Cardiac Rehabilitation
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by Nandgaonkar's Therapy Services

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Exercise rehabilitation decreases angina pectoris in patients with coronary
disease and decreases symptoms of heart failure in patients with left
ventricular systolic dysfunction. Exercise training is recommended as an
integral component of the symptomatic management of these patients.


EXERCISE AND HEART DISEASE

The American Heart Association has now added " lack of exercise" to the list of major risk factors for heart disease. The other risk factors are smoking, high blood pressure, and high blood cholesterol.
Exercise not only helps fight heart disease, but for sedentary people, just adding a little exercise to your daily routine reduces the risk of high blood pressure, osteoporosis, breast and colon cancer, depression, anxiety and stress. Ideally, you should exercise three to five times a week for 20-50 minutes within your target heart rate. However, your health can benefit simply by accumulating 30 minutes of moderate activity per day, such as stair climbing, walking to work, or gardening.
Also, it is not just aerobic exercise such as walking, cycling, jogging and swimming that is recommended.Resistance training, or weight lifting, is an important component of a good fitness program because it increases your strength, leads to decreased body fat and helps improve blood cholesterol levels.


Benefits of Regular Exercise
Improves heart and lungs
Decreases resting blood pressure
Decreases body fat
Decreases total and LDL cholesterol ("bad cholesterol")
Raises HDL cholesterol ("good cholesterol")
Increases energy level
Increases tolerance to stress and depression
Controls or prevents the development of diabetes
Decreases risk of orthopedic injury
Guidelines for Safe Exercise

Frequency - 3-5 times a week
Duration - 20-60 minutes
Intensity (how hard) - within your target heart rate
Calculating Your Target Heart Rate
1) 220 - age = MHR (maximum heart rate)
2) MHR x 0.6 = _____ (this is the low end of your target HR)
3) MHR x 0.8 = _____ (this is the upper end of your target HR)

Example: If you ar 40 years old, your MHR is 220 - 40 = 180.
180 x 0.6 = 108
180 x 0.8 = 144
Therefore, your Target Heart Rate is between 108 and 144 beats per minute.


Effects of Cardiac Rehabilitation Exercise Training

Exercise Tolerance
Cardiac rehabilitation exercise training consistently improves objective measures of exercise tolerance, without significant cardiovascular complications or other adverse outcomes. Appropriately prescribed and conducted exercise training is recommended as an integral component of cardiac rehabilitation services, particularly for patients with decreased exercise tolerance. Continued exercise training is required to sustain improved exercise tolerance.

Strength Training
Strength training improves skeletal muscle strength and endurance in clinically stable coronary patients. Training measures designed to increase skeletal muscle strength can safely be included in the exercise-based rehabilitation of clinically stable coronary patients, when appropriate instruction and surveillance are provided.

Exercise Habits
Cardiac rehabilitation exercise training promotes increased participation in exercise in addition to rehabilitation exercise training in patients after myocardial infarction or CABG. This effect does not persist long-term after completion of exercise rehabilitation. Long-term cardiac rehabilitation exercise training is recommended to provide the benefit of enhanced physical activity and exercise habits.