Cardiac Rehabilitation

Question 1

How many Phases of cardiac rehab are there?

Answer 1

Three phases

Question 2

What is Phase I considered?

Answer 2

Phase I is the inpatient phase

Question 3

How long does Phase one typically last

Answer 3

Hospital stay for 3-5 days for uncomplicated MI (complicated MI includes ischemia, LV failure or significant ventricular arrhythmias)

Question 4

What should the intensity be for Phase I cardiac patients?

Answer 4

Low intensity (2-3 METs) progression to >5METs by discharge

Question 5

What should the frequency be during Phase I?

Answer 5

2-3x/day

Gradually duration is lengthened and frequency decreased

Question 6

True or False: During the first Phase of cardiac rehabilitation a patient may perform resistance training.

Answer 6

False: May not perform resistance training until 6 weeks post-op

Question 7

What is the THR limited to in the Phase I ?

Answer 7

THR is limited to 70% of MHR and/or 5 METs until 6 weeks post-MI

Question 8

What should the RPE Borg scale limit be?

Answer 8

The patient should exercise in the fairly light range

Question 9

For an increase of 1-2 METs a _____ increase in HR is appropriate?

Answer 9

20 bpm

Question 10

True or False: A patient must sit upright in bed and demonstrate appropriate hemodynamic response prior to ambulating in hallway

Answer 10

True

Question 11

A patient’s HEP protocol for ambulation should be?

Answer 11

Goal of 20-30 minutes; 1-2 times/day at 4-6 weeks post-MI

Also, perform UE/LE mobility exercises

Question 12

Cardiac Rehab can begin when?

Answer 12

After patient has been hemodynamically stable for 24 hours

Question 13

What should the first day look like?

Answer 13

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.

Question 14

While sitting in a chair what exercises can a patient perform?

Answer 14

Ankle pumps, knee extension or marching in place

Question 15

What is the second phase of cardiac rehabilitation known as?

Answer 15

Outpatient Cardiac Rehabilitation (subacute)

Question 16

When does Phase II typically begin ?

Answer 16

4-6 weeks post MI

Question 17

What test do patients typically undergo during phase II?

Answer 17

Exercise treadmill training Test (ETT) or maximal stress test

Question 18

What would be the Exercise Rx for a test (-) fore ischemia?

Answer 18

70-85% of the peak achieved on the test (i.e. MHR) or equally effective alternative would be 65%-80% of MHR

Question 19

For a positive ETT, what is the exercise Rx?

Answer 19

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)

Question 20

When incorporating resistance training into phase II, what should the load be?

Answer 20

Begin with resistance bands and light hand weights (1-3lbs) for 15 reps

Low load, High reps

Question 21

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

Answer 21

True

Question 22

What are the exercise guidelines given by AACVPR for resistance training?

Answer 22

1. Large muscles groups before small
2. Stressing exhalation with exertion
3. Avoiding sustained tight grip
4. Focusing on RPE 11-13
5. Slow controlled movements
6. Stopping exercise with any warning/concern with s+s

Question 23

What is the frequency of phase II?

Answer 23

2-3x/week

Question 24

What is the typical duration during phase II?

Answer 24

30-60 minutes with 5-10 minutes of warm-up and cool-down

Question 25

What is the suggested exit point?

Answer 25

9 MET functional capacity

Question 26

What is the last Phase of Cardiac Rehab known as?

Answer 26

Community Exercise programs

Question 27

What is the entry level criteria for Phase III?

Answer 27

5 METs, medically stable angina, medically controlled arrhythmias during exercise

Question 28

What is the progression for Phase III?

Answer 28

50-85% of functional capciaity, 3-4 times/week, 45 minutes or more/session

Question 29

When is discharge typically for phase III?

Answer 29

6-12 months

Question 30

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)

Answer 30

True

Question 31

For Post transcatheret procedure (PTCA) a minimum of ____ weeks following procedur and ___ weeks of consistent participation in a supervised CR endurance training program

Answer 31

3 weeks; 2 weeks

Phase III

Question 32

Phase III resistance training the load should be?

Answer 32

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