An update on exercise options for those who have suffered a heart attack or heart problems. There is a much larger level of survivors due to improved procedures, but what about the aftercare. Increasing numbers are headed to workout facilities for their aftercare routines.
Check this article out that was found on the web.
Recovering from Heart Attack or Surgery: Importance of Cardiac Rehabilitation
by barbara a. brehm, ed.d
You've accompanied your dad to his cardiac rehabilitation program. "I'd like to add some strength training to my exercise program," he tells the exercise physiologist. "When I started my cardiac rehab after my heart attack a year ago, all we did was walk and work out on the cardio machines. But I have read that strength training is important, too. My cardiologist says I'm doing great, and my stress test showed a lot of improvement. Do you think it would be OK to work out at the fitness center twice a week with my son?"
If you think cardiac rehabilitation programs are only for hospitals, think again. You are likely to see an increasing number of clients performing their cardiac rehabilitation exercise programs in fitness centers in the coming years. The number of people who survive heart attacks has increased greatly over the past several years. The number of operations to improve blood flow to the heart, such as bypass surgery and angioplasty, has increased dramatically as well. More heart patients are now looking for exercise options. Some fitness centers are hiring trained personnel and forging links with medical centers to increase the availability of cardiac rehabilitation services in their communities.
What is cardiac rehabilitation?
Before the 1950s and 1960s, patients who survived heart attacks were advised to rest in bed for several weeks to avoid straining their damaged hearts. We now know that bed rest has many harmful consequences, including blood clots in the legs and lungs, bone-mineral loss and loss of muscle strength. To avoid such complications, doctors began telling patients to participate in low levels of activity. As techniques for assessing heart function became available, and as activity seemed to improve patients' health, doctors began to urge many of their patients to get moving. Now, patients without complications usually begin simple arm and leg exercises one or two days after a heart attack or heart surgery. After leaving the intensive care unit, people may begin walking for about five minutes at a time, at least twice a day. Walking time is gradually increased to about 30 minutes, at which time patients may begin climbing stairs. Health care personnel monitor heart rate and blood pressure frequently to be sure the patients heart is responding well to the activity.
As recovery continues, and usually before leaving the hospital, patients may perform an exercise stress test to check for heart rate and rhythm abnormalities, and chest pain during exercise. From test results, patients are given target exercise heart rate zones. These zones represent exercise intensities that will be both beneficial and safe -- where the heart gets plenty of blood and oxygen, but does not experience excessive stress.
After leaving the hospital, patients sometimes enroll in medically supervised exercise programs designed for people recovering from heart attack or heart surgery. Unfortunately, many people do not have access to such programs, due to geographical, financial, time, motivational or other limitations. Some doctors may neglect to emphasize the importance of rehabilitation. A growing number of patients are given appropriate instruction, and are then told to exercise on their own. They may use heart rate monitors that can send recorded signals via telephone to health care providers, or they may simply monitor exercise intensity and warning signs on their own, and check in periodically with their health care providers.
While regular exercise is the cornerstone of cardiac rehabilitation programs, these programs should also include multiple strategies to aggressively reduce risk for subsequent cardiovascular events, such as heart attack and stroke, and to encourage regression of the plaque that has built up in the arteries. Good programs provide support for quitting smoking, developing heart-healthy eating behaviors and exercising regularly. When necessary, medications to control blood pressure and blood lipids (especially to reduce LDL levels) are prescribed. Patients may also have access to a variety of therapies for reducing stress and coping with the depression, anxiety and grieving that often follow a heart disease diagnosis.
Cardiac rehabilitation programs are lifesavers. Studies have found that people who participate in these programs have about half the risk of dying from a subsequent heart attack as those who do not exercise.
What kind of exercise is best for cardiac rehabilitation?
Exercise prescriptions will vary enormously depending upon a person's health status, and should be written only by health care providers trained in cardiac rehabilitation. Some cardiac patients must limit exercise because their conditions are unstable, and exercise may do more harm than good. Patients whose cardiac problems are relatively minor, who recovered well and who have been in stable condition for a while are capable of fairly vigorous exercise programs. As described previously, exercise prescriptions are based on exercise test results. Patients should learn how to monitor exercise intensity using both heart rate and perceived exertion. They must also learn how to recognize warning signs that mean they should stop exercising and seek medical attention.
