ATTENTION!! Due to bad actors, txti will be shutting down permanently on July 1st, 2023. Please make arrangements to move your content elsewhere.
Cardiovascular diseases are among the diseases with the highest morbidity and mortality in the world. And they are very prevalent diseases in the Indian population. Affected people experience a loss in quality of life and often demand care, such as what can be accomplished by cardiovascular rehabilitation.
The is an important element in regaining the well-being of people affected by heart, coronary and cerebrovascular diseases. When prescribing exercises, the professional must observe, among other factors, the clinical risk of each patient.
The role of the physical therapist in the multidisciplinary team
In cardiovascular rehabilitation, the works with doctors and nurses trained to address clinical conditions. explains that the prescription of the programs is based on a multifocal approach (exercise and physical activity, control of risk factors, occupational, sexual counseling, education, etc.) and promoting autonomy.
The service begins with the application of ergometric, cardiopulmonary exercise or clinical tests, which assess the patient's responses to physical exertion. Metabolic variables should be measured, in addition to heart rate, blood pressure, perceived exertion and oxygen saturation.
According to , possible physical limitations such as osteomioarticular injuries should be considered when prescribing training. Whenever possible, we professionals should try to adapt the schedule of physical exercises to the patient's preference, he adds.
Psychological factors should not be ignored. "Anxiety, depression, among other behaviors, can also be limiting factors for the patient's evolution in cardiovascular rehabilitation", says the postdoctoral researcher. In these cases, the must make the referral to a professional qualified to offer specialized support.
In addition to gaining specific knowledge about diseases, need to keep up to date in the use of basic life support equipment, such as the automated external defibrillator.
Exercise prescription based on clinical risk
The exercise prescription should also consider the clinical risk, classified as low, intermediate and high according to each individual's health history, limitations and training objectives. Low: Long-term training can be done at home, with face-to-face or distance supervision. The goal is to maintain overall health and make greater gains in physical fitness. Intermediate: Seeks to improve aerobic and non-aerobic physical fitness (muscular strength, flexibility and balance). The patient can perform home treatment with indirect professional supervision. High: These patients should be constantly monitored with checking heart rate, blood pressure, oxygen saturation, capillary blood glucose and electrocardiogram during exercise to allow rapid response to any signs of risk. Therefore, face-to-face, clinical or outpatient care, for example, is essential to ensure patient safety. The program should consider intensity, duration, frequency, training modality and progression appropriate to individual clinical conditions.
It is important to emphasize the need for special care in remote or home care. We must always evaluate the resources that the patient has available at home and adapt them so that he can have the greatest benefits from the physical exercise program, explains . In the physical absence of the professional, the execution of the training must be accompanied by a family member, in case some type of support is needed or for a quick reaction to intercurrences.
All cases must undergo reassessment. And, if necessary, by indicating a new exercise program. Furthermore, it is essential to act with a focus on promoting well-being, improving quality of life and reducing the risk of clinical complications, such as smoking cessation, dietary reeducation and body weight control.
should also advise all patients to maintain the prescribed medication administration.
Physical exercises for cardiovascular rehabilitation
Physical exercises should preferably take place in open spaces, such as athletics tracks, multi-sport gyms and parks. Indoors used for sessions should contain non-slip properties to minimize the risk of accidents and falls.
For aerobic practice, the most used equipment are treadmills and cycle ergometers for lower and upper limbs, rowing machines, ski ergometers, elliptical trainers, among others. As for muscle strengthening, cases of more debilitated patients demand, mainly, the use of body weight to perform exercises such as sitting and standing assisted by a bench or a chair.
Other cases have a wide variety of resources, most commonly free weights, dumbbells and shin guards with varying weights, which allow the execution of different muscle groups. Bars, poles, weighted balls, Swiss balls and elastic bands or bands with different degrees of resistance are also widely used in cardiovascular rehabilitation.
Other exercises may be indicated to improve overall health, such as manual isometric and inspiratory muscle training and to improve balance and flexibility. Whatever the prescribed training, the has a duty to guide the proper execution of all movements to avoid injuries, as well as when handling equipment.