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Cardiac Rehabilitation

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chap 5 presentation

chap 5 presentation

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  • 1. CARDIAC REHABILITATIONCARDIAC REHABILITATION CHAPTER 5 PRESENTATIONCHAPTER 5 PRESENTATION SAMSON VASSAMSON VAS
  • 2.  Cardiac rehabilitation aims to reverse limitationsCardiac rehabilitation aims to reverse limitations experienced by patients who have suffered theexperienced by patients who have suffered the adverse pathophysiologic and psychologicaladverse pathophysiologic and psychological consequences of cardiac events.consequences of cardiac events.
  • 3. The major goals of a cardiac rehabilitation programThe major goals of a cardiac rehabilitation program are:are:  Curtail the pathophysiologic and psychosocialCurtail the pathophysiologic and psychosocial effects of heart diseaseeffects of heart disease  Limit the risk for reinfarction or sudden deathLimit the risk for reinfarction or sudden death  Relieve cardiac symptomsRelieve cardiac symptoms  Retard or reverse atherosclerosis by institutingRetard or reverse atherosclerosis by instituting programs for exercise training, education,programs for exercise training, education, counseling, and risk factor alterationcounseling, and risk factor alteration  Reintegrate heart disease patients intoReintegrate heart disease patients into successful functional status in their familiessuccessful functional status in their families and in societyand in society
  • 4. Indications for cardiac rehabIndications for cardiac rehab  Acute myocardial infarctionAcute myocardial infarction  Coronary artery bypass graftingCoronary artery bypass grafting  Percutaneous coronary vessel remodeling (i.e.Percutaneous coronary vessel remodeling (i.e. angioplasty, atherectomy, stenting)angioplasty, atherectomy, stenting)  Valve replacement or repairValve replacement or repair  Heart transplantationHeart transplantation  Major pulmonary surgery, great vessel surgery,Major pulmonary surgery, great vessel surgery, sustained ventricular tachycardia or fibrillationsustained ventricular tachycardia or fibrillation  Class III or IV congestive heart failureClass III or IV congestive heart failure unresponsive to medical therapyunresponsive to medical therapy  Chronic stable angina pectoris unresponsive toChronic stable angina pectoris unresponsive to medical therapy which prevents the membermedical therapy which prevents the member from functioning optimally to meet domestic orfrom functioning optimally to meet domestic or occupational needsoccupational needs
  • 5. Cardiac Rehabilitation PhasesCardiac Rehabilitation Phases Phase I – InpatientPhase I – Inpatient  Cardiac rehabilitation begins during in-hospitalCardiac rehabilitation begins during in-hospital recovery following surgery or a cardiac event.recovery following surgery or a cardiac event. The first phase is conducted by an exerciseThe first phase is conducted by an exercise physiologist. Before each cardiac patient isphysiologist. Before each cardiac patient is discharged, questions regarding personaldischarged, questions regarding personal recovery are answered, and preparation for therecovery are answered, and preparation for the second phase of cardiac rehabilitation takessecond phase of cardiac rehabilitation takes place.place.
  • 6. Phase I includes:Phase I includes:  Monitored hall walking program.Monitored hall walking program.  Education about coronary artery disease, theEducation about coronary artery disease, the need for aerobic exercise and the fundamentalsneed for aerobic exercise and the fundamentals of exercise. An outline of the symptoms ofof exercise. An outline of the symptoms of exercise intolerance, and a home walkingexercise intolerance, and a home walking program.program.  Personal plan of risk-factor management andPersonal plan of risk-factor management and activity progressionactivity progression
  • 7. Phase II – OutpatientPhase II – Outpatient  The outpatient phase of cardiac rehabilitationThe outpatient phase of cardiac rehabilitation begins two to six weeks after discharge from thebegins two to six weeks after discharge from the hospital. The second phase is conducted by anhospital. The second phase is conducted by an RN and exercise specialist. The patient attendsRN and exercise specialist. The patient attends one-hour outpatient sessions, two to three timesone-hour outpatient sessions, two to three times per week.per week.
  • 8. Phase II includes:Phase II includes:  Up to 36 sessions of EKG monitored exerciseUp to 36 sessions of EKG monitored exercise (Two to three sessions per week, one hour per(Two to three sessions per week, one hour per session).session).  Blood pressure and heart rates monitored.Blood pressure and heart rates monitored.  Exercise performed on treadmills, stationaryExercise performed on treadmills, stationary bikes, rowing machines, stairmasters and lightbikes, rowing machines, stairmasters and light weight-lifting.weight-lifting.  Individual dietary consultation.Individual dietary consultation.
  • 9. Phase III – Outpatient MaintenancePhase III – Outpatient Maintenance  This optional phase of cardiac rehabilitationThis optional phase of cardiac rehabilitation promotes independence within a structuredpromotes independence within a structured exercise program. The third phase is conductedexercise program. The third phase is conducted by an exercise physiologist in consultation withby an exercise physiologist in consultation with the program director. At the outpatient facility,the program director. At the outpatient facility, cardiac patients exercise under supervision twocardiac patients exercise under supervision two times a week during regular facility hours. Pulsetimes a week during regular facility hours. Pulse rate and blood pressure continue to berate and blood pressure continue to be monitored.monitored.
  • 10. Phase III includes:Phase III includes:  Two sessions per week, one hour per session.Two sessions per week, one hour per session.  Blood pressure and heart rate monitoring.Blood pressure and heart rate monitoring.
  • 11. CARDIAC REHABILITATION HOME EXERCISE PROGRAM GUIDELINES FOR EXERCISE  ♥ Try to walk on level surfaces. Walk slower if you do walk on hilly terrain.  ♥ Space your activities. Wait at least 1 hour after you eat a heavy meal or bathe before exercising.  ♥ Avoid exercising in extremely hot/humid weather: greater than 80°F/75 percent humidity.  ♥ Avoid exercising in extremely cold/damp weather: less than 32° F unless you cover your face with a scarf or mask.  ♥ If you are feeling ill, do not exercise. When you are feeling better, start your program again slowly.