Interview

Mr. Masahiro Kohzuki, Professor of the Department of Internal Medicine and Rehabilitation Science, Chief of Tohoku University Hospital Rehabilitation Medicine, and Head of Internal Medicine and Rehabilitation Medicine, and his five staff members were invited to the 2014 Binhai International Cardiac Rehabilitation Symposium and Chinese Cardiac Rehabilitation Clinical Skill Conference held at Tianjin Medical University TEDA International Cardiovascular Hospital in Tianjin, China, on September 21 (Sunday) to 23 (Tuesday), 2014. They delivered speeches on rehabilitation after cardiovascular surgery and gave instructions on required practical skills.

We visited Tianjin Medical University TEDA International Cardiovascular Hospital in Tianjin, China, to deliver speeches on our cardiac rehabilitation programs for cardiovascular surgery and give instructions on required practical skills. This event, combining a symposium and a skill conference related to cardiac rehabilitation, was held this year for the first time as a follow-up to the special speech titled, “Effects and Realities of Cardiac Rehabilitation: Convalescent Phase Rehabilitation Extends Patients’ Lives,” which I gave at TEDA International Cardiovascular Hospital after I was appointed as a guest professor of Tianjin Medical University.

After the opening ceremony on the first day, I delivered a speech on the development of rehabilitation specialists in Japan. In this speech, I presented three things that make Tohoku University Hospital’s cardiac rehabilitation programs unique. First, Tohoku University Hospital is the only institute in Japan that offers comprehensive programs for rehabilitation in all the phases of major cardiovascular disease. These are a 12-day hospital stay program and an outpatient program for the acute phase and convalescent phase and a program for the maintenance phase run by a nonprofit organization called “MedEx Club Sendai.” Second, Tohoku University Hospital is also the only institute that not just deals with cardiac rehabilitation but addresses general rehabilitation needs including programs for respiratory rehabilitation, kidney rehabilitation, stroke rehabilitation and rehabilitation from severe obesity as well as for multiple handicaps. Third, Tohoku University Hospital also focuses on basic academic researches on cardiac rehabilitation using animal models. After my speech, Assistant Professor Daisuke Ito (Tohoku Medical Megabank Organization, physical therapist), who had received a medical degree in this field, gave a speech titled, “Evaluation of Exercise Tolerance of Patients Who Have Undergone Cardiovascular Surgery and Exercise Therapy.” He delivered a lecture on blood circulation, respiration and metabolism during exercise, explaining about how to conduct a cardio pulmonary exercise test and what to measure during the test. After the speeches, a big welcome party was held by Professor Xiaocheng Liu serving for both TEDA International Cardiovascular Hospital and Tianjin Medical University Caldiovascular Institute, Professor Jiazhong Wang of Tianjin Medical University, Chief of Rehabilitation and Sports Medicine, Dr. Guixiang Zhang, President of the Tianjin Association of Rehabilitation Medicine and other doctors playing pivotal roles in the treatment of major cardiovascular disease and rehabilitation medicine. We reaffirmed that promoting cardiac rehabilitation with the aim of extending the life prognoses of patients with major cardiovascular disease was a common goal for both Japan and China.

In the morning of the second day, Assistant Professor Yoshiko Sakata gave a speech, titled “Acute Phase Rehabilitation Program after Cardiovascular Surgery,” outlining the evidence of acute phase rehabilitation after cardiovascular surgery and the rehabilitation schedule. Takaaki Kakihana (rehabilitation medicine, physical therapist), enrolled in the doctoral program in this field (Graduate School of Medicine, Disability Sciences), spoke about rehabilitation evaluation and physical therapy before cardiovascular surgery and explained what should be done before surgery to prevent postoperative complications. In the afternoon, we first gave instructions on practical skills for preoperative rehabilitation interventions, such as how to evaluate muscle strength and exercise tolerance at bed side and respiration training aimed at preventing respiratory complications. We then exercised the cardio pulmonary exercise test in the cardiac rehabilitation room in the hospital ward and confirmed the test execution method and measurement items explained on the first day as well as the points to note regarding the execution of the test.

In the morning of the third day, Masashi Takeuchi (rehabilitation medicine, physical therapist), who joined the master course of Graduate School of Medicine, Medical Sciences this October, delivered a speech on rehabilitation evaluation and physical therapy in the acute phase after cardiovascular surgery. After that, Dr. Qi Guo (Tianjin Medical University assistant professor) and Dr. Pengyu Cao (Jilin University assistant professor), both of whom received a doctoral degree by studying at the Department of Internal Medicine and Rehabilitation Science, spoke about the current situation of cardiac rehabilitation in China. In the afternoon, we gave instructions on practical skills for postoperative ambulation training. We first did practice using a staff member as a model and then went to the ICU where we gave instructions on practical skills using a patient who had undergone coronary artery bypass surgery. Instructions were given not only on skills for patients but also on minute details such as the points to note about vital signs and changes on the electrocardiogram and the placement of beds and lines at the time of rehabilitation.

At the meeting with Director Liu, it was decided to hold a symposium by inviting cardiac rehabilitation specialists in the world and a skill conference focused on practical skill instructions once a year. The Binhai area where TEDA International Cardiovascular Hospital is located is a so-called special healthcare zone in China, and enormous investments have been made in medical services in this area. TEDA International Cardiovascular Hospital is playing a central part of the project. This hospital is one of the largest cardiovascular hospitals in Asia with 600 hospital beds, 80 ICU beds, 40 CCU beds, 16 operating rooms and five catheter rooms. They perform 1500 to 2000 direct intracardiac surgical operations annually. Furthermore, there is a plan afoot to establish a hospital specializing in cardiovascular rehabilitation with over 300 hospital beds several years from now. Therefore, the hospital will undoubtedly become a model for cardiac rehabilitation in China. As a result, it is expected that the high-quality cardiac rehabilitation programs of Tohoku University Hospital that we exercise daily will spread around the world. During the visit, I was able to witness students who completed the master course of the Graduate School of Medicine doing an excellent job in their home country by using the knowledge and experience they had gained in Japan. This makes me want to put more effort into the development of younger people.