1. Cardiac Rehabilitation Part I
Dr. Rrhab F. Gwada

2. Introduction
Up until the 1950s, strict bed rest was thought to be the best medicine after a heart attack.
Following discharge moderately stressful activity such as climbing stairs was discouraged for a year or more.

3. Definition:
Cardiac rehabilitations services are comprehensive, long-term programs involving
medical evaluation,
prescribed exercise,( Monitored progressive ex.)
cardiac risk factor modification,
educations and counseling.
The primary goal of cardiac rehabilitation is to enable the participant to achieve his/her optimal physical, psychological, social and vocational functioning through exercise training and lifestyle change.

4. Core Components of Cardiac Rehabilitation
Prescribed exercise to improve cardiovascular fitness without exceeding safe limits
Education about heart disease along with counseling on ways to stabilize or reverse heart disease by improving risk factors.
cardiac risk factor modification
Reduction/Cessation of Smoking
Lipid Management
Controlling High Blood Pressure
Weight Loss/Control
Improve/Manage Diabetes
Increasing Physical Activity
Encourage Healthy Eating Habits
Improve Psychological Well Being

5. To detect appropriate pt. Determine goals
medical evaluation
To detect appropriate pt.
Determine goals
Develop individualized program
Detect the amount of supervision for safety
Define outcome measures
Component of CR

6. Goals of Cardiac rehabilitation program
limit the physiologic and psychological effects of cardiac illness.
Reduce the risk for sudden death or re-infarction.
Control cardiac symptoms.
Stabilize or reverse the atherosclerotic process.
Enhance the psychosocial and vocational status.
Improves Functional Capacity.
Improve quality of life.

7. Characteristics of Cardiac Rehabilitation
Cardiac rehabilitation should be :
Comprehensive.
Initiated as early as possible.
Continuous.
Staged (phases).
Individualized depending on the clinical state.
Acceptable for the patient.

8. Candidate for cardiac rehabilitation (who can benefit)
A- Individuals with cardiac ms dysfunctions: e.g
Post Myocardial Infarction .
Chronic stable angina.
Chronic Heart failure.
Cardiomyopathy .
B -Individuals with heart surgery; e.g
Percutaneous Coronary Intervention(balloon angioplasty, stenting, cutting balloon…..)
Coronary Bypass Grafting.
Heart transplantation.
Valve heart disease and surgery : valve replacement or repair
C- Individuals with Peripheral arterial disease

9. Team of Cardiac Rehab Medical Director.
Referring Physician ( cardiologist , cardiac surgeon ).
Physical & occupational physical therapy .
Nurses.
Exercise Physiologists.
Dieticians/Nutritionists.
Social Services/Psychosocial specialists.
Pharmacists
Cardiac Rehab uses a multidisciplinary approach to patient care. All cardiac rehab staff directly involved report to and consult with the referring physicians and other medical specialists. Cardiac rehab programs vary in the staff professionals they use to form the best team to meet the specific needs of each program.
(please identify the healthcare professionals involved in your specific program).

10. Cardiac Rehabilitation Program duration
According to American Heart Association ,Your rehabilitation plan is designed to meet your needs. You may need six weeks, six months or longer to learn how to manage your condition and develop healthier habits. Many programs last only three months, but some continue for years.
. from 1982 to March 2006, Program duration include 36 visits in 12 weeks(3visit/week).
from March up to now , 36 visits in 18 weeks(following review, up to 72 visits in 36 weeks) [2visit /week].
Kraus WE and Keteyian SJ. Cardiac Rehabilitation. Humana Press Inc. Totowa, New Jersey

11. Effect of ex. On the heart http://www.youtube.com/watch?v=_AXQnM-jai0

12. Any Q?