Cardiac rehabilitation aims to optimize physical, psychological, and social functioning for cardiac patients through coordinated interventions. It includes exercise training, risk factor management, and education. Rehabilitation occurs in phases: phase I in the hospital focuses on mobilization; phase II after discharge emphasizes education and gradual activity; phase III incorporates supervised exercise and ongoing support; and phase IV is long-term maintenance. The goals are to improve symptoms, quality of life, and prognosis through lifestyle changes and secondary prevention.
Cardiac Rehabilitation has been defined as:
Coordinated, multifaceted interventions designed to optimize a cardiac patient’s physical, psychological, and social functioning so that they may, by their own efforts, resume and maintain as normal a place as possible in the community
What does cardiac rehab involve? Cardiac rehabilitation doesn't change your past, but it can help you improve your heart's future. Cardiac rehab is a medically supervised program designed to improve your cardiovascular health if you have experienced heart attack, heart failure, angioplasty or heart surgery.
Cardiac Rehabilitation has been defined as:
Coordinated, multifaceted interventions designed to optimize a cardiac patient’s physical, psychological, and social functioning so that they may, by their own efforts, resume and maintain as normal a place as possible in the community
What does cardiac rehab involve? Cardiac rehabilitation doesn't change your past, but it can help you improve your heart's future. Cardiac rehab is a medically supervised program designed to improve your cardiovascular health if you have experienced heart attack, heart failure, angioplasty or heart surgery.
Pulmonary rehabilitation is a comprehensive intervention based on a thorough patient assessment followed by patient tailored therapies that include, but are not limited to, exercise training, education, and behavior change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the long-term adherence to health-enhancing behaviors”
coronary artery bypass graft surgery CABGSunil kumar
coronary artery bypass graft surgery, explanation of CABG on-pump and off-pump procedures, physiotherapy management after surgery. indications of CABG. description of the procedure, investigations before surgery, per operative and post operative management
this power point presentation provides main emphasis on the phases of the rehabilitation post op. it will enhance the knowledge about do's and dont's during the rehabilitation phases in brief. U may ask the questions if you have in your mind in the comment section. this ppt includes upper extremity as well as lower extremity exercises and also provides easy understanding with the help of suitable and intresting diagrams
The 6-minute walk test (6MWT) is an easy to perform and practical test that has been used in the assessment of patients with a variety of cardiopulmonary diseases including pulmonary arterial hypertension (PAH). It simply measures the distance that a patient can walk on a flat, hard surface in a period of 6 minutes.
Pulmonary rehabilitation is a comprehensive intervention based on a thorough patient assessment followed by patient tailored therapies that include, but are not limited to, exercise training, education, and behavior change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the long-term adherence to health-enhancing behaviors”
coronary artery bypass graft surgery CABGSunil kumar
coronary artery bypass graft surgery, explanation of CABG on-pump and off-pump procedures, physiotherapy management after surgery. indications of CABG. description of the procedure, investigations before surgery, per operative and post operative management
this power point presentation provides main emphasis on the phases of the rehabilitation post op. it will enhance the knowledge about do's and dont's during the rehabilitation phases in brief. U may ask the questions if you have in your mind in the comment section. this ppt includes upper extremity as well as lower extremity exercises and also provides easy understanding with the help of suitable and intresting diagrams
The 6-minute walk test (6MWT) is an easy to perform and practical test that has been used in the assessment of patients with a variety of cardiopulmonary diseases including pulmonary arterial hypertension (PAH). It simply measures the distance that a patient can walk on a flat, hard surface in a period of 6 minutes.
Cardiac rehabilitation is a broad term. It includes physical activities for cardiac patients as well as risk stratification, management of risk factors, occupational rehabilitation and patient education and counselling. This presentation deals with the prescription of physical activity and exercise for patients with acute coronary syndrome, chronic coronary syndrome, heart failure etc.
Overview of phases of cardiac rehabilitationnihal Ashraf
Cardiac Rehabilitation
Cardiac rehabilitation programs aim to limit the psychological and physiological stresses of CVD, reduce the risk of mortality secondary to CVD, and Improve cardiovascular function to help patients achieve their highest quality of life possible.
Definition, epidemiology, physiology, effects of physical inactivity, benefits of habitual physical activity, contraindications, phases, physical assessment, exercise sessions, description of cardiac rehabilitation program phase II @ University Hospital University of Puerto Rico School of Medicine
Catdiac Rehabilitation and phases of cardiac rehabilitation gurusardaar
it includes description of cardiac rehabilitation with its phases in hospital and post hospital care and physiotherapy management of cardiac patients with follow up this includes introduction indications contraindications with four phases of cardiac rehabilitation in this ppt u will get everything to know about the cardiac rehabilitation and advancements in cardiac rehabilitation
1. Phase -1 Cardiac Rehabilitation in CABG patients.ShagufaAmber
Cardiac Rehabilitation refers to the process of restoring psychological, physical, and social functions in people with manifestations of coronary artery diseases(CAD).Why do we need Cardiac Rehabilitation?-Effect upon the mortality and morbidity.-An approach to other risk factor modification.-Impacting the quality of life-Combating stress, depression and behavioural changes-In CABG, the post surgical stiffness and complications are overcome with physical activity.The Cardiac Rehabilitation program is individually tailored depending upon the risk stratification, prognosis ,functional capacity and specific needs. The ACSM classifies it into four distinct phases.