Cardiac rehabilitation programs for low- to moderate-risk patients often include cardiovascular, strength and flexibility training. Since most cardiac patients must keep their heart rates within a target zone, activities that allow for easy heart rate monitoring, such as walking and exercising on cardio machines, are commonly prescribed.
Many cardiologists recommend that patients exercise as much as they can without sustaining injuries, since greater exercise volumes have been associated with a greater likelihood of plaque regression. Most cardiac patients do best with low-impact exercise modes and, when possible, varying modes from day to day to avoid musculoskeletal overuse injuries. Patients in good health may progress over several months to a program of exercising from 30 to 60 minutes per day, four to six days per week. Adequate warm-up and cool-down are crucial for people who have heart disease, as both help the heart adjust to changing demands on the circulatory system.
Strength training provides many health benefits to people recovering from heart attack or heart surgery. Muscles and joints that are prepared to encounter the everyday challenges of lifting, pushing and stair climbing are less stressed and, in turn, less stress is placed on the heart when exertion is required. Strength training increases physical function and daily quality of life. Cardiac rehab strength-training programs generally begin with fairly light weights to avoid strain and injury, but can progress according to each patients health and ability.
Recovering after a heart attack, heart surgery or a diagnosis of artery disease is a challenge. Exercise helps people who have heart disease overcome the fear of exertion, and gives them confidence to perform the physical activities that are part of daily life. Exercise not only improves physical function, but it helps people with heart disease become active participants in their recovery, and in life.
REFERENCES
Beniamini, Y., et al. Effects of high-intensity strength training on quality-of-life parameters in cardiac rehabilitation patients. American Journal of Cardiology 80: 841-846, Oct. 1997.
Burns, K.J., D.N. Camaione, R.D. Froman and B.A. Clark III. Predictors of referral to cardiac rehabilitation and cardiac exercise self-efficacy. Clinical Nursing Research 7(2): 147-164, May 1998.
Franklin, B.A., and R.J. Shephard. Avoiding repeat cardiac events. Physician and Sportsmedicine 28(9): 31-58, Sep. 2000.
Speed, C.A., and L.M. Shapiro. Exercise prescription in cardiac disease. Lancet 356(9237): 1208-1212, Oct. 7, 2000.
Barbara A. Brehm, Ed.D., is associate professor of exercise and sport studies at Smith College, Northampton, Mass.
Check this article out that was found on the web.
Recovering from Heart Attack or Surgery: Importance of Cardiac Rehabilitation
by barbara a. brehm, ed.d
You've accompanied your dad to his cardiac rehabilitation program. "I'd like to add some strength training to my exercise program," he tells the exercise physiologist. "When I started my cardiac rehab after my heart attack a year ago, all we did was walk and work out on the cardio machines. But I have read that strength training is important, too. My cardiologist says I'm doing great, and my stress test showed a lot of improvement. Do you think it would be OK to work out at the fitness center twice a week with my son?"
If you think cardiac rehabilitation programs are only for hospitals, think again. You are likely to see an increasing number of clients performing their cardiac rehabilitation exercise programs in fitness centers in the coming years. The number of people who survive heart attacks has increased greatly over the past several years. The number of operations to improve blood flow to the heart, such as bypass surgery and angioplasty, has increased dramatically as well. More heart patients are now looking for exercise options. Some fitness centers are hiring trained personnel and forging links with medical centers to increase the availability of cardiac rehabilitation services in their communities.
What is cardiac rehabilitation?
Before the 1950s and 1960s, patients who survived heart attacks were advised to rest in bed for several weeks to avoid straining their damaged hearts. We now know that bed rest has many harmful consequences, including blood clots in the legs and lungs, bone-mineral loss and loss of muscle strength. To avoid such complications, doctors began telling patients to participate in low levels of activity. As techniques for assessing heart function became available, and as activity seemed to improve patients' health, doctors began to urge many of their patients to get moving. Now, patients without complications usually begin simple arm and leg exercises one or two days after a heart attack or heart surgery. After leaving the intensive care unit, people may begin walking for about five minutes at a time, at least twice a day. Walking time is gradually increased to about 30 minutes, at which time patients may begin climbing stairs. Health care personnel monitor heart rate and blood pressure frequently to be sure the patients heart is responding well to the activity.
As recovery continues, and usually before leaving the hospital, patients may perform an exercise stress test to check for heart rate and rhythm abnormalities, and chest pain during exercise. From test results, patients are given target exercise heart rate zones. These zones represent exercise intensities that will be both beneficial and safe -- where the heart gets plenty of blood and oxygen, but does not experience excessive stress.
