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Exercise Prescription. Cardiac Rehabilitation. WHY EXERCISE?. Hypertension Dyslipidemia Smoking Obesity Diabetes Stress. Unstable angina systolic/diastolic hypertension orthostatic drop > 20mm Hg with symptoms critical aortic stenosis acute systemic illness or fever uncompensated CHF
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Exercise Prescription Cardiac Rehabilitation
WHY EXERCISE? • Hypertension • Dyslipidemia • Smoking • Obesity • Diabetes • Stress
Unstable angina systolic/diastolic hypertension orthostatic drop > 20mm Hg with symptoms critical aortic stenosis acute systemic illness or fever uncompensated CHF active pericarditis, myocarditis recent embolism Uncontrolled atrial or ventricular arrhythmias uncontrolled sinus tachycardia > 120 bpm 3rd degree AV block resting ST displacement > 2 mm uncontrolled diabetes (BG > 15) severe orthopedic problems other acute metabolic problems CONTRAINDICATIONS TO EXERCISE
Exerciseis Medicine “the art of exercise prescription is successful integration of exercise science with behavioural techniques that result in long-term program compliance and the attainment of the individual’s goal”
Exercise Prescription Exercise is prescribed taking into account 4 different factors: • F-frequency-how often • I-intensity- using RPE scale or heart rate • T-type - aerobic exercise • T-time - number of minutes per session
RPE scaleRate of Perceived Exertion • 6 • 7 very,very light • 8 • 9 very light • 10 • 11 fairly light • 12 • 13 somewhat hard • 14 • 15 hard • 16 • 17very hard • 18 • 19 very,very, hard
Exercise PrescriptionPost Discharge • Frequency - every day, once or twice • Intensity - easy, comfortable pace • Type - walking • Time- start at 5 minutes and increase by 5 minutes per week if tolerated
Exercise PrescriptionRecovery Program • - every day • - 10-30 beats above resting heart rate or RPE between 11 and 13 • - walking, cycling, arm ergometer • - increasing by 5 minutes per week to 30 to 40 minutes of exercise
Exercise PrescriptionMaintenance • - 5 to 6 times per week • - moderate intensity, 11-13 on the RPE scale, talk test – best values obtained from a stress test: 60%-80% of heart rate reserve (Karvonen’s Equation) • - walking, jogging, cycling, swimming, paddling, rowing, cross country skiing, snowshoeing,skating • - 30 -60 minutes
Resistance Training Light weight training for muscle endurance is appropriate for cardiac patients: • 3 months post event • start with light weights and increase gradually • does not replace an aerobic workout • increases muscle tone and maintains mass to maintain muscular power