Glimpse of Cardiac rehabilitation for health care professionals to update themselves, with aim of helping people with or without disease. Focus on primary, secondary, tertiary prevention.
Exercise prescription for health and fitness.pptxAvaniAkbari
An effective exercise prescription for health and fitness involves customizing a plan based on personal goals, fitness level, health condition, and preferences. It usually includes a mix of aerobic exercises (like walking, jogging, cycling), strength training (using body weight or weights), flexibility work (such as yoga or stretching), and balance exercises (like Tai Chi). These activities enhance cardiovascular health, build muscle strength, improve flexibility, and prevent injuries. Adjusting the frequency, intensity, duration, and type of exercises gradually over time, while considering individual capabilities and health, is crucial for optimal benefits. Seeking guidance from a healthcare professional or certified trainer ensures a safe and tailored program to achieve fitness goals effectively.
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Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
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The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
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2. What is cardiac rehabilitation
The term cardiac rehabilitation refers to
coordinated, multifaceted interventions
designed to optimize a cardiac patient’s
physical, psychological, and social
functioning, in addition to stabilizing,
slowing, or even reversing the progression
of the underlying atherosclerotic processes,
thereby reducing morbidity and mortality.
9. Definition
Phase I relates to the period of
hospitalization following an acute cardiac
event.
The duration of this phase may vary
depending on the initial diagnosis, the
severity of the event and individual
institutions, usually one week acute
event/post-operative.
10. Objectives
Early mobilization and adequate discharge
planning.
Risk factor assessment and risk
stratification
Receiving information regarding their
diagnosis, risk factors, medications and
work/ social issues.
Involvement and support of the partner and
family.
11. Mobilization- Post MI
The classic Wenger cardiac rehabilitation
program was to get individuals from bed
rest to climbing 2 flights of stairs in 14 days.
Under current practices, clinicians have
modified the classic program of cardiac
rehabilitation in of 3–5 days .
12. Steps of mobilization
Day 1-2 : bed rest, bed mobility, sitting on
the bed, breathing exercises
Day 3: short distance ambulation and
bathroom privileges with monitoring
Day 4-5: home exercise program, climbing
stairs, and increasing duration of
ambulation.
Intensity: Post MI HR 20bpm and SBP
20mmhg from base line, RPE <13 in a 6-20
Borg scale (old scale)
13. Mobilization – Post PTCA
◦ May ambulate at comfortable pace
following surgery
◦ Avoid aerobic training for 2 weeks post-op
◦ Exercise prescription to be based on post-
op ETT results
◦ Often progress faster than MI patients
17. Lipid management
Goal: LDL<100 mg/dl (<70 mg/dl is
desirable), HDL >40 mg/dl, TC >200 mg/dl,
TG <150 mg/dl
Intervention: If LDL > 100 mg/dl, advice
nutritional counseling and weight reduction
and Statins are prescribed.
If HDL < 40 mg/dl, advice exercise, smoking
cessation.
18. Hypertension management
Goal: Optimal BP is < 120/80 mmHg
Intervention: If BP >130/80 mmHg advice
about lifestyle modification before
discharge . Add drug therapy for patients
with diabetes, heart failure, or renal failure.
If BP > 140/90 mmHg advice lifestyle
modification and initiate drug therapy.
19. Diabetes management
Goal: Near normal fasting plasma
glucose(< 7 mmol/l) and near normal HbA1
C (<7)
Intervention: Appropriate hypoglycemic
therapy e.g. diet modification, oral
hypoglycemic agents and/or insulin
21. Survival kit before discharge
Clear information about medication
Clear advice on managing chest pain and
reassurance
Advice and information on ‘what and when
they can do’ (work, travel, exercise etc)
23. Definition
This phase encompasses the immediate
post discharge period, which is typically a
period of four to six weeks.
24. Objectives
It focuses on health education and
resumption of physical activity, however the
structure of this phase may vary
dramatically from centre to centre.
It may take the format of - telephone follow
up, home visits, or individual or group
education sessions.
