10 things you must know about Cardiac Rehab

  1. What is cardiac rehab?

Cardiac rehabilitation or cardiac rehab is nothing but a medically supervised program to help individuals with heart diseases get back to normal health and routine activities as early and safely as possible. A cardiac rehab program is an exercise cum education program individualised to the medical, psychological and social needs of the participants.

  1. Why is it gaining importance?

Several research studies from the recent past have demonstrated that individuals who undergo cardiac rehab have better immediate and long-term outcomes as compared to those who do not receive cardiac rehab. The benefits of cardiac rehab are improvement in risk factor control, positive changes in health-related behaviour, increased physical ability to do things, better psychological wellbeing and disease coping skills, and a reduction in symptoms, repeat hospitalisations and complications. The American Heart Association, the European Society of Cardiology and the British Cardiovascular Society recommend that all eligible individuals should be referred for cardiac rehabilitation.

 

Benefits of cardiac rehabilitation
BENEFITS OF CARDIAC REHABILITATION

 

3. Who is eligible for cardiac rehab?

Individuals with one or more of the following conditions are eligible for cardiac rehab: coronary heart disease (blocks in the blood vessels supplying the heart), angina (chest pain on exertion), angioplasty (stenting), bypass surgery (coronary artery bypass graft or CABG), heart failure, heart valve surgery, heart transplantation and device implantation.

  1. How is cardiac rehab provided?

Cardiac rehab centres may be housed within a hospital or they may be located in the community as outpatient units. The program is typically provided by a multidisciplinary team of healthcare professionals, which includes a physician, a physiotherapist, a nutritionist and a counselling psychologist.

There are typically 4 phases and 4 components in a cardiac rehab program:

Phase 1 – guidance and counselling during hospitalisation (the rehab team will meet the affected individual and his/her family and provide clarification about the health condition)

Phase 2 – monitoring and support during the recovery period (which might be just a few days for a stent procedure and about 6 weeks for bypass surgery)

Phase 3 – supervised exercise cum education sessions (participants will attend two or three sessions a week for 6-12 weeks)

Phase 4 – maintenance and follow-up (upon completion of the program, participants will continue to adhere to the lifestyle changes at home and visit the rehab centre periodically)

  1. When should one enrol in a cardiac rehab program?

Enrolment in a cardiac rehab program is best done immediately after a heart disease is diagnosed (such as myocardial infarction or heart attack) or after an intervention or surgery (such as stent placement or bypass surgery). Having said this, not everybody would have easy access to a cardiac rehab facility. Nevertheless, participating in a cardiac rehab program any time after a cardiac event or procedure will lead to better outcomes than not doing so.

  1. Are there any side effects or hazards of cardiac rehab?

Cardiac rehab is generally safe, especially when safety guidelines are adhered to and participants are grouped according to their risk. There is a very small risk of adverse effects such as rhythm problems or injuries but the benefits far outweigh the risks. The rehab team will explain about the warning signals to look for when exercising and ensure that rehab participants exercise safely during the sessions as well as at home.

  1. How are the benefits of cardiac rehab assessed?

Some of the assessment tools used pre-program and at end-of-program are questionnaires to assess health-related behaviour, psychosocial wellbeing and nature and frequency of symptoms, anthropometry (weight, body mass index, waist hip ratio etc.), blood pressure, blood biochemistry (blood sugar, cholesterol levels), functional capacity (ability to exercise) and ejection fraction (an echocardiographic assessment of heart function).

  1. What happens after a cardiac rehab program?

Upon completion of a cardiac rehab program, individuals will be put on a maintenance program whereby periodic visits to the rehab centre will pave the way for better long-term adherence and adequate clinical monitoring.

  1. Is cardiac rehab an alternative to medications, stenting or bypass surgery?

Cardiac rehab is not a replacement for medications, stenting or surgery. It is a more holistic approach to treatment addressing the root cause of disease rather than just the symptoms and signs.

  1. How to get further information about cardiac rehab?

The following links give useful and reliable information:

http://www.nhlbi.nih.gov/health/health-topics/topics/rehab

https://www.bhf.org.uk/heart-matters-magazine/wellbeing/cardiac-rehab

You could visit our website www.cardiacwellnessinstitute.com or contact us for any clarifications or additional information about cardiac rehabilitation in India.