After leaving the hospital, patients sometimes enroll in medically supervised exercise programs designed for people recovering from heart attack or heart surgery. Unfortunately, many people do not have access to such programs, due to geographical, financial, time, motivational or other limitations. Some doctors may neglect to emphasize the importance of rehabilitation. A growing number of patients are given appropriate instruction, and are then told to exercise on their own. They may use heart rate monitors that can send recorded signals via telephone to health care providers, or they may simply monitor exercise intensity and warning signs on their own, and check in periodically with their health care providers.
While regular exercise is the cornerstone of cardiac rehabilitation programs, these programs should also include multiple strategies to aggressively reduce risk for subsequent cardiovascular events, such as heart attack and stroke, and to encourage regression of the plaque that has built up in the arteries. Good programs provide support for quitting smoking, developing heart-healthy eating behaviors and exercising regularly. When necessary, medications to control blood pressure and blood lipids (especially to reduce LDL levels) are prescribed. Patients may also have access to a variety of therapies for reducing stress and coping with the depression, anxiety and grieving that often follow a heart disease diagnosis.
Cardiac rehabilitation programs are lifesavers. Studies have found that people who participate in these programs have about half the risk of dying from a subsequent heart attack as those who do not exercise.
What kind of exercise is best for cardiac rehabilitation?
Exercise prescriptions will vary enormously depending upon a person's health status, and should be written only by health care providers trained in cardiac rehabilitation. Some cardiac patients must limit exercise because their conditions are unstable, and exercise may do more harm than good. Patients whose cardiac problems are relatively minor, who recovered well and who have been in stable condition for a while are capable of fairly vigorous exercise programs. As described previously, exercise prescriptions are based on exercise test results. Patients should learn how to monitor exercise intensity using both heart rate and perceived exertion. They must also learn how to recognize warning signs that mean they should stop exercising and seek medical attention.
Cardiac rehabilitation programs for low- to moderate-risk patients often include cardiovascular, strength and flexibility training. Since most cardiac patients must keep their heart rates within a target zone, activities that allow for easy heart rate monitoring, such as walking and exercising on cardio machines, are commonly prescribed.
Many cardiologists recommend that patients exercise as much as they can without sustaining injuries, since greater exercise volumes have been associated with a greater likelihood of plaque regression. Most cardiac patients do best with low-impact exercise modes and, when possible, varying modes from day to day to avoid musculoskeletal overuse injuries. Patients in good health may progress over several months to a program of exercising from 30 to 60 minutes per day, four to six days per week. Adequate warm-up and cool-down are crucial for people who have heart disease, as both help the heart adjust to changing demands on the circulatory system.
Strength training provides many health benefits to people recovering from heart attack or heart surgery. Muscles and joints that are prepared to encounter the everyday challenges of lifting, pushing and stair climbing are less stressed and, in turn, less stress is placed on the heart when exertion is required. Strength training increases physical function and daily quality of life. Cardiac rehab strength-training programs generally begin with fairly light weights to avoid strain and injury, but can progress according to each patients health and ability.
Recovering after a heart attack, heart surgery or a diagnosis of artery disease is a challenge. Exercise helps people who have heart disease overcome the fear of exertion, and gives them confidence to perform the physical activities that are part of daily life. Exercise not only improves physical function, but it helps people with heart disease become active participants in their recovery, and in life.
REFERENCES
Beniamini, Y., et al. Effects of high-intensity strength training on quality-of-life parameters in cardiac rehabilitation patients. American Journal of Cardiology 80: 841-846, Oct. 1997.
Burns, K.J., D.N. Camaione, R.D. Froman and B.A. Clark III. Predictors of referral to cardiac rehabilitation and cardiac exercise self-efficacy. Clinical Nursing Research 7(2): 147-164, May 1998.
Franklin, B.A., and R.J. Shephard. Avoiding repeat cardiac events. Physician and Sportsmedicine 28(9): 31-58, Sep. 2000.
Speed, C.A., and L.M. Shapiro. Exercise prescription in cardiac disease. Lancet 356(9237): 1208-1212, Oct. 7, 2000.
Barbara A. Brehm, Ed.D., is associate professor of exercise and sport studies at Smith College, Northampton, Mass.
