cardiac rehabilitation and exercise Flashcards
what is the definition of cardiac rehabilitation?
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.
what is the evidence supporting cardiac rehabilitation?
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.
what are the 5 components of the 2023 BACPR model for cardiovascular disease prevention and rehabilitation?
1- lifestyle risk factor management
2- long term strategies
3- health behaviour change and education
4 - psychological health
5- medical risk management
what is the difference between activity and exercise?
is being physically inactive the sam as being sedentary?
what is fitness?
what are the physiological benefits of exercise?
- 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
what are psychological benefits of exercise?
- reduced anxiety and depression
- restoration of self confidence
- resumption of sexual activity
- return to work
- increased social interaction
- enhanced mood
what group of patients should be doing exercise?
those with:
- acute coronary syndrome
- coronary revascularisation
- heart failure
- stable angina
- many more
what should take lace in the initial physiotherapy assessment?
- 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
why do we assess the risk of the patient before they are allowed to do exersie?
- 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.
what are the 6 steps in the cycle of change?
1- not interested
2- thinking about it
3- planning it
4- doing it
5- had enough
6- give up or start again
what should you do in a motivational interview?
- try to understand the patients beliefs and address any misconceptions
- listen with empathy
- empower the patient
- try not to fix the problems here.
wha barriers do people face when they are about to do exersise?
- bad weather
- tired
- can’t afford
- fear
- don’t have time
what does SMART stand for?
Specific
Measurable
Achievable
Realistic
Time based
what is the FITT principle?
the recommend dose of cardiovascular exercise can be achieved by varying the FITT principle:
Frequency
Intensity
Time
Type
Frequency?
at least 3 times a week
Intensity?
moderate intensity aerobic exercise (40-70% HRR/ 11-14 RPE)
Time?
duration and frequency interchangeable, min of 20 mins for the conditioning phase
Type?
aerobic, taking balance/ co-rdination and flexibility into consideration
training Heart range
40-70% of heart rate reserve
heart rate reserve?
maximum heart rate - resting heart rate
what is the calculation for max heart rate?
206-(0.7xage)
sing
good level to start of with or warm up
talk
slightly short of breathe but able to chat is good level for moderate exersie
gasp
if you cannot talk fluently you are working too hard
a warm up should be?
- 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
a cool down should be?
- min of 10 mins
what is there a risk of within the first 30 minutes following exercise?
hypotension
ischamia
arrhythmias
- a graduated cool down has been found to reduce these incidences
what is the impact of the pandemic on cardiac rehabilitation?
- 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
how has things changed since the pandemic?
- 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