Cardiac
rehabilitation
Definitions
In individuals with cardiac problem
it is a process of restoring the maximal level of activity for improving the
functional capacity of the heart .
According to USPHS (United State
Public Health Service) is defined as a rehabilitation program that involve:
Medical evaluation, prescription of Exercise , education, psychological
counseling.
Aims of cardiac rehabilitation
program
 |
| cardiac rehabilitation |
Increase functional activity
& Return to safe vocation and recreation activities
Restore pt to active and productive
life style & Decrease sign and symptoms such as angina
Implement safe and effective home
exercise program
Rehabilitation team
Cardiologist, Pulmonologist, Physiotherapist,
Occupational therapist, Dietician, Medical social worker, Psychiatrist
Indication
Most common Myocardial infarction and
angina
Second commonest CABG( Coronary Artery
Bypass Grafting)
And others Cardiac transplant,
Pre-cutaneous angioplasty, valve replacement
Contraindication
Uncontrolled diabetes, angina, post
MI infarct and arterial/ventricular arrhythmia
And other like orthostatic
hypotension, recent embolism
Phases of cardiac rehabilitation
There are 4 phases of cardiac
rehabilitation
A. 1st Phase [Acute phase]
It is the initial phase 0 – 7 days,
the multidisciplinary team act:
1st day:-Monitoring (ECG
report), Observation (position of the patient), Auscultation (Cardiac & pulmonary),
Check Vitals (BP,HR,PR,RR,Temp)
2nd day:- Add exercise
like upper limb exercise till 900 , chest expansion exercise like
deep breathing exercise& spirometry. Along with step marching can be done.
1st-2nd day
:-Patient is encourage to sit at the edge of bed or in a chair.
3rd day:-Same like above all
the exercise is repeated.
2nd-3rd day :-
Short distance ambulation around 6 – 9 steps is taught.
4th day :-Discontinue the
BP line & check for the vitals.
5th day :- Increase the
short distance ambulation around 10 – 13 steps is advised , along with stair
climbing is done but before that check for the vitals.
6th day :-Six minute walk
test is done and if the patient vitals and ejection fraction (50 – 60) is
normal then the patient is eligible for the training of phase 2.
B.2nd Phase [convalescent phase]
After the discharge from the hospital
3 – 6 weeks of home exercise program are taught to the patient for maintaining
the early mobilization & gradual increase in endurance exercise.
1st week :- Advise to have
8 – 10 hrs of rest at night and stair climbing once or twice daily.
2nd week :-Able to walk
out of the doors in the gardens.
3rd week :-The daily walk
can be gradually extended so by the end of 6th week the patient walk
1 – 2 miles.
C.3rd Phase [Training
phase]
Both aerobic and anaerobic exercise
is done.
The training that have to be followed
is
1. Warm up exercise like arm
swinging, trunk sideflexion, Trunk rotation with arm swing,
2. F I T T
Frequency:- based on 6 mnts walk test
Intensity:- Moderate slowly
Type :- Walking (1RM=3 steps),
jogging
Time :-20 – 30 minutes
3. Cool down period.
D.4th phase [Maintaining
phase]
Exercise should be done at least
twice a week for 30mnts like walking, bicycling, jogging, swimming, resisted
exercise with dumbbells & pulleys.
Exercise prescription for Hypertension
Exercise prescription for Hypertension
