Week 7 - Outpatient Cardiac Rehab

Question 1

Who qualifies for outpatient cardiac rehab

Answer 1

MI
Angina
Cardiac surgery (CABG or valve)
Coronary artery angioplasty/stents
Heart failure
Heart transplant

Question 2

Services provided

Answer 2

Patient assessment
Exercise training/physical activity counseling
Nutritional counseling
CVD risk factor management
Psychosocial assessment and counseling

Question 3

Outpatient cardiac rehab

Answer 3

Close supervision w medical personnel and equipment on site
3 visits/week for 12 weeks
Some programs are more flexible - longer or shorter depending on the patient’s needs
While exercising, pts monitored visually and by telemetry

Question 4

Why attend?

Answer 4

Reduced mortality
Reduced readmission rates to hospital
Improved function, exercise capacity and quality of life
Strong dose response relationship because # of CR visits and long term outcomes

Question 5

Exercise sessions

Answer 5

Group exercise sessions w individualized exercise prescription based on a graded exercise test
Most consistent of walking on a treadmill at an intensity designed to reach a target HR
Target HR based on his risk factors, arrhythmias and abnormal hemodynamic during GXT
Progression to other activities once tolerance increases

Question 6

Exercise prescription - no GXT

Answer 6

Includes aerobic flexibility and resistance exercise

Question 7

Exercise prescription - no GXT, for patients on B-blockers

Answer 7

Prolonged warmup and cool down
RPE < 12 is light or 40% HRR
RPE 12-13 is “somewhat hard” or 40% - 59% HRR
RPE 14-16 is “hard” or 60% - 80% HRR

Question 8

Exercise prescription - no GXT - for patients on diuretics

Answer 8

Watch for dehydration, hypokalemia and their consequences

Question 9

Progression to resistance exercise

Answer 9

Pt must first show normal response to aerobic exercise
Start with large muscle groups
Weights that can be lifted for at least 20 reps
Weight increased when they reach 30 reps