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INTRODUCTION
Definition by WHO –Sum of activities required to influence
favourably the underlying cause of the disease as well as the
best possible mental physical ,mental and social condition so
that they may be by there own effort preserve or resume when
lost as normal place as possible in the community .
According to AHA –Cardiac rehabilitation refer to
coordinated multifactorial intervention designed to optimize a
cardiac patient physical psychological and social function in
addition to stabilizing slowing or even reversing progression
of underlying process and thus reducing the mortality and
morbidity .
HISTORY OF CARDAIC REHABLITATION
In the 1930s, patients with myocardial infarction (MI) were
advised to observe 6 weeks of bedrest. Chair therapy was
introduced in the 1940s, and by the early 1950s, 3-5 minutes
of daily walking was advocated, beginning at 4 weeks
Clinicians gradually began to recognize that early
ambulation avoided many of the complications of bed rest,
including pulmonary embolism (PE), and that it did not
increase the risk. However, concerns about the safety of
unsupervised exercise remained strong; this led to the
development of structured, physician-supervised
rehabilitation programs, which included clinical supervision,
as well as electrocardiographic monitoring.
Hellerstein presented his methodology for
the comprehensive rehabilitation of patients recovering from
an acute cardiac event.9 he advocated a multidisciplinary
approach to the rehabilitation program.
PHASES OF CARDIAC REHABILITATION
CARDIAC REHABILITATION SERVICES ARE DIVIDED INTO 3
PHASES, AS FOLLOWS:
A representative schedule might begin exercise at intervals, such as 7-21 days following
uncomplicated acute myocardial infarction (MI), 3-10 days following angioplasty, or 14-28
days after bypass surgery.
Physiology of exercise in cardiac events
Normally there exit balance between nitrous oxide which is
a vasodilator which is produce by activity of nitrous
synthase and reactive oxygen
Correction in Decrease in
nitrous deactivation of Increase
nitrous synthase endothelial
synthase
activity by reactive Control
relaxation
oxygen
group
Reversal of
endothelial
dysfunction
Reduction in mortality and
morbidity
Exercise prescription and surveillance
Phase 2 of a cardiac rehabilitation program is initiated based on the result of the exercise testing, and the exercise prescription is
individualized. Three main components of an exercise training program are as follows:
Frequency - The minimum frequency for exercising to improve cardiovascular fitness is 3 times weekly.
Time - Patients usually need to allow 30-60 minutes for each session, which includes a warm-up of at least 10 minutes
Intensity - The intensity prescribed is in relation to one's target heart rate. Aerobic conditioning is emphasized in the first few weeks
of exercise. Strength training is introduced later. The Borg scale of Rate of Perceived Exertion (RPE) is used. Patients usually should
exercise at an RPE of 13-15.
Borg scale of perceived exertion
6
7 - Very, very light
8
9 - Very light
10
11 - Light
12
13 - Somewhat hard
14
15 - Hard
16
17 - Very hard
18
19 - Very, very hard
20 - Exhaustion