28-09-22 - Cardiac Rehabilitation and Exercise Flashcards
1
Q
Learning outcomes
A
- To list the barriers to exercise that some cardiac patients may have
- To explain why motivational interview techniques are useful with this patient group
- To list the benefits of exercise specific to cardiac disease
2
Q
What is the definition of cardiac rehab from BACPR 2017?
A
- Definition of cardiac rehab from BACPR 2017:
- The coordinated sum of activities required to influence favourably the underlying cause of CVD, as well as provide the best possible physical, mental and social condition, so that the individuals may, by their own efforts, preserve or resume optimal functioning in their community and through improved health behaviour, slow or reverse progression of disease.”
3
Q
What is the 2020 vision statement from SIGN guidelines 150 regarding cardiac rehabilitation?
A
- 2020 vision statement from SIGN guidelines 150 regarding cardiac rehabilitation:
- “Cardiac Rehabilitation will be delivered by an integrated, clinically competent, multidisciplinary team with a central focus on specialised assessment providing an individualised programme of care to improve patient outcomes.”
4
Q
What 9 types of patients are included in cardiac rehabilitation?
A
- Patients are included in cardiac rehabilitation?
1) Stable/stabilised Angina
2) Myocardial Infarction
3) Angioplasty (+/- Stent)
4) Coronary Artery Bypass Graft
5) Valve Repair
6) Congenital Repairs
7) Heart Transplant
8) Heart failure
9) Cardiac Arrhythmias
5
Q
What are 8 physiological benefits of cardiac rehabilitation?
A
- Physiological benefits of cardiac rehabilitation:
1) Reduction in atherogenic and thrombotic risk factors
2) Control weight
3) Improved cardiovascular efficiency
4) Strengthen muscles and bones
5) Improvement in coronary blood flow, reduced myocardial ischaemia, and severity of atherosclerosis
6) Benefits for other conditions
7) Improvement in functional capacity
8) Reduction in risk of cardiovascular disease mortality
6
Q
What are 9 psychological benefits of cardiac rehabilitation?
A
- Psychological benefits of cardiac rehabilitation:
1) Reduced anxiety and depression
2) Restoration of self-confidence
3) Enhanced mood
4) Enhanced self-efficacy
5) Increased social interaction
6) Decreased illness behaviour
7) Resumption of chores/hobbies
8) Resumption of sexual activity
9) Return to work/vocation
7
Q
What is activity?
What is exercise?
What is the aim of cardiac rehabilitation?
A
- Activity is movement – for example wandering from your kitchen to your bedroom
- Exercise is planned, purposeful and structured – for example going for a 20-minute walk in your lunch hour
- Aim of the cardiac rehabilitation to increase activity and decrease sedentary behaviour
8
Q
What are national recommendations for exercise?
A
- National recommendations for exercise:
1) At least 150 mins of moderate intensity exercise per week.
2) Bouts of at least 10 mins.
3) Strength activities twice a week.
4) Balance / relaxation.
5) Decrease time spent sitting.
9
Q
What are 7 types of exercise?
A
- 7 types of exercise:
1) Walking (jogging if appropriate)
2) cycling/ /exercise bike
3) Swimming / water-based exercise
4) Circuits / dvd
5) Racket sports.
6) Dancing.
7) Gardening.
10
Q
What are 5 ways to increase activity levels?
A
- 5 ways to increase activity levels:
1) Use the stairs instead of the lift
2) Walk to next bus stop
3) Go for a walk at lunchtime rather than sitting
4) Set reminders to stand up and move every hour
5) Park further from the supermarket….
11
Q
What are the 4 steps in the initial assessment?
A
- 4 steps in the initial assessment:
1) Individual Assessment with the Cardiac Rehab Physio
2) ‘Setting goals for increasing and maintaining activity in CR is important to help individuals stay motivated’ (Thow 2006)
3) Risk assessment using the AACVPR guidelines
4) Risk stratification – identify appropriate level of care and services for distinct groups of patients
12
Q
What are the steps in the initial physiotherapy assessment?
A
- Steps in the initial physiotherapy assessment
1) Diagnosis and procedure(s)
2) Cardiac function
3) Current symptoms
4) Current medication
5) Past medical history / co-morbidities
6) Risk stratification
7) Functional capacity testing
8) Heart rate and BP response to exercise
9) Patient SMART goals: - Specific - Eating healthier sounds like a good idea. …
- Measurable - Make your goal one you can measure. …
- Achievable - Avoid aiming too high or too low. …
- Realistic - Losing 10 pounds a week sounds great. ..
- Time based - Choosing specific, measurable goals means you can track your progress over time.
- Example: I want to be able to walk up the hill to my daughters, without stopping, within 6 weeks.
13
Q
What is the cycle of change?
A
- The cycle of change:
1) Not interested
2) Thinking about it
3) Planning it
4) Doing it
5) Had enough
6) Give up or start again?
14
Q
What are 4 musts when motivational interviewing?
A
- 4 musts when motivational interviewing?
1) Understand the patient’s beliefs and address misconceptions
2) Listen with empathy
3) Empower the patient – use open questions
4) Try not to fix the patient’s problems!
15
Q
What are 7 barriers to activity and exercise?
A
- 7 barriers to activity and exercise?
1) Bad weather
2) Too tired
3) Not in the mood
4) Don’t know how to
5) Can’t afford it
6) Fear
7) Don’t have time….
16
Q
What is The Borg Rating of Perceived Exertion (RPE)
What are different levels of RPE in NHS Tayside RPE chart?
A
- The Borg Rating of Perceived Exertion (RPE) is a way of measuring physical activity intensity level
*Different levels of RPE in NHS Tayside RPE chart:
- Sing - Good level to start off with or for warm up (around RPE 10)
- Talk - Slightly short of breath but able to chat is a good level for moderate exercise. (around RPE 13)
- Gasp - If you cannot talk fluently, you are working too hard (around RPE 17)
