Exercise Prescription Cardiac Rehabilitation WHY EXERCISE Hypertension Dyslipidemia
Exercise Prescription Cardiac Rehabilitation
WHY EXERCISE? ªHypertension ªDyslipidemia ªSmoking ªObesity ªDiabetes ªStress
CONTRAINDICATIONS TO EXERCISE ª Unstable angina ª systolic/diastolic hypertension ª orthostatic drop > 20 mm Hg with symptoms ª critical aortic stenosis ª acute systemic illness or fever ª uncompensated CHF ª active pericarditis, myocarditis ª recent embolism ª Uncontrolled atrial or ventricular arrhythmias ª uncontrolled sinus tachycardia > 120 bpm ª 3 rd degree AV block ª resting ST displacement > 2 mm ª uncontrolled diabetes (BG > 15) ª severe orthopedic problems ª other acute metabolic problems
Exercise is 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: ªF-frequency-how often ªI-intensity- using RPE scale or heart rate ªT-type - aerobic exercise ªT-time - number of minutes per session
RPE scale Rate of Perceived Exertion ª ª ª ª 6 7 very, very light 8 9 very light 10 11 fairly light 12 13 somewhat hard 14 15 hard 16 17 very hard 18 19 very, hard
Exercise Prescription Post Discharge ªFrequency - every day, once or twice ªIntensity - easy, comfortable pace ªType - walking ªTime- start at 5 minutes and increase by 5 minutes per week if tolerated
Exercise Prescription Recovery Program F - every day I - 10 -30 beats above resting heart rate or RPE between 11 and 13 T - walking, cycling, arm ergometer T - increasing by 5 minutes per week to 30 to 40 minutes of exercise
Exercise Prescription Maintenance F - 5 to 6 times per week I - 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) T - walking, jogging, cycling, swimming, paddling, rowing, cross country skiing, snowshoeing, skating T - 30 -60 minutes
Resistance Training Light weight training for muscle endurance is appropriate for cardiac patients: ª 3 months post event ªstart with light weights and increase gradually ªdoes not replace an aerobic workout ªincreases muscle tone and maintains mass to maintain muscular power
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