Carmel Valley physical therapist helps people with heart and breathing problems improve quality of life

By Catherine Kolonko

A Carmel Valley woman has set up a new physical therapy facility designed to help people with heart and breathing troubles improve their mobility and quality of life.

Vital Physical Therapy Practice in Mission Valley includes cardiac services as well as pulmonary physical therapy for people with breathing difficulties, said owner Komal Deokule, who lives with her husband and two children in Carmel Valley.

“Basically it’s a niche outpatient, physical therapy practice that specializes in cardio vascular, pulmonary patients,” explained Deokule.

Deokule also looks at comorbidities of her patients, such as diabetes, balance issues, and aches and pains associated with muscular skeletal problems.

“When these patients come to us we give them a complete evaluation of all their problems.”

Deokule is a board certified cardiopulmonary clinical specialist physical therapist. She has two decades of experience in her field and received her U.S. board certification last year from the American Physical Therapy Association. She earned a bachelor of physiotherapy from Maharaja Sayairao University, India, in 1992 and master’s from University College of London, Britain in 1999. She practiced in Britain and New Zealand before moving to the United States in 2007. In addition to her practice, she is an adjunct professor at the University of St. Augustine in San Marcos, where she teaches cardiopulmonary physical therapy.

She opened her business in April of this year because she observed a gap in availability of outpatient services for cardiac care patients. She set out to offer comprehensive, evidence-based cardiovascular physical therapy for people who have experienced health issues, such as heart attacks, surgeries, stint implants and transplants.

Deokule said her facility has a well-equipped gym with a treadmill, bike and weight machines and state-of-the-art monitoring and testing equipment. A typical nine-week program involves whole-body strengthening to improve muscle weakness, and balance. Patients go to the facility for an hour and complete their exercise therapy on site with a goal to empower them with knowledge and techniques that they can continue to use in their everyday lives.

Based on findings from her initial evaluation, Deokule develops individualized exercise prescriptions for patients to follow. The physical therapy plan that she develops depends on the patient’s cardiac state and issues, as well as comorbidities, but typically includes circuit training of alternate upper and lower limbs, she said.

“Basically it’s balance, strength and endurance training that we offer to our cardiac patients and it’s all monitored” Deokule said.

While at the clinic, patients wear a heart rate monitor to ensure they exercise at the optimal, beneficial rate. At the same time they are getting attuned with their perception of exertion.

“Then when they go out into the community, they know exactly how to exercise,” Deokule said.

Her program includes quality of life questionnaires before and after the program that enables her to evaluate a patient’s progress. “That way we know exactly what outcome we have.”

Patients come to the practice through doctor referral or on their own because they want to do more to recover from an acute cardiac event such as a heart attack, she said. Often patients have diabetes or other additional health concerns that need to be considered along with the heart condition. Deokule works closely with healthcare professionals involved with her patients to ensure continuity. She noted that in California a physician referral is required before a patient can start cardio physical therapy.

“If there has been an acute event, then they can go to the doctor get a referral and come to us,” she said.

If a patient wants to go to Deokule for health maintenance, insurance typically will not cover the cost. In that case, a cash-based program that cost roughly $1,800 for nine weeks of twice weekly visits including initial and final assessments and testing.

Pulmonary physical therapy for patients with breathing problems as a result of asthma, cardio obstructive pulmonary disease (COPD) or chronic heart failure is another service that Deokule offers at her facility. Through supervised monitored therapeutic exercises patients increase exercise tolerance and learn different techniques to help them breathe better, she said.

In addition to the physical therapy, she instructs patients on relaxation techniques and educational sessions that cover different topics specific to their disease or condition. The relaxation techniques are aimed at reducing psychological stress, a key risk factor for coronary artery disease, she said. Exercise therapy also targets other risk factors such as hypertension and diabetes, high cholesterol, and physical inactivity, Deokule said.

“When they are finished with the program they have all the tools that they can use to continue the long-term health benefit,” Deokule said.

The practice is at 5353 Mission Center Road, Suite 120, San Diego, 92108. For more information, call 858-255-7976 or email