 

Author:

Dr. Priya Chockalingam, MBBS, MRCPCH, PhD Cardiology cardiacwellnessinstitute@gmail.com, Phone: +91 9940408828, +9144 43192828

Physical activity improves quality of life as you age

Physical activity (PA) is associated with reduced risk for several disorders including coronary heart disease, cancers, diabetes, and stroke. Regular physical activity can relieve tension, anxiety, depression and anger. You may notice a “feel good sensation” immediately following your physical activity, and most people also note an improvement in general wellbeing over time as physical activity becomes a part of their routine. Some of the hormones responsible for these changes are endorphins, growth hormone and serotonin.

According to the AHA (American Heart Association), too much sitting and other sedentary activities can increase your risk of cardiovascular disease. One study showed that adults who watch more than 4 hours of television a day had a 46% increased risk of death from any cause and an 80% increased risk of death from cardiovascular disease.

Becoming more active can help lower your blood pressure and also boost your levels of good cholesterol.

Regular Physical activity can improve the anti aging process by increasing strength, stamina and ability to function well. Recent research showed that people who are physically active and at a healthy weight live about 7 years longer than those who are not active and are obese.

If you want to improve your physical fitness, but you find the idea of exercise overwhelming, it may help you to know exercise and physical activity is not the same thing—yet both are beneficial to your health.

Exercise, however, is a type of physical activity that requires planned, structured, and repetitive bodily movement with the intent of improving or maintaining your physical fitness level. Exercise can be accomplished through activities such as cycling, dancing, walking, swimming, yoga, working out at the gym, or running etc. Regular exercise, depending upon the kind, improves aerobic fitness, muscular strength, and flexibility.

Everyday physical activities such as performing housework, walking at work place, or climbing stairs keep your body moving and still count toward the recommended amount of weekly physical activity.

Regular exercises like brisk walking, cycling and swimming can have the following effects on our body…

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Reduces risk of diabetes

Regular physical activity helps maintain blood sugar levels and lowers the risk of developing non-insulin-dependent diabetes mellitus. If you have a body mass index (BMI) greater than 25 or if you have a family history of diabetes, this benefit of exercise may have special value to you.

Helps maintain weight

Physical activity has been shown to be the single most important factor in successful weight maintenance. Aim for burning about 1000-2000 calories per week from activity.

Reduces risk of premature death

The highest risk of death and disability is found among those who do no regular physical activity.

Reduces risk of heart disease

Physical activity increases the level of high density lipoprotein (HDL) or “good” cholesterol in your blood. HDLs are like cholesterol scavengers – they pick up the “bad” cholesterol in the arteries and transport it to the liver for eventual removal from the body. An increase in your HDL is protective; it can decrease the risk of a heart attack. The other ways by which physical activity protects the heart are controlling blood pressure, maintaining blood glucose, preventing obesity and keeping your stress levels at bay.

Improves health of muscles and bones

Regular aerobic physical activity improves blood flow to your muscles and helps them use energy. Strength training increases muscle size and strength. Physical activities like jogging, walking and strength training strengthen your bones and make them denser, thereby preventing osteoporosis and arthritis.

Improves mental health

Regular physical activity can reduce anxiety and depression and improve mood. It may be a beneficial strategy to lower the risk of Alzheimer’s disease, cognitive impairment and vascular dementia. Exercise may directly benefit brain cells by increasing blood and oxygen flow to the brain.

Reduces risk of high blood pressure

Not only does regular physical activity reduce the risk of developing high blood pressure but it also helps lower blood pressure in people who already have elevated blood pressure.

Helps older adults become stronger

The loss of strength and stamina that is often attributed to aging is partly caused by reduced physical activity. Inadequate physical activity leads to a thinning of bones, a weakening of muscles, and a reduction in metabolic rate (the rate at which your body burns calories). This often leads to weight gain. Physical activity improves nearly all systems, especially the cardiovascular system and the ability to perform the routine tasks of daily life.