REHABILITATING THE FAILED HEART


No more FAKE & HYPED exercises. We bring you the most authentic & scientifically proved Physical therapy interventions from across the globe.

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Aerobic interval training in patients with heart failure and an implantable cardioverter defibrillator: a controlled study evaluating feasibility and effect, European Journal of Preventive Cardiology: January 8, 2014, doi: 10.1177/2047487313519345

Conclusions: An AIT programme is feasible and seems safe in a well-treated, stable ICD population. Further, AIT for 3 months results in significantly increased aerobic capacity and endothelial function in this population. 

Blumenthal et al, Effects of Exercise Training on Depressive Symptoms in Patients With Chronic Heart Failure: The HF-ACTION Randomized Trial, Journal of the American Medical Association

Conclusions: Compared with guideline-based usual care, exercise training resulted in a modest reduction in depressive symptoms, although the clinical significance of this improvement is unknown. 

REHABILITATING THE FAILED HEART

Cardiac rehabilitation post heart attack or a bypass surgery, generally involves 3 phases;
Phase I, is the duration when the patient is still on the hospital bed. Routine activities or activities of daily living are initiated.
Phase II & III are tabulated below;
Adopted from ACSM

THIS IS WHAT YOU ARE SUPPOSE TO KNOW MORE

Gradual mobilisation otherwise known as callisthenics .
Whether or not you are a heart patient , it's always good to be physically active than being a couched potato! Just don't sit & expand yourself, move.

Aerobic interval training in conditions of energetic yield is the most efficacious exercise intervention because of its well demonstrated efficacy and safety.The rule of thumb is to start low and go slow and is easily taught usually on a cycle ergometer or a treadmill. Recommended training intensities are initially 40 – 50% increasing to a target of 70 – 80% of VO2peak or 40-70% of heart rate reserve. (Refer our previous posts).

Resistance or strength training is muscle contraction performed against resistance.The amount of cardiovascular stress expected during resistance strength training depends on three factors; the amount of resistance, the size of the working muscle, and the relationship between the duration of muscle contractions and rest periods. The magnitude of resistance is measured as a percentage of one repetition maximum (% 1-RM).

Respiratory muscle training can improve exercise capacity and quality of life in those who present with inspiratory muscle weakness and would be most beneficial if used as an adjunct to standard endurance training.

*Stay within your heart rate range. Monitor through a heart rate monitor or manually at carotid artery on neck or radial artery on thumb side of wrist. ( To know how to calculate your exercising heart rate range refer our previous posts).


Cider A  et al, Hydrotherapy—a new approach to improve function in the older patient with chronic heart failure, European Journal of Heart Failure, 2013. 

Conclusion: Physical training in warm water was well tolerated and seems to improve exercise capacity as well as muscle function in small muscle groups in patients with CHF.


BARRIERS TO EXERCISE IN HEART PATIENTS

  • As recently as twenty years ago it was common practice to recommend that heart failure patients avoid exercise at all stages of the disease. It was thought exercise was deleterious to the failing heart for fear that it could aggravate disease progression many people in India still live with this myth.
  • Poor patient referral systems in India. Most of the medicos today want to haunt their  patients, scare them and land them in surgery wards or push them into the viscous cycle of painkillers.(It's not our personal opinion, but an overall picture of the medical system printed in newspapers & debated on national news channels).
  • In India, women in particular are not empowered enough to think and decide for themselves. This social issue is clearly reflected on their health status too. Most women do not step out of their homes for gyms , recreational parks or long walks unless there is some important task in hand.
  • Lack of efficient & quality physical therapy clinics, fitness centers and shortage of good physical therapists in India.
  • Lack of self motivation to exercise in heart patients.
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Happy Health!
YUVAAN


















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