Cardiovascular disease(CVD) is defined as any critical or abnormal condition of the heart itself or its blood vessels (arteries and veins). One of the significant causes of death worldwide and in the United States is CVD. Cardiovascular disease includes o Coronary heart disease, o Stroke, o Peripheral vascular disease, o Congenital heart diseases& heart failure, o Myocardial infarction. Causing factors for CVD CVD is the main cause of death globally. • Behavioural risk factors such as physical inactivity, tobacco use and unhealthy diet explain nearly 80% of the CVD burden. Symptoms of CVD o Pain or discomfort in the centre of the chest o Pain or discomfort in the arms, left shoulder, elbows, jaw, or back. o Shortness of breath o Nausea or vomiting o Light-headedness o Pallor o Cold sweat Indications For Cardiac Rehabilitation : o Heart attack or Myocardial Infarction o Angina o Angioplasty o After Coronary Artery Bypass Surgery o Other cardiac issues that involve cardiac surgery. Beginning of the Cardiac Rehab by the Physiotherapist : Cardiac Rehabilitation should start as early as possible, in the ICU (Intensive Care Unit). The early start of rehabilitation and mobilization improves the patient’s physical functioning and return to work after cardiac urgery. The Phases Of Cardiac Rehabilitation Cardiac Rehabilitation consists of 3 main phases that are : Phase 1: The Clinical Phase In this phase, the patient’s current physical abilities, motivation, and will to start and tolerate the rehabilitation process is checked. The physiotherapist and or the nurse can start rehabilitation by non-strenuous exercises and simple passive movements to avoid complications such as bed sores etc. Should start these passive movements to maintain the patient’s range of motion (ROM), achieving ADLs, i.e., activities of daily living. Phase 2: The Outpatient Cardiac Rehabilitation When the patient is stable and is marked out of danger by the cardiologist, this phase starts. His functional limitations, painful ranges of motion, and activity are assessed by his physiotherapist. The therapist enhances his mobility by PNF techniques, Passive Exercises, Assisted Exercises, etc., to make the patient perform his daily life activities. Phase 3: The Post Cardiac Rehab or Return to The Home Phase After the patient is independent to perform his basic daily life activities, his physiotherapist teaches him strengthening exercises and a few aerobic exercises to improve his endurance while performing his tasks. The patient can continue to perform those exercises at home by himself or with the assistance of his family members. The Warm-up Period: Before starting any exercise, there must be a warm-up time for about 5-10 mins in which the patient stretches his limbs and raises the blood supply to the required area. The Main Class : Depending on the patient’s current cardiovascular and physical state, the therapist makes a plan of care and an exercise regimen followed by the patient regularly. The exercise should be started by following a proper warm-up period guided by the patient’s physiotherapist. The aerobic exercises should be of fixed time interval followed by a fixed amount of rest time period between the repetitions; this means that the exercises should be rhythmical and have equal rest intervals. The Cool Down Time Period : After the exercise, there must be a 10 min rest or cool down time given to the patient to bring their body back to the resting phase. Health And Safety : If the patient’s general health is not stable enough or they are still in a critical state, then the patient should not be advised of proper physical therapy or follow an exercise program. But still, the passive movements (to avoid bed sores and other complications like loss of available range of motion, etc.) should be continued by the therapist or the head nurse as guided by the physiotherapist in charge. Following are the cardiac symptoms in which any type of exercise must be avoided or discontinued : o In fever o If a patient’s blood pressure rises or drops significantly o Resting BP systolic >200 mmHg and diastolic > 110 mmHg o If the patient has uncontrolled diabetes o If there is breathlessness o In lethargy, nausea, and if the patient feels dizzy o Chest pain or unstable angina
In a world where Cardiovascular Disease (CVD) remains a leading global cause of mortality, it’s crucial to foster a compassionate and informed approach. CVD encompasses a spectrum of conditions, affecting not just the heart but also the intricate network of blood vessels, including arteries and veins. This includes Coronary Heart Disease, Stroke, Peripheral Vascular Disease, Congenital Heart Diseases, Heart Failure, and Myocardial Infarction.
Understanding the Underlying Factors of CVD
CVD is the predominant contributor to global mortality, with nearly 80% of cases attributed to behavioral risk factors such as physical inactivity, tobacco use, and unhealthy dietary habits. It’s crucial to recognize the symptoms and seek timely care. Some common indicators of CVD include:
- Discomfort or pain in the center of the chest
- Pain or discomfort radiating to the arms, left shoulder, elbows, jaw, or back
- Shortness of breath
- Nausea or vomiting
- Cold sweats
Role The of Physiotherapy in Cardiac Rehabilitation
Cardiac Rehabilitation should commence at the earliest opportunity, often in the Intensive Care Unit (ICU). This early intervention optimizes a patient’s physical recovery and their ability to resume normal activities after cardiac surgery. Cardiac Rehabilitation typically involves three essential phases:
Phase 1: The Clinical Phase In this phase, the physiotherapist assesses the patient’s current physical abilities and motivation. Gentle exercises and passive movements are initiated to prevent complications such as bedsores while maintaining the patient’s range of motion and aiding in the performance of daily activities.
Phase 2: Outpatient Cardiac Rehabilitation Once the patient is deemed stable and out of immediate danger, the outpatient phase begins. Here, the physiotherapist evaluates the patient’s functional limitations, painful ranges of motion, and overall activity levels. Techniques like Proprioceptive Neuromuscular Facilitation (PNF), Passive Exercises, and Assisted Exercises are employed to enhance mobility.
Phase 3: Post Cardiac Rehab or Return to The Home Phase After achieving independence in basic daily activities, the patient is guided in performing strengthening and aerobic exercises. These exercises can be continued at home with family support.
A Holistic Approach to Cardiac Rehabilitation
Before engaging in any exercise, a 5-10 minute warm-up period is essential to stretch the limbs and increase blood flow to the targeted areas. The main exercise regimen should be tailored to the patient’s cardiovascular and physical condition. Aerobic exercises should follow a rhythmic pattern with defined rest intervals. After exercise, a 10-minute cool-down period is crucial to bring the body back to its resting state.
Safety is Paramount
Patients with unstable health or in critical states should refrain from strenuous exercise programs. However, passive movements, guided by a physiotherapist, should be continued to prevent complications. It’s essential to be cautious and discontinue or avoid exercise in the following situations:
- Significant fluctuations in blood pressure
- Uncontrolled diabetes
- Lethargy, nausea, dizziness
- Chest pain or unstable angina
Cardiovascular Disease is a global concern, and timely intervention and rehabilitation are essential. With the guidance of dedicated physiotherapists, patients can embark on a journey of recovery and improved quality of life.
Whether it’s recovering from heart surgery, managing symptoms, or enhancing overall well-being, the journey begins with compassion and a commitment to health.
At PhysiotherapistInDelhi.com, we offer expert care and support, ensuring that your path to recovery is marked by hope and wellness. Our dedicated team, including the best Physiotherapists in Patel Nagar, is here to assist you at every step of your cardiac rehabilitation journey. Your heart matters, and so do you.