Phase III Cardiac Rehab Flashcards
(35 cards)
When does the Phase III maintenance program begin?
After pt is discharged form a phase II program
Pt needs medical clearance
Pt monitors RPE and HR throughout program
Requirements for Phase III
Pt completed 36 visits of phase II
Pt will have established THR
Pt will have medical clearance
Pt will participate in an orientation to Phase II, between week 6-10
Other requirements for Phase III (1)
Pt will achieve their THR and maintain that HR for the last 2 weeks of Phase II
Pt will be independent in monitoring HR and RPE
Other requirements for Phase III (2)
Pt will be independent in transfers on and off of equipment
Pt will be independent in equipment set up
Pt will have good understanding of their exercise prescription
What are the Phase III options?
Phase III cardiac rehabilitation program
Public gym
Home
What pt’s are appropriate for phase III CR program?
Who are not independent with exercise prescription
Who have ambulation deficits
Who are at risk for exercising alone
Who are high risk
Who is unable to monitor self with exercise
Who request
Prior to start of phase III, what must the phase II treatment team do?
Contact facility
Forward all records
Discuss prescription with staff, send detailed prescription
Max exercise prescription achieved in your gym
Notify on contraindications
What patients are appropriate for public gym in phase III?
Who are independent with exercise prescription
Who are at low - moderate risk
Who are independent with all equipment
Who are independent in monitoring HR
Requirements prior to start for public gym phase III (1)
You must become familiar with gym equipment and staff
Max prescription achieved in your gym
Bring pt to gym to instruct on equipment
Requirements prior to start for public gym phase III (2)
Detailed prescription for warm up cool down stretching
Can add equipment that achieves same outcomes as in your gym
Contraindications
What patients are appropriate for home phase III? (1)
Who are at high risk ( can be low or mod at pts request)
Who do not wish to join a gym
Who can benefit form lower level exercise
What patients are appropriate for home phase III? (2)
Who can self monitor
Who have a good understanding of prescription
Who have the means to exercise
Who request
Requirements prior to start at home phase III
Establish what exercise equipment is available to patient
Must be safe; ( walking in street, walking in mall)
May not be able to attain MET level
Prescription established by time
Contraindications and limitations
HR and O2 uptake are ___________ during dynamic exercise involving large mm groups
linearly related
What should be the THR for phase III
The THR achieved during the 36 visits in phase II
Borg scale RPE
Scale ranging from 6 (no exertion at all) to 20 (maximal exertion)
Modified Borg scale
Scale ranging from 0 (nothing at all) to 10 (very, very heavy)
Equipment recommendations for Phase III (1)
Treadmill
Stair stepper
Bikes
UBE
Cybex rower
Equipment recommendations for Phase III (2)
ICRIAN (cable column, standing rower)
Cybex leg ext/standing HS
Nautilus lat pull down
Free weights
What equipment should NOT be recommended?
No pool
No sauna
No cycle classes
No step classes
Upright exercises only
Patient Guidelines for Phase III (1)
Follow prescription from Phase II (Do not exceed)
Follow up c rehab team if having difficulty c exercises
Follow up c MD if symptoms arise
Patient Guidelines for Phase III (2)
Do not walk outside if its above 85 or below 50
Do no exercises if you forgot to take meds
When should the pt rest and decrease physical activity temporarily?
If experiencing excessive fatigue, SOB, dizziness, HR above THR, flu, cold, fever
If change in medical condition or medication
When should the pt stop the exercise and contact MD?
Chest tightness/pain
Pain in jaw, arms, ears, or teeth
Nausea, vomiting, headache
Irregular heart beat
Heavy sweating
SOB that doesn’t subside in 15 min
