Cardiac Rehab

Question 1

MET =

Answer 1

The amount of oxygen required to sustain an individual in a seated, upright position

Question 2

Cardiac rehab - dr rule

Answer 2

NEEDS TO BE A PHYSICIAN WITHIN 800 ft

Question 3

Phase 1

Answer 3

Inpt
Starts within 24 hrs of sx or 2-3 days after MI
Before d/c graded ex test is done

GOALS = achieve 3 MET level! (3.0 mph ambulation)
improve mental, risk, HEP

Question 4

Tx options in phase 1

Answer 4

Bed exercises, PROM, AROM, transfers

Question 5

Precautions in phase 1

Answer 5

AVOID ISOMETRICS until 8 weeks 
NO DRIVING 3-4 wks
MAX 5-10# lifting
DOOR with 2 hands
NO SHLD FLEX/ABD above 90 
NO ARMS TO PUSH up from chair

Question 6

Phase 1 freq

Answer 6

2 times a day for stay in inpatient

5 min warm up and cool down

Question 7

ACSM termination guideline for phase 1

Answer 7

Inc HR 20 above resting
SBP above 220
DBP above 110
SBP drop more than 10 
RPE above 13

Question 8

Risk Stratification (phase 1)

Answer 8

LOW = EF norm (over 50%), uncomplicated course, no evidence of ischemia, fxn capacity over 6 METs (NEED ALL)

MOD = EF 40-49%, angina with mod ex (5-6.9 METs) - NEED EITHER - CONSTANT MONITORING REQ

HIGH = MI involving more than 35% of L vent, EF less than 40%, fxn cap less than 5 METs (either)

Question 9

Phase 2

Answer 9

Outpatient

Lasts 6-12 weeks after discharge from inpt

Question 10

Phase 2 includes

Answer 10

Rotation between treadmill, stairs, arm/leg bike and rowing
Initially want 2:1 (for ex:rest)
Each station for 5 minutes, 1 minute recovery

Ex rx is 60-70% of GXT

Question 11

Goal for phase 2

Answer 11

5 METs

Improve fxn, education, psych well being

Question 12

Freq for phase 2

Answer 12

4-7 days a week

30-60 min sessions

Question 13

Phase 3

Answer 13

NO INSURANCE COVERAGE FOR 3 or 4

Outpatient maitenance program
Involves conditioning of 70-85% max

Lasts 6-8 wks beyond phase 2

Sessions are about an hour

Question 14

Phase 4

Answer 14

Long term maintenance program

Question 15

MET levels

Answer 15

3 = 3 mph walking, 5 mph bike
6 = 4.5 to 5 mph amb, 10 biking
8 = 5.5 amb, 13 biking