25. Assessment before phase II
rehabilitation
Vitals (HR, BP, RR and rhythm, RPE, O2 sats,
pulses)
Dyspnea
Auscultation of lungs
Edema
Surgical sites
Heart rhythm via ECG if monitored
Pain
Posture
Strength
Medications and effects
26. Exercise guidelines
Frequency: 3 times /wk,
Duration: 30-60 minutes (5-10 min of warm-
up and cool down)
Mode: walking and/or cycle/arm ergometer
and strength training
Intensity: Submaximal, or determined by
ETT data upto a level of 70% maximum HR
or MET level 5 or RPE 7 in modified Borg
scale.
27. Exercise guidelines (cont..)
• Strength training
begin at 3 weeks cardiac rehab, 5 weeks
post MI, 8 wks post CABG
Begin with bands and light weights (1-3
lbs)
Progress to moderate loads, 12-15 reps
28. Risk factor management
It includes the risk factors addressed as in
the phase I.
Lipid, hypertension and diabetes
management must be continued as in
phase 1.
Active initiation of smoking cessation, and
weight reduction.
29. Psycho-Social Rehabilitation
Common psychological reactions: low
mood, tearfulness, sleep disturbance,
irritability, anxiety, acute awareness of
minor somatic sensations or pains, poor
concentration and memory.
Proper counseling must be done. Seek
professional help if needed.
31. Definition
This phase is sometimes erroneously
referred to as the ‘Exercise’ phase. The
duration of Phase 3 may vary from six to 12
weeks.
It incorporates exercise training in
combination with ongoing education and
psychosocial and vocational interventions.
32. Objectives
Functional goals – Exercise training under
supervision
Psychosocial goals – Return to work, return
to hobbies and lifestyle, anxiety/depression
management
Secondary preventive targets
34. Assessments before phase III
rehab
Clinical risk stratification is suitable for low
to moderate risk patients undergoing low to
moderate intensity exercise.
Low level ETT and ECHO are
recommended for high risk patients and/or
high intensity exercise.
36. Risk stratification before exercise
Ischemic risk-
Postoperative angina
LVEF (EF <35%)
NYHA grade III or IV CHF
Ventricular tachycardia of fibrillation in the
postoperative period
SBP drop of 10 points or more with
exercise
Excessive ventricular ectopic with exercise
Myocardial ischemia with exercise
37. Risk stratification before exercise
Arrhythmic risk-
Acute infarction within 6 weeks
Active ischemia by angina or exercise
testing
Significant left ventricular dysfunction (LVEF
<30%)
History of sustained VT
History of sustained life-threatening SVT
Initial therapy of a patient with a rate
adaptive cardiac pacemaker
38. Exercise prescription
The Modified Borg RPE (rate of perceived
exertion) scale and % HRmax (220- age of
the person) are considered during
prescription of exercise.
In low risk patients, a program to achieve
85% of the maximum HR is safe. But in the
patients with risk of angina or arrhythmia,
achievement of HRmax as low as 60% is
safe.
39. Rate of Perceived Exertion (RPE)*
Sing – Talk –Gasp Test
Gasp: breathing heavily
Talk: enough breath to carry a conversation
Sing: Enough breath to sing
*Modified Scale adapted by Borg
Maximal
10 very, very hard
9
8
7 very hard
6
5 hard
4 somewhat hard
3 moderate
2 easy
1 very easy
0.5 very, very easy
0 nothing at all
40. Heart Failure
Criteria for exercise-
Medically stable
Exercise capacity >3 METS
Exercise training-
Prolonged Warm up and cool down
Low intensities (40-60%)
Increase duration as tolerated
Maintain HR below 115 bpm
Monitor RPE: fairly light
Avoid isometrics
May include light resistance
41. Exercise Modalities in Heart Failure
(2013 Candian Heart failure management guideline)
Discharged with
Heart Failure NYHA I-III NYHA IV
Flexibility Exercises Recommended Recommended Recommended
Aerobic Exercises
•Selected population only
•Supervision by an expert
team needed
• Walk
• Treadmill
• Ergocycle
• Swimming
•Selected population only
•Supervision by an expert
team needed
Continuous training:
Moderate intensity:
• RPE scale 3-5,or
• 65-855 HRmax, or
• 50-75% peak VO2
Moderate intensity aerobic interval may be incorporated in
selected patients
• Intervals of 15-30 seconds with a RPE scale of 3-5
• Rest intervals of 15-30 seconds
• Intensity
• Starting with 2-3 days/week
• Goal: 5 days/week
• Frequency
• Selected population only
• Supervision by an expert
team needed
• 10-20 repetitions of 5-10 pounds free weights
•Selected population only
•Supervision by an expert
team needed
Isometric/Resistance
Exercises
• Starting with 10-15 minutes
• Goal: 30 minutes
• 2-3 days/week• Frequency
• Suggested modality
• Intensity
43. Contraindications of exercise
training Unstable angina
Resting systolic BP (SBP) > 200 mm Hg or resting
Diastolic BP (DBP) > 110 mm Hg . Orthostatic BP
drop of >20 mm Hg with symptoms.
