CLOSE TO YOUR HEART By Becky Blaauw Biokineticist.
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Transcript of CLOSE TO YOUR HEART By Becky Blaauw Biokineticist.
Role of exercise in modern cardiology
Benefits of Physical Activity
Maintaining a safe level of activity with Heart Disease
Role of exercise in modern cardiology Help you return to an active life ↑ quality of life ↑ exercise intolerance ↑ functional capacity ↑ symptoms of dyspnea and fatigue ↑ your energy level and lifts your
spirits ↓ your chances of future heart
problems including heart attacks.
1. Primary prevention
Higher activity /fitness = with lower death rates from cardiovascular diseases
2. Secondary prevention(after cardiac event)
Research shows mortality is reduced in post cardiac event in patients who participate in cardiac rehab due to multi risk factor reduction
Uncontrollable Risk Factors Age ↑ Gender: Men > women Heredity Race: RSA > Indian community then
coloured followed by white and then Black communities.
1. Smoking
Smokers ↑ 2 - 4
Good news is that in the year after you quite smoking your risk of future problems drops by 50%. After 15 years your risk is as low as someone that never smoked.
2. Blood Pressure
High Blood Pressure: 130/85 or >.
Immediate: After exercise systolic may decrease for several hours.
Long term: At Rest B.P may be reduced moderately
3. Obesity BMI >25 waist circumference• Male > 100cm• Female > 90cm
Being overweight is bad for your health.• Exercise can decrease and control
your weight• Decrease total fat and intra
abdominal fat
TOTAL > 5.18mmol
High Cholesterol: The higher your LDL (Bad cholesterol) > your risk for heart disease. The higher your HDL (good cholesterol) the lower your risk of Coronary Heart Disease.
12 weeks of endurance training increase HDL and decrease Triglyceride levels
5. Cholesterol
6. DiabetesDiabetes > 5.5mmol/L (fasting)Diabetes: Having diabetes puts you in the highest heart attack risk category. Prediabetic Risk of developing heart disease is high.
Physical activity can prevent and control Type 2 diabetesImprove glucose tolerance and insulin needs
7. Stress
Exercise will also help your manage stress
Decrease in anxiety and depression.
Exercise will enhance feelings of well being.
BENEFITS OF EXERCISE ON THE HEART
Heart Rate Resting heart rate 10 – 15 bpm
Stroke Volume (average volume of blood ejected per heart beat) Stroke Volume
Cardiac Output Cardiac Output
OTHER BENEFITS
Increased exercise threshold (angina, heart failure)
Reduce blood platelet adhesiveness Health for muscles, bones and joints
Independence for older cardiac patients
Reduced risk of falls
WHY ????
According to Cooper et al (1999)
Being older, less aware of cholesterol values, less likely to be employed and not believing their condition is controllablePatients have not been advised by their doctor
The risk of Sudden Death during exercise is very small the most problems associated to any exercise program is musculoskeletal injury.
It is important to remember that the cause of death in these cases is Cardiovascular Disease NOT EXERCISE.
MYTH 4
Cardiac rehabilitation is just exercise
It is a professionally supervised program to help people recover from Heart attacks, Heart surgery and help patients reduce risk factors.
1.Who needs a Cardiac Rehab Program Anyone of all ages who have Heart
conditions and high risk factors Did you know if you already some
form of heart or blood vessel disease or diabetes, you have a > 20% chance of having a heart attack or dying from heart disease within the next 10 years.
2.How long do people attend Cardiac Rehab program For the rest of your life You may need 6 weeks, 6 months or
longer to manage your condition with your biokineticist
3. What should you consider when picking a program Biokineticist - the Health Professional
Council of South Africa Time: is the program offered at a time you
can be there Place: is the program easy to get to Services: does the program offer the
services you need Setting: is it a group or individual program Cost: can you afford it. Is it covered by your
medical aid
4. How can you find out about programmes in your community
Your doctor and Helderberg Cardiac Support group
www.biokinetics.org
Helderberg Cardiac Support Group Cardiac support system Formal rehabilitation Guidance on medication, exercise, diet,
stress control.
