Indians have traditionally faced high mortality due to a wide array of Cardiovascular Diseases (CVDs), including those like Hypertension, blocked arteries, cholestrol leading to Ischaemic Heart Disease (IHD), Hypertensive Heart Disease (HHD), Rheumatic Heart Disease (RHD), Cardiomyopathies, Congenital Heart Disease (CHD), Peripheral Artery Disease. However it is estimated that 90% of CVDs are preventable.
Also most of the CVD patients can help lower their risk of future heart problems if they make changes to improve their health.
Cardiac Rehabilitation has emerged as a very reliable and sustainable protocol to improve cardiac health and improve outcomes of cardiac surgery.
Read what some of our Cardiac Rehab patients have to say, after completing the Rehab Program at ReLiva by clicking here.
What is Cardiac Rehabilitation?
Cardiac Rehabilitation (Cardiac Rehab) is a professionally supervised program to help people recover from heart attacks, heart surgeries, percutaneous coronary intervention procedures such as stenting & angioplasties.
Cardiac Rehab programs usually provide education & counselling services to help heart patients increase physical fitness, reduce cardiac symptoms & improve health.
BENEFITS OF CARDIAC REHAB
- Reduction in all cause mortality rate by 20-30% (as per AHA)
- Reduced cardiac symptoms (angina, dyspnea, fatigue)
- Improved adherence & preventive medication
- Increased exercise performance
- Improved quality of life.
More details of what goes in a Cardiac Rehab Program can be found at an earlier post. Click here to read.
Increasingly even the government setups in India are also acknowledging and approving of Cardiac Rehab Programmes as effective and needed to ensure SPEEDY Recovery and enhance surgical OUTCOME.
Cardiac rehabilitation takes place as
- In-patient Rehabilitation Programs
- Outpatient exercise Programs
Outpatient cardiac rehab programs should begin as soon as hospital dismissal. Most patients are capable of beginning a supervised exercise program with 1-2 weeks of leaving the hospital.
Its time we start giving importance to clinic based Cardiac Rehab programs who plan for the Outpatient Exercise programs for cardiac patients.
We believe in “Exercise is Medicine”.
Like all medicines, ‘Effective Dosage” of exercise is important for achieving the desired results. “More” is not better. For cardiac patients, more exercise could be as or more dangerous as consuming higher dosage of medication than prescribed. “Less” would not deliver desired & long term outcomes. Patients cardiovascular capabilities may remain suboptimal; thus impacting the quality of life & overall health.
“ Effective dosage” changes as physical capacity & capabilities change. Hence regular monitoring is critical to evaluate & arrive at “effective Dosage” at different stages of Cardiac rehab.
Here is a real story about the progress of a patient due to Cardiac Rehab Program at ReLivaTM
A 66 year old male was experiencing chest heaviness & restlessness. The intensity of chest discomfort increased & extended to the epigastric region after which the patient was admitted to the hospital. The patient was diagnosed with ischeamic heart disease & had an LVEF of 25-30%. Tha patient was advised external counterpulsation therapy & he was later referred to cardiac rehabilitation.
S – “ I had a cardiac episode 3 months back”
O –Vitals – WNL/ BMI- 26 kg/m2
No acute distress, Regular heart rate.
C/o early fatigue on walking for more than 15-20 minutes.
First 6 MWT – 308 meters-5.13 laps
Target Heart rate (THRlower limit – 93/ THRupper limit – 113)
P – Initiate a 4 week (12 sessions) rehabilitation program
EXERCISE PROGRAM GOALS :
- Peak exercise tolerance > 6 MET’s
- Increase functional capacity
- Improve muscular endurance
- Reinforce lifestyle changes
- Improve overall quality of life.
The patient underwent 12 sessions of cardiac rehab which consisted of 4 muscular conditioning sessions & 8 cardiac conditioning sessions (mod bruce protocol).
In the initial 2 cardiac conditioning sessions, patient complained of chest heaviness on incline.
But subsequent sessions conditioned his heart helping him attain the Stage 5 of Mod Bruce protocol with THR-118, Speed-5 & an incline of 18 with al, the vital parameters within normal limit.
He chose to continue cardiac rehabilitation with a home based exercise programs.
For the home based exercise programs ReLiva also offers a unique remote monitoring technology in cardiac rehab by use of a Vital jacket.
Vital Jacket is the first certified medical device combining medical technology & mainstream engineering solutions.
It is an easy to wear t-shirt with a reliable cardio monitor.
VitalJacket is equipped with a Bluetooth transmitter, enabling users to view the signal in real time, before a recording takes place or during a training session. With this special feature, it is also possible to send the signal remotely to another location using either a computer or a PDA with an internet connection.
QUALITY CONTROL & ASSURANCE:
Good results can be obtained with such sophisticated & higher standards services & can provide a greater flexibility in physical training, research opportunities & improve an overall standard of patients in the health care industry.
CONCLUSION & FUTURE DIRECTIONS:
Read what some of our Cardiac Rehab patients have to say after the Rehab Program by clicking here.
With these advances in Cardiac rehab, this program can become recognized as a cornerstone in a comprehensive management of cardiac patients.
More awareness is the prime necessity to optimize the effectiveness of the cardiac rehab program.
With such initiatives together we can definitely contribute towards a better life for the Cardiac patients.
Read more detailed description of the protocol of Cardiac Rehab Program in the previous post by clicking here.
Contributed by Dr. Anuradha Purohit – Mandlekar (PT). She is BPT, MPT(Cardio-thoracic), MIAP, American Health Association (AHA) certified specialist at ReLiva Physiotherapy & Rehab and pioneers the Cardiac Rehab Program.