For his PhD, Nnamdi further explored his Master’s area of interest in cardiopulmonary physiotherapy.
“Cardiopulmonary physiotherapy relates to the heart and lungs and is an area of specialisation that not many people are aware of. It is particularly important for people who suffer from lung or heart disease and/or who are undergoing lung or heart surgery, both in a prehabilitation (prehab) and rehabilitation (rehab) setting.
“My PhD is about using hand grip strength (HGS) as a predictor of lung function and health-related quality of life (HRQoL) in cardiac patients. Because lung function and health-related quality of life can be indicators of overall wellbeing, it is particularly important to assess such indicators in persons with heart diseases, both before and after their heart surgery.
“In clinical practice, lung function is currently assessed using a device called a spirometer. However, in rural and regional areas, there is often limited access to spirometers and/or spirometry-trained professionals. Therefore, the determination of hand grip strength as a monitoring tool for lung function can be of great benefit for patients in rural and remote areas.”
For the study, Nnamdi measured hand grip strength, lung function and health-related quality of life of cardiac patients at four timepoints. These included prior to surgery, during physiotherapy discharge from the hospital, and at six weeks and six months post-discharge.
“Hand grip strength includes the muscles of the hand and the forearm, and previous studies have shown that hand grip strength is a good indicator of lung function as it relates to the strength of the respiratory muscles, including the diaphragm, intercostal and abdominal muscles.
“For my research, I wanted to further explore the use of hand grip strength in the context of cardiac patients. If hand grip strength can be an indicator for the lung function and health-related quality of life at six weeks or six months, in essence, it can show the prognosis in the recovery process of heart surgery.”
Nnamdi’s research findings, however, unexpectedly showed that hand grip strength was only a predictor of lung function prior to cardiac surgery rather than post-surgery.
“What these findings show is how useful it can be for heart surgery patients to undergo what is termed ‘prehabilitation’ or prehab for short. Prehab is becoming a more common physio practice, particularly in relation to preventing sports injuries, but it is also an area of treatment that can be used by clinicians for cardiac patients prior to surgery.
“The research also showed that the values of lung function and health-related quality of life prior to surgery were the respective key predictors at the other three timepoints post-surgery. So, if patients’ lung function can be improved before cardiac surgery, then the research shows that they are going to have better outcomes post-surgery.
“However, it seems that there are also other predictors happening right after the cardiac surgery that relate to lung function and health-related quality of life, particularly in relation to the pain levels that these patients were experiencing around their sternums.”