Post on 22-Jan-2021
CardiacRehabilitationNikkiGardiner
ClinicalleadforCardiac&PulmonaryRehabilitation
12th November2016
CardiacRehabilitation– Theevidence…
• Cardiacrehabilitation(CR)isaprofessionallysupervised,menu-basedprogrammeincorporatinganumberofcomponentswhich,takentogether,ensurethatpeoplewhohaveacardiaccondition,eventortreatmentareabletorecoverandgetbackto‘everydaylife’asquicklyandfullyaspossible.
• CRhelpstoreducethechanceoffuturecardiaceventsandmortality
• CRservicehasthepotentialtoreduceunplannedcardiacreadmissionsby28-56%,(Lam,2011).
• TheNationalAuditofCardiacRehabilitation(NACR)overallcurrentuptakeforCardiacRehabilitationis47%withanaimofreaching65%(BHF,2015).
• TheBACPR-NACRCertificationprogrammewaslaunchedinJune2015andhasstartedtocertifyprogrammeswithanaimtocertifyatleast25programmesperyear.
CardiacRehabilitation
StagesofCardiacRehabilitation
BenefitsofCardiacRehabilitation• Reducesthechanceoffuturecardiaceventsandmortality
• Reducesre-admissionstohospitalwithchestpain
• Identifiessafeandcomfortablelevelsofexercise
• Understandingmedications
• Helpstoreduceanxietyanddepression
• Improveonoverallqualityoflife
• Increasesconfidence/returningtohealthylifestyle
Leicester- Individualisedcare• HospitalBasedProgramme– LGH,GGH,LRIandNational
CentreofSportsandExerciseMedicine(NCSEM)
• CommunityBasedProgramme– LeisureCentre'saroundthecounty(directreferral)
Web-basedCRprogramme
Whathappensnext?
Referraltocommunityexercisesessions
ReferraltootherHealthProfessionals
SupportGroups
Exercise
Whyexercise?• Lowersrestingbloodpressure
&heartrate• Lowerscholesterollevels• Helpsreduceweight• Reducesstress• Promotesasenseofwell
being• ImprovescontrolofdiabetesOverallregularEXERCISEreducesyourriskoffurthercardiacevents.
• Helpstoimprovemusclestrengthandmusclemass
• Helpstoimprovedailyactivities
• Preservebonedensity
TypesofexerciseAerobic– Aimfor30minutesx5week
WalkingCyclingDancingSwimmingClassesGym
Strength– Aimfor2-3timesweek
UsinghandheldweightsUsinggymweightsmachines
BeSafe!• Alwayswarmupbeforetheaerobicexerciseandcooldownafter.
– Helpstopreventinjuryandmusclesorenessaswellas– Getsyourheartintoasteadystatepriortodemandinglotsofextraoxygenforittopumparound
yourbody
• Ifyoufeelanysuddenpain,dizzinessorextremeshortnessofbreath,thenstopexercisingandseekhelp.
• Ifyouhavehadavirusorarefeelingparticularlyunwellandtireddonotforceyourselftoexercise– yourbodyisalreadyusingmoreupmoreenergy.– Takesometimeofftogetbetter.– Whenre-startingremembertobuildyourselfupsteadilyagain.
• Neverexerciseifyouhavebeendrinkingalcoholorhavejusteatenaheavymeal.
• Avoidexerciseinveryhotorverycoldweather.
3phasesofexercise
• Warmup
• Conditioningphase
• Cooldown
Howtomonitoryourself?RateofPerceivedExertion(RPE)
6 Noexertionatall7 Extremelylight89 Verylight1011 Light1213 SomewhatHard1415 Hard1617 VeryHard1819 Extremelyhard20 MaximalExertion
Howtostart…Step1 3-5minutes4– 6timesperdayStep2 5-10minutes3– 4timesperdayStep3 10-15minutes2– 3timesperdayStep4 15-20minutes1– 2timesperdayStep5 20-30minutes4– 6daysperweekStep6 morethan30minutes5daysperweek
Usethescaleofperceivedexertiontohelpyouwithyourprogression
Makinglifestylechanges• Workingtogether
• Understandingyourcondition
• Havingrealisticgoals
• Takingaction/responsibility
• Addressingbarrierstochange
Prioritisinggoals• Whichonefirst?
• Ithastobeimportanttoyou
• Rateimportanceofyourgoals(scale1-10)
• Howconfidentdoyoufeelaboutmakingthechanges?(scale1-10)
• Usingagoalsettingchart.
Future
• EducationofSCADtoHealthcareprofessionals-developCRprogrammes
• PromotionofreferraltoCRspecialistteam
• AddressingpatientswithadiagnosisofSCAD- IndividualisedcarewithinCR(self-management/web-based).