Exercise for Patients for Cardiac Rehabilitation - Indications, Contraindications, and Results

Introduction:

Exercise or exercise training is a repetitive body movement that improves physical fitness. Regular exercise helps to achieve optimal strength, balance, and confidence; it also increases the antioxidant production responsible for protecting and strengthening cardiac tissues. Increased physical activity, exercise training, and cardiorespiratory fitness protect against cardiac disorders.

What Are the Potential Benefits of Exercise Training?

• Increases serum good cholesterol levels.

• Reduces serum bad cholesterol levels.

• Reduces obesity.

• Reduces blood pressure.

• Maintains blood glucose level.

• Reduces stress.

• Helps in habit cessation (smoking).

• Improves skin rejuvenation.

• Reduces inflammation.

• Improves blood viscosity.

• Improves quality of life.

• Reduces morbidity and mortality.

What Are the Exercises for CHD (Coronary Heart Disease)?

• Aerobic Exercise: This includes walking, jogging, cycling, swimming, rowing, stair climbing, and aerobic dancing; it should be done for at least 20 to 30 minutes (preferably 45 to 60 minutes) regularly (at least five days per week and preferably six to seven days/ per week) with increased intensity (50 to 75 %).

• Resistance Training: This includes hand weights, elastic bands, and weight machines; it should be done for two to three sessions weekly (nonconsecutive days). Duration: ten to 15 repetitions; one to two sets of eight to ten different exercises for both the upper and lower body with moderate intensity.

What Are the Risks Associated With Intense Exercise Training?

During intense exercise training, the risk of myocardial infarction (MI) is higher than at rest. At present, exercise plus medical management helps to reduce the risk rates.

Who Can Undergo Exercise Training?

• Individuals who have undergone myocardial revascularization.

• Individuals with recent acute myocardial infarction (MI).

• Individuals with stable angina pectoris.

• Individuals with compensated heart failure.

Who Is Contraindicated from Exercise Training?

• A person with unstable coronary or cerebral ischemia.

• Uncontrolled blood pressure.

• Unstable medical conditions (severe anemia).

• Inability to exercise due to musculoskeletal and neuromuscular disorders.

• A person with uncompensated heart failure.

What Is CRSP?

CRSP (cardiac rehabilitation or secondary prevention) is an exercise program that helps in assisting lifestyle changes, including a healthy diet, quitting smoking, weight loss, stress management, and emotional support. It also refers the patient with CHD (coronary heart disease) for cardiac rehabilitation, which is not covered by insurance companies and remains underused.

What Are the Potential Benefits of Exercise Training?

1. Should walk slowly for three minutes with a moderate speed and then gradually increase. In case of breathlessness, slow down the speed.

2. Walk for five to ten minutes for the first time and then gradually increase by one to two minutes daily. Later 30 to 40 minutes of walking is necessary daily with rest intervals. At the end of walking, gradually reduce the speed and cool down.

3. Should not lie down immediately after exercise.

4. Practice walking nearby the living area so that it will not be difficult for the patient to return once after completing.

5. Choose aerobic exercise like jogging, swimming, and walking outside or on the treadmill.

6. Consult with a doctor before doing weight-lifting exercises.

7. Do exercise regularly.

8. In case of breathlessness that does not resolve within 15 minutes, stop walking, take a rest and consult the doctor.

9. Get into the habit of doing exercise at the same time every day.

What Are the Indications for Cardiac Rehabilitation/Secondary Prevention Program?

Individuals who have:

• Myocardial infarction.

• Undergone bypass grafting.

• Angina pectoris (chest pain).

• Heart or lung transplants.

• Advanced heart failure.

• Valve replacement.

• A high risk of heart disease.

How to Choose a Cardiac Rehabilitation Program?

Contact doctors, nurses, physiologists, psychologists, dietitians, or the program-conducting staff. These persons will design appropriate programs for each patient according to their needs.

What Are Cardiac Rehabilitation Exercises?

Exercises in cardiac rehabilitation depend on the fitness level and risk factors.

• Aerobic Exercises: This type of exercise includes walking and riding a stationary cycle.

• Physical Activities That Strengthen the Muscles: Free weight lifting and using resistance bands.

• Other Components: Eating healthier, following stress management protocols, maintaining a healthy weight, quitting tobacco products, and taking medications properly.

What Happens During the Program?

The program involves medical evaluation, physical activity, lifestyle education, and support.

• Medical Evaluation: Initial evaluation involves checking health-related issues and physical abilities. After that, during exercise, they evaluate the risk factor for heart problems and draw a program that is more beneficial for the patient.

• Physical Activity: Physical activity improves cardiovascular fitness. The health care team will teach proper exercise techniques and suggest low-impact activities and weight-lifting procedures. In addition, they make sure that the patient is in a comfortable zone during the training hours.

• Lifestyle Education: This involves educating about healthy lifestyle changes, including eating a healthy diet, exercising regularly, maintaining a healthy weight, and quitting smoking. They also give guidance in managing conditions like high blood pressure, diabetes, high cholesterol, and obesity.

• Support: It is hectic to come back to normal life after major health issues. Feeling depressed is the worst part that affects the health and rehabilitation program. Hence counseling is the only way to overcome depression. Taking antidepressants and occupational therapy may help a person come back to normal.

What Happens After the Program?

A healthy diet, regular exercise protocol, and healthy lifestyle habits help maintain good health conditions. At the end of the program, tools are provided to exercise and follow a healthier lifestyle.

What Are the Outcomes of the Program?

• Improvement in strength.

• Adopted a healthy behavior.

• Terminated bad habits.

• Weight regularization.

• Learned stress reduction protocol.

• Learned to cope with heart diseases.

How to Increase CRSP (Cardiac Rehabilitation / Secondary Prevention) Services?

• Should give high priority to CRSP (cardiac rehabilitation or secondary prevention) services.

• Should educate physicians and patients.

• Should increase resources.

• It should simplify the enrollment and referral process.

Conclusion:

Starting a cardiac rehabilitation program may be quite difficult during illness, but it will help them benefit from it in the long run. A successful cardiac rehabilitation program solely depends on the input of the individual. Cardiac rehabilitation programs improve the quality of life. Under the guidance of a medical professional, the person can get stronger.