As physical therapists we have to be very knowledgeable. This knowledge encompasses not only the conditions for which our clients are being treated but other pathologies which they may have. So many variables and factors can affect the rehabilitative process.
Imagine a therapist treating a client who needs an exercise prescription yet not considering that the client is diabetic. What if the client were also hypertensive? As physical therapists we are aware of not only the systemic effects of various pathologies, we are also aware of the impact on the rehabilitative process.
Many individuals often suffer from comorbidities. According to the National Heart, Lung and Blood Institute (2019) metabolic syndrome is the name given to a group of risk factors that predispose an individual to heart disease and other health issue such as diabetes and cerebrovascular accidents (CVA). A cluster of these risk factors in an individual puts them at greater risk of CVAs and coronary heart than if they had only one condition.
For a diagnosis of metabolic syndrome to be made at least three or more of the following ought to be present in an individual:
- Increased abdominal girth (For females this is a waist circumference greater than 35 inches, in males it is greater than 40 inches)
- A triglyceride level of 150 milligrams per decilitre (mg/dL) of blood or above
- Low levels of high density lipoprotein cholesterol, (in females <50 milligrams per decilitre and <40 milligrams per decilitre in males)
- Systolic blood pressure of 130 mmHg or higher or diastolic blood pressure of 85 mmHg • Fasting glucose of 100 mg/dL or above
Many clients that we see fit three or more of the above criteria. It is therefore imperative that we are aware of metabolic syndrome and how it affects the client. Those persons who attend to individuals with neurological injuries such as cerebrovascular accidents (CVA), traumatic brain injuries (TBI) and spinal cord injuries (SCI) ought to take special note of metabolic syndrome. According to Moore et al (2016) “nearly all those with SCI develop metabolic syndrome” and this in in proportion to the severity of the deficit. According to Baffi et al (2016) a link has been noted between metabolic syndrome and lung pathologies in studies that have been done. Recognition of metabolic syndrome can assist in the identification of clients at high risk for vascular events such as a second stroke or myocardial infarction in the future.
The physical therapist can play a part in the care of clients with this condition. Management entails management of the various comorbidities. As exercise and movement specialists we are able to play a role in helping our clients with weight management, and blood pressure and glycemic control. We therefore need to be aware of metabolic syndrome. Our clients are sometimes aware of their cholesterol, blood pressure readings and blood sugar levels. We sometimes measure blood sugar levels and blood pressure in our facilities. Abdominal girth is easily measured with a tape measure. These elements will give us information as to which clients may be at risk of metabolic syndrome and are therefore at increased risk. Our management may therefore be tailored accordingly.
References
- Baffi CW, Wood L, Winnica D, Strollo Jr PJ, Gladwin MT, Que LG, Holguin F. Metabolic syndrome and the lung. Chest. 2016 Jun 1;149(6):1525-34.
- https://www.heart.org/en/health-topics/metabolic-syndrome/about-metabolic-syndrome
- https://www.nhlbi.nih.gov/health-topics/metabolic-syndrome
- Moore G, Durstine JL, Painter P, American College of Sports Medicine. ACSM’s Exercise Management for Persons With Chronic Diseases and Disabilities, 4E. Human Kinetics; 2016.