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Cardiac Rehabilitation Cardiac RehabilitationAjay Elias,Physiotherapy SpecialistKarimbilackil,Mekkadanbu.PO.Muvattupuzha .Kerala,IndiaCharacteristics:General features: Longitudinal, Participatory, Preventive, Personalized to a limited extendComponents: Physiological, Vocational nike lunar force one altas , Psychological, Educative.Ideal Program:Individualized, supervised, therapeutic, relaxing, dynamic, aerobic, viable intensity, enjoyable, educational, recreational, non 芒鈧€?competitive.Candidates:Post MI, Post CABG, Post transplant, Post valvular.Primary goals1. Increase the functional capacity.2. After natural history of cardiac disease.PrecautionsNo heavy meals prior to exerciseExercise in a cool environmentDrink water before & after exercises and allow sips during exercises.Loose and comfortable dressing Early morning and late evening are the best time for exercise.GoalsPhase 1 prevent secondary complications of inactivity.Phase 2 achieve strong scars in the area of ischemiaPhase 3 improve endurance and return to work if possible to previous activity itselfPhase 4 maintenance and endurance PHASE 1 PHASE 2 PHASE 3Name In Hospital Early Post Hospitalization Maintenance PhaseTiming Admission to hospital 2 weeks post discharge or 6-8 week Post MI nike lunar force 1 baratas ,3-4 wee Post CABG Duration Up to discharge hospital 8-12 weeks Life longCondition Acute MI, CABG, Post angioplasty, Angina pectoris Phase 1 graduates, and CAD with risk factors Phase 2 graduatesMajor goals Prevent deconditioning, Patient an family education, functional mobilization, early hospital discharge Develop cardio vascular endurance, conditioning, complete return to work. Maintain life time exercise program for CVS maintenanceSupervision Highly supervised Highly supervised Home programMajor activity Program of progressive activity Aerobic exercise for 15 to 20 min Aerobic exerciseInitial intensity 2-3 MET increasing 1 MET gradually 70- 80 % 70 芒鈧€?75 %Monitoring HR & BP HR HROthers Pre-discharge stress test not more than 5 MET low fat diet. Most intensive and vigerous.5 min warm up & cool down. low intensity, high frequency NilGuideline for GraduationAge Male Female49 or less 10 MET 8 MET50-59 9 MET 7 MET60-69 8 MET 6.5 MET70 or above 7 MET 6.5 METAbsolute contraindications芒鈧?Unstable angina with recurrent chest pain芒鈧?Untreated arrythemia芒鈧?Uncompensated CHF芒鈧?Advanced AV block芒鈧?Acute myocarditis or pericarditis芒鈧?Aortic stenosis芒鈧?Sever hypertrophy cardiac myopathy芒鈧?Uncontrolled hyper tension芒鈧?Acute M I芒鈧?Active endocarditis芒鈧?Active pulmonary embolism芒鈧?Pulmonary infarction芒鈧?DVT芒鈧?Acute systemic illnessRelative contraindications芒鈧?Pulmonary hypertension芒鈧?Arterial hypertension芒鈧?Moderate valvular disease芒鈧?Myocardial heart disease芒鈧?Electrolytic abnormalities芒鈧?Coronary obstruction L main芒鈧?Psychiatric diseaseFacts on exercise physiology茂茠录 Aerobic capacity = measure the work capacity茂茠录 VO2 maxMaximum O2 consumption of whole body primarily.