Cardiac Rehabilitation Flashcards
How many Phases of cardiac rehab are there?
Three phases
What is Phase I considered?
Phase I is the inpatient phase
How long does Phase one typically last
Hospital stay for 3-5 days for uncomplicated MI (complicated MI includes ischemia, LV failure or significant ventricular arrhythmias)
What should the intensity be for Phase I cardiac patients?
Low intensity (2-3 METs) progression to >5METs by discharge
What should the frequency be during Phase I?
2-3x/day
Gradually duration is lengthened and frequency decreased
True or False: During the first Phase of cardiac rehabilitation a patient may perform resistance training.
False: May not perform resistance training until 6 weeks post-op
What is the THR limited to in the Phase I ?
THR is limited to 70% of MHR and/or 5 METs until 6 weeks post-MI
What should the RPE Borg scale limit be?
The patient should exercise in the fairly light range
For an increase of 1-2 METs a _____ increase in HR is appropriate?
20 bpm
True or False: A patient must sit upright in bed and demonstrate appropriate hemodynamic response prior to ambulating in hallway
True
A patient’s HEP protocol for ambulation should be?
Goal of 20-30 minutes; 1-2 times/day at 4-6 weeks post-MI
Also, perform UE/LE mobility exercises
Cardiac Rehab can begin when?
After patient has been hemodynamically stable for 24 hours
What should the first day look like?
Sit patient on EOB, monitor for Orthostatic Hypotension. If fine, Walk patient to bedside chair and allow them to sit for 30 minutes without any other tasks.
While sitting in a chair what exercises can a patient perform?
Ankle pumps, knee extension or marching in place
What is the second phase of cardiac rehabilitation known as?
Outpatient Cardiac Rehabilitation (subacute)
When does Phase II typically begin ?
4-6 weeks post MI
What test do patients typically undergo during phase II?
Exercise treadmill training Test (ETT) or maximal stress test
What would be the Exercise Rx for a test (-) fore ischemia?
70-85% of the peak achieved on the test (i.e. MHR) or equally effective alternative would be 65%-80% of MHR
For a positive ETT, what is the exercise Rx?
During aerobic training it is important to keep the MVO2 below the patient’s ischemic MVO2–DO NOT exceed 90% of ischemic RPP
MVO2 = HR x SBP (same as RPP)
When incorporating resistance training into phase II, what should the load be?
Begin with resistance bands and light hand weights (1-3lbs) for 15 reps
Low load, High reps
True or false: Resistance training should not begin until patient has been in cardiac rehab program for 3 weeks and is at least 5 weeks post MI or 8 weeks post CABG
True
What are the exercise guidelines given by AACVPR for resistance training?
- Large muscles groups before small
- Stressing exhalation with exertion
- Avoiding sustained tight grip
- Focusing on RPE 11-13
- Slow controlled movements
- Stopping exercise with any warning/concern with s+s
What is the frequency of phase II?
2-3x/week
What is the typical duration during phase II?
30-60 minutes with 5-10 minutes of warm-up and cool-down
What is the suggested exit point?
9 MET functional capacity
What is the last Phase of Cardiac Rehab known as?
Community Exercise programs
What is the entry level criteria for Phase III?
5 METs, medically stable angina, medically controlled arrhythmias during exercise
What is the progression for Phase III?
50-85% of functional capciaity, 3-4 times/week, 45 minutes or more/session
When is discharge typically for phase III?
6-12 months
True or False: For cardiac surgeries, LE resitance training can be initiated right away in the absences of peri-operative MI. UE resistance training should be avoided until soft tissue and boy healing has occurred (6-8weeks)
True
For Post transcatheret procedure (PTCA) a minimum of ____ weeks following procedur and ___ weeks of consistent participation in a supervised CR endurance training program
3 weeks; 2 weeks
Phase III
Phase III resistance training the load should be?
Low resistance (1 set of 10-15 reps)
50% of 1 RM
1-5 lb hand weights, wall pulley’s, elastic bands
RPE 11-13