Critical aortic stenosis
Uncompensated CHF.
3rd degree atrioventricular (AV) block wihout
pacemaker.
Active pericaditis or myocarditis.
Recent embolism
Thrombophlebitis
Resting ST-segment depression or elevation (>
2mm)..
44. Lifestyle modification
Patients must be regularly monitored for
DM, HTN control in very visit, and change in
drug therapy and exercise as needed.
Blood lipids must be monitored 2 months
after initiation of drug therapy.
Diet modification, smoking cessation and
weight reduction, stress management must
be addressed.
45. Nutritional Counseling
Recommended diet low in fat (especially
saturated fat), and high in complex
carbohydrates.
Diet should consist of 50-60% calories from
carbohydrates, up to 30% from fat (with
saturated fat forming 10% or less), and 10-
15% from protein.
Individualized plans should be formulated,
depending on the presence of other risk
factors.
46. Weight management
Goal: BMI 21-25 kg/m2 , waist < 35 inches
in men and < 31 inches in women.
Intervention: Advice a reduction in total
caloric intake, and increase in energy
expenditure through a combined program of
diet, and exercise.
Initially reduction of weight 10% from
baseline is indicated. If successful, then
further reduction can be advised.
47. Smoking/ Tobacco cessation
Goal: Complete cessation
Intervention: Provide individual education
and counseling. Encourage patient to quit
in every visit.
Provide nicotine replacement and
pharmacological therapy as appropriate.
48. Return to Work
Although improvement in functional
capacity and the associated reduction in
cardio-respiratory symptoms may enhance
a cardiac patient’s ability to return to work.
The time to return to work, after an MI can
vary greatly from about two weeks, to
upwards of six weeks.
50. Definition
This phase constitutes the components of
long-term maintenance of lifestyle changes
and professional monitoring of clinical
status.
It is when patients leave the structured
Phase 3 program and continue exercise
and other lifestyle modifications indefinitely.
51. Objectives
Maintenance of achieved functional status
Return to work
Return to hobbies and lifestyle
modifications
Secondary preventive targets
52. Exercise
The exercises need to be integrated into
the patient’s lifestyle and interests to assure
compliance.
The ongoing exercises should be
performed at the target HR for at least 30
minutes, three times a week, if at a
moderate level. If at a low level, exercises
need to be performed five times a week.
53. Secondary prevention
The secondary prevention measures also
need to be integrated into the patient’s
lifestyle.
The continued control and monitoring of
DM, HTN, lipids must be ensured.
54. Patient and family
responsibilities
Self care and self management in
emergency situations
Family must help the patients to adhere to
their long term managements.
Patients are often encouraged to join-
local heart support groups
community exercise and activity groups
community dietetic and weight
management services
smoking cessation services.
56. Stable angina
Full-level ETT should be done in order to
determine the maximum HR, and angina
threshold.
The program of rehabilitation can begin at
phase III (training).
The primary goal of rehabilitation in this
group of patients is aimed at increasing
work capacity and education in
primary/secondary prevention strategies.
57. Post-CABG
Cardiac rehabilitation after CABG has two
stages:
Immediate postoperative period
Later maintenance stage.
• In-hospital period lasts 5–7 days.
• At-home program is usually conducted as
an outpatient procedure, and intensity of
exercise is determined according to risk
stratification.
58. Valvular Heart Disease
In valvular heart disease, the major problem
is often deconditioning along with CHF.
In patients receiving surgical correction of
the valvular disease, a post-CABG-type
program is used.
In uncorrected valvular heart disease with
heart failure, the program resembles the
program for CHF.
59. Cardiomyopathy
Dynamic exercise is preferred with a target
HR 10 bpm. Isometric exercise should be
avoided where possible, and limited to 2-
minute intervals when performed.
Unstable angina, decompensated CHF,
and unstable arrhythmias are
contraindications to cardiac rehabilitation.
60. Pacemakers
Should know setting for HR limit
Use RPE
ST segment changes may be common
Avoid aerobic or strengthening exercises
initially after implant
61. Cardiac Transplant
HR alone is not an appropriate measure of
exercise intensity (heart is denervated).
◦ Use RPE, METS, dyspnea scale, BP
Use longer periods of warm-up and cool-
down because the physiological responses
to exercise and recovery take longer
62. Benefits
Reduces cardiovascular and total mortality
Improves myocardial perfusion
May reduce progression of atherosclerosis
when combined with aggressive diet
Improves exercise tolerance without
significant CV complications
Improves skeletal muscle strength and
endurance in clinically stable patients
Promotes favorable exercise habits
Decreases angina and CHF symptoms