Cardiac Rehabilitation can be defined as a multifactorial process with several objectives: the promotion of clinical stability, the reduction of disabilities deriving from the condition and a support to the recovery and upkeep of an active role in society. The general aim is to reduce the risk of subsequent cardiovascular events, to improve the quality of life and to have an overall positive impact on survival (WHO).
Exercise is now a central element in Cardiac Rehabilitation programs for acute myocardial infarction (AMI), which continues to be one of the most common and debilitating pathologies among adults, or coronary revascularization (percutaneous angioplasty or bypass), but also for users with angina or cardiac insufficiency. Most patients are advised to do aerobic exercise, of low or moderate intensity, suitable for different levels of physical ability.
OBJECTIVES OF THE REHABILITATION:
Prevent the effects of immobilization
Decrease the risk of respiratory diseases
Improve muscle tone and efficiency and functional self-sufficiency
Decrease or control one’s own disease symptoms
Motivate patients to change their lifestyle and tackle the risk factors
CONTRAINDICATIONS TO REHABILITATION:
Myocardial infarction that is not yet stabilized and/or severe heart failure
Major cardiac arrhythmias
Severe cardiac conduction disorders
Symptoms of persistent ischemia or unstable angina
Severe impairment of respiratory functions
Atrial fibrillation not under drug treatment
Significant concurrent disorders
STAGES OF THE REHABILITATION PROTOCOL:
Consultation of medical records: recent and past medical history (significant events, previous cardiac or other surgery, level of self-sufficiency prior to the acute event, etc.); type of heart attack; reading of radiological examinations (X-ray, CT, MRI) to check respiratory involvement; completion of the rehabilitation record with evaluation sheets and treatment planning.
Respiratory Rehabilitation is considered in all respects a non-pharmacological therapy for the prevention of respiratory complications. The development of a personalized rehabilitation program is essential for it to succeed, as are the evaluation and selection of sensitive indicators to document changes to the clinical condition.
Patients who have had a heart attack or other acute cardiac event are confined to bed for the first few days after the event, most often in a semi-supine position. This time frame may extend further at the onset of any complication, so these patients, besides respiratory exercises, also require adequate physical re-education to prevent:
– muscle and joint stiffness and pain;
– atrophy and muscular weakness;
– circulatory disorders (e.g. oedema, DVT);
At IRR there is an active Outpatient Cardiology Rehabilitation service where cardiac patients are greeted by specialized medical personnel (Cardiologist, Heart surgeon, Physiatrist) and qualified physiotherapists. Customized rehabilitation protocols, lasting about four weeks, help each individual to gradually resume physical activity taking into account existing physical and health conditions: this is all accomplished under close clinical and instrumental control (baseline and stress ECG and telemetry monitoring, TT Echocardiogram, and Ergo metric and Cardiorespiratory Test if necessary).