cardiac rehabilitation and exercise

Question 1

what is the definition of cardiac rehabilitation?

Answer 1

the co-ordinated sum of activities required to influence favourably the underlying cause of CVD, as well as provide the best possible physical, social and mental condition so that the individuals may, by their own efforts, preserve or resume optimal functioning.

Question 2

what is the evidence supporting cardiac rehabilitation?

Answer 2

for patients with post MI or revascularisation , attending and completing a course of exercise based CR is associated with an absolute risk reduction in CV mortality from 10.4% to 7.6% compared to those who do not receive cardiac rehabilitation.

Question 3

what are the 5 components of the 2023 BACPR model for cardiovascular disease prevention and rehabilitation?

Answer 3

1- lifestyle risk factor management
2- long term strategies
3- health behaviour change and education
4 - psychological health
5- medical risk management

Question 4

what is the difference between activity and exercise?

Question 5

is being physically inactive the sam as being sedentary?

Question 6

what is fitness?

Question 7

what are the physiological benefits of exercise?

Answer 7

• improvement in functional capacity
• improved CV efficiency
• reduction in risk of CVD mortality
• control weight
• stregthen muscles and bones
• reduction in atherogenic and thrombotic risk factors

Question 8

what are psychological benefits of exercise?

Answer 8

• reduced anxiety and depression
• restoration of self confidence
• resumption of sexual activity
• return to work
• increased social interaction
• enhanced mood

Question 9

what group of patients should be doing exercise?

Answer 9

those with:
- acute coronary syndrome
- coronary revascularisation
- heart failure
- stable angina
- many more

Question 10

what should take lace in the initial physiotherapy assessment?

Answer 10

• diagnosis and procedure
• cardiac function
• current symptoms
• current medication
• past medical history
• risk stratification
• functional capacity testing
• heart rate and bp response to exercise
• patient SMART goals

Question 11

why do we assess the risk of the patient before they are allowed to do exersie?

Answer 11

• asses the risk of further cardiac events
• assess the likelihood of complications during exercise
• to guide exercise prescription and patient management
• to identify the site of exersie session and staffing ratios.

Question 12

what are the 6 steps in the cycle of change?

Answer 12

1- not interested
2- thinking about it
3- planning it
4- doing it
5- had enough
6- give up or start again

Question 13

what should you do in a motivational interview?

Answer 13

• try to understand the patients beliefs and address any misconceptions
• listen with empathy
• empower the patient
• try not to fix the problems here.

Question 14

wha barriers do people face when they are about to do exersise?

Answer 14

• bad weather
• tired
• can’t afford
• fear
• don’t have time

Question 15

what does SMART stand for?

Answer 15

Specific
Measurable
Achievable
Realistic
Time based

Question 16

what is the FITT principle?

Answer 16

the recommend dose of cardiovascular exercise can be achieved by varying the FITT principle:
Frequency
Intensity
Time
Type

Question 17

Frequency?

Answer 17

at least 3 times a week

Question 18

Intensity?

Answer 18

moderate intensity aerobic exercise (40-70% HRR/ 11-14 RPE)

Question 19

Time?

Answer 19

duration and frequency interchangeable, min of 20 mins for the conditioning phase

Question 20

Type?

Answer 20

aerobic, taking balance/ co-rdination and flexibility into consideration

Question 21

training Heart range

Answer 21

40-70% of heart rate reserve

Question 22

heart rate reserve?

Answer 22

maximum heart rate - resting heart rate

Question 23

what is the calculation for max heart rate?

Answer 23

206-(0.7xage)

Question 24

sing

Answer 24

good level to start of with or warm up

Question 25

talk

Answer 25

slightly short of breathe but able to chat is good level for moderate exersie

Question 26

gasp

Answer 26

if you cannot talk fluently you are working too hard

Question 27

a warm up should be?

Answer 27

• mobilise joints
• include else rating activities
• include stretching interspersed with raising pulse moves to maintain HR
• increase effort gradually
• should last for a min of 10 mins

Question 28

a cool down should be?

Answer 28

• min of 10 mins

Question 29

what is there a risk of within the first 30 minutes following exercise?

Answer 29

hypotension
ischamia
arrhythmias

• a graduated cool down has been found to reduce these incidences

Question 30

what is the impact of the pandemic on cardiac rehabilitation?

Answer 30

• face to face consultations stopped
• assessment and review consultations moved to phone and video calls
• individual appointments only
• peer suport lost
• reduced FTA rate
• complications with advise

Question 31

how has things changed since the pandemic?

Answer 31

• face to face consultations have restarted
• assessment and review consultations offered as face to face, telephone or video calls
• individual app only
• no group sessions in tayside yet
• increased flexibility and individualised care