Cardiac Rehabilitation

Simplified and presented by: Pishgahi A. MD

References Physical medicine and rehabilitaion, fourth

edition. Randall l. Braddom

Cardiac Rehabilitation 2012 Advancing the Field Through Emerging Science, AHA

Scottish Intercollegiate Guidelines Network, Cardiac Rehabilitation, 2002

What?

Cardiac rehab programs usually provide education and counseling services to help heart patients

increase physical fitness, reduce cardiac symptoms, improve health and reduce the risk of future

heart problems, including heart attack.

Why?

PhysiologyVO2VO2 maxMetabolic equivalent

(MET)

The Fick equation

Low intensity exercises (SV)High intensity exercises (HR)

Aerobic training50-80% of VO2 max 30-60 min dailyMuscle specificBiomechanical changes (10 days)Adaptative changes (6-10 weeks)Increased A-V gradient

MVO2

Who?

Contraindications Unstable anginaRest ST dep. More than 2 mmUncontrolled arrhythmiaSevere ASUncontrolled CHFSBP> 200 or DBP> 11oSBP decline more than 10 mmHg during

exercisesOrthostatic hypotension about 10-20 mmHg

How?

Phases1. Inpatient2. Transitional3. Outpatient4. Maintenance

CR prescriptionFITT principles

Frequency FIntensity IDuration/Time TMode/Type T

Combination of aerobic(continous/ interval) and resistance training

Intensity 1. Risk stratification 2. Determine Training HR

Protocol(aerobic)Cardio-respiratory fitness requires aerobic

training of low to moderate intensity, long duration and with repetitive movement of large muscle groups.

At least 3 session/wk for 8 week

Protocol(aerobic)

Protocol(resistive)Improve muscle strength, cardiovascular

function, coronary risk factors, psychological well being.

Low to moderate intensity (<70% maximal voluntary contraction)begins 4 weeks after aerobic training

Long-term follow up

Summary

Summary

Thank u.