First of it’s kind in South Africa
Maintaining a safe level of activity with Heart Disease Most patients are capable of beginning
a supervised exercise program 1 to 2 weeks of leaving hospital
It’s best to be under supervision for first 6 - 12 weeks
You are capable of doing your own home program quite successful if you have the basics right
FREQUENCY: According to ACSM 4 – 7 days per week
INTENSITY:RPE scale: 11 – 13 (40 – 60 %) and 11 – 16 (50 – 75%)
THR = (220-Age) – RHR x (intensity) + RHR
Nb: Beta blockers subtract 10bminInitial cardiac rehab should be 40 – 60% of M.H.R The American Heart association recommends a Target Heart Rate of 50 – 75% of Maximal Heart Rate .
TIME: American Heart Association 20 – 60min depending on your intensity. i.e.: the higher your intensity the lower your duration
1. Warm up (5 – 10min)How…- Slow walking or biking with no/light resistanceWhy…Gradually improves blood flow to heartand exercising musclesIncrease body temperatureHelps prevent injuries, muscle soreness
2. Muscular Strength and endurance (20min)
How…..Use interval training (fartlec)
Endurance: Rowing, step ups, more cycling, walking, swimmingMuscle strength: Light weights, resistance bands
Why…..
Cardio – respiratory endurance: this is the main focus of physical fitness as this causes the most physiological changes known to reduce symptoms and risk factors.
Light resistance training can make our activities of daily living easier and has been shown to modify coronary risk factors.
Flexibility and BalanceHow……Light stretches
Why…..Improves range of motionImproves co-ordinationReduces risk of injuryDecreases muscle soreness
3. Cool Down (5 – 10min)
How…- Easy walking or biking with no resistance,
Why…To prevent blood poolingPrevents muscle stiffness and sorenessReturn the heart, lungs, and muscle activity to resting levelsCool down will minimize the potential for Arrhythmic episodes
Patients with sternotomy (bypass patient)
: resistance exercises at 6 weeks and light weights (0.5 - 1kg female and 1.5 - 2 kg males) with limited R.O.M exercises
Pace maker and defibrillator implantation patients: Know what your upper HR limit is (10%
below the ischemic threshold). Exercise at 10 beats below programmed HR threshold.
Initially avoid exercises above shoulder level.
Rather use RPE scale for intensity
Cardiac Transplant patient: for several months heart does not
respond normally to sympathetic nervous system therefore resting heart rate is elevated and HR response is abnormal.
Rather use RPE scale. Use an extended warm up and cool
down.
Chronic Heart Failure Exercise at a lower intensity Use a prolonged warm-up and cool –
down Avoid isometric exercises Rather use a RPE scale for intensity Rather use interval training
Hypertensive Patients: Do not exercise if BP IS > 200/110mmHg rather use a bicycle ergometer than arm
ergometer. Smaller muscle mass causes increases SBP
Normal Response To Systolic Blood Pressure: Systolic Blood Pressure should go up and Diastolic Blood Pressure remain the same or go slightly down. SBP that fails to rise or fall with exercise could be due to severe coronary artery disease or Left Ventricle dysfunction
Artrial Fibrillation Patients
Should only do moderate intensity exercise to ensure left ventricular filling time
Diabetes patients Do not exercise if blood glucose are
>13mmol/l
Do not inject insulin into area into active muscle (rather abd than thigh)
Final Points To Remember
Ideal temp 18 – 22 degrees and humidity of 65 degrees. Anything hotter you should decrease your intensity
Water Move feet Do not hold your breath. Use rest stations Avoid isometric exercises. Listen to your body. Pain is natures way
of saying something is wrong.
Conclusion It’s NEVER too late to start exercising (it’s never too early, either) Small changes make BIG differences There are 1440 minutes in every
day…Schedule 30 of them forExercise and
Get Close To Your Heart!!