMINALA ND 
ANDREW D HIRSCHHORN  SEAN F MUNGOVAN   
■ ■
CARDIOTHORACIC SURGERY  
DAVID A B RICHARDS
FOR ADULTS ........................................513
 5 RESPIRATORDY ISEASE.S .....................163
DOA EL-ANSARY   JULIE C REEVE   LINDA DENEHY
■ ■
ANNE E HOLLAND  JENNIFER A ALISON
■ WITH CONTRIBUTIONS FROM SULAKSHANA BALACHANDRAN, 
WITH A CONTRIBUTION FROM ALEX HARVEY AND MANDY JONES MICHELLE MULLIGAN
vii
viii CONTENTS
12 PHYSICALA CTIVITYA ND  APPENDIX –  NORMAL  VALUES,  CONVERSION  
REHABILITATION .................................579 TABLE AND ABBREVIATIONS ................757
Index ................................................................. 767
Physical Activity and Physical Fitness  
in Health and Disease ...................................... 580
CHRIS BURTIN   VASILEIOS ANDRIANOPOULOS   
■ ■ EVOLVE RESOURCES 
MARTIJN A SPRUIT
(evolve.elsevier.com/Main/cardiorespiratory):
Pulmonary Rehabilitation ................................. 586  bank of 350 images
■
KATY MITCHELL  FABIO PITTA   ANNE E 
■ ■
HOLLAND   ANNEMARIE L LEE   LINDA DENEHY
■ ■
Cardiac Rehabilitation ..................................... 597
JULIE REDFERN  JENNIFER JONES
■
13 CARDIORESPIRATORYM  ANAGEMENT 
OF SPECIAL POPULATIONS .................639
LINDA DENEHY  ELEANOR MAIN
■
WITH CONTRIBUTIONS FROM SARAH SMAILES, ANITA PLAZA, 
JENNIFER PARATZ, LEANNE WILLIAMS, CLAIRE BRADLEY, 
JACQUELINE L LUKE, JACQUELINE ROSS, BROOKE WADSWORTH, 
KATE J HAYES, PRUE E MUNRO, PAUL AURORA, HELENA VAN 
ASWEGEN, CRAIG A WILLIAMS, SARAH RAND, CATHERINE L 
GRANGER, SUE BERNEY, AMY NORDON-CRAFT, LINDA DENEHY