Cardiac rehabilitation and exercise

Question 1

Why is cardiac rehabilitation important?

Answer 1

For patients post MI and/or revascularisation, attending and
completing a course of exercise-based CR is associated with an absolute risk reduction in cardiovascular mortality from 10.4% to 7.6% compared to those
who don’t receive CR.

Question 2

What patient groups may benefit from cardiac rehabilitation

Answer 2

♥Stable Angina
♥MI
♥Angioplasty (and Stent) ♥Coronary Artery Bypass Graft (CABG)
♥Valve Repair ♥Congenital Repairs ♥Transplant
Heart failure

Question 3

What are the physiological benefits of cardiac rehabilitation

Answer 3

• Improvement in functional capacity.
• Improved cardiovascular efficiency.
• Reduction in atherogenic and thrombotic risk factors.
• Improvement in coronary blood flow, reduced myocardial ischaemia, and severity of atherosclerosis.
• Reduction in risk of cardiovascular disease mortality.

Question 4

What are the psychological benefits of cardiac rehabilitation?

Answer 4

Reduced anxiety and depression
 Enhanced mood
 Enhanced self-efficacy
 Restoration of self-confidence
 Decreased illness behaviour
 Increased social interaction
 Resumption of chores/hobbies
 Resumption of sexual activity
 Return to work/vocation Physiotherapy for Cardiac and Respiratory Problems

Question 5

What is the difference between activity and exercise

Answer 5

• Activity is sporadic in nature and inconsistent in intensity. E.g. climbing the stairs.
• Exercise is purposeful and sustained e.g. going for a walk.

Question 6

What are the national recommendations for exercise

Answer 6

• At least 150 mins of moderate intensity exercise per week.
• Bouts of at least 10 mins.
• Strength activities twice a week.
• Balance / relaxation.
• Decrease time spent sitting.

Question 7

Give some types of exercise

Answer 7

• Walking (jogging if appropriate)
• cycling/ /exercise bike
• Swimming / water-based exercise
• Circuits / dvd
• Racket sports.
• Dancing.
• Gardening.

Question 8

Give some examples of activities

Answer 8

• Stairs instead of lift.
• Walk to next bus stop.
• Park further from the supermarket.
• Bowls.
• Housework.
• Gardening.

Question 9

What will the initial assessment of a patient be for cardiac rehabilitation?

Answer 9

• Individual Assessment with the Cardiac Rehab Physio
• ‘Setting goals for increasing and maintaining activity in CR is important to help individuals stay motivated’ (Thow 2006)
• Risk assessment using the AACVPR guidelines
• Risk stratification

Question 10

What are common barriers to exercise

Answer 10

• Bad weather
• Too tired
• Not in the mood
• Don’t know how to
• Can’t afford it
• Fear
• Don’t have time….

Question 11

Describe the SMART goals method to increase activity

Answer 11

• Specific •Measurable •Achievable •Realistic •Time based
• Eg I want to be able to walk up the hill to my daughters, without stopping, by the time I have done 6 exercise classes.

Question 12

What is the FITT principle of exercise?

Answer 12

• Frequency
• Intensity
• Time
• Type