Exercise Prescription

1
Exercise Prescription

• Cardiac Rehabilitation

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WHY EXERCISE?

• Hypertension
• Dyslipidemia
• Smoking
• Obesity
• Diabetes
• Stress

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CONTRAINDICATIONS TO EXERCISE

• Unstable angina
• systolic/diastolic hypertension
• orthostatic drop gt 20mm Hg with symptoms
• critical aortic stenosis
• acute systemic illness or fever
• uncompensated CHF
• active pericarditis, myocarditis
• recent embolism

• Uncontrolled atrial or ventricular arrhythmias
• uncontrolled sinus tachycardia gt 120 bpm
• 3rd degree AV block
• resting ST displacement gt 2 mm
• uncontrolled diabetes (BG gt 15)
• severe orthopedic problems
• other acute metabolic problems

4
Exercise is Medicine
the art of exercise prescription is successful
integration of exercise science with behavioural
techniques that result in long-term program
compliance and the attainment of the
individuals goal
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Exercise Prescription

• Exercise is prescribed taking into account 4
  different factors
• F-frequency-how often
• I-intensity- using RPE scale or heart rate
• T-type - aerobic exercise
• T-time - number of minutes per session

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RPE scaleRate of Perceived Exertion

• 6
• 7 very,very light
• 8
• 9 very light
• 10
• 11 fairly light
• 12
• 13 somewhat hard
• 14
• 15 hard
• 16
• 17very hard
• 18
• 19 very,very, hard

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Exercise PrescriptionPost Discharge

• Frequency - every day, once or twice
• Intensity - easy, comfortable pace
• Type - walking
• Time- start at 5 minutes and increase by 5
  minutes per week if tolerated

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Exercise PrescriptionRecovery Program

• - every day
• - 10-30 beats above resting heart rate or RPE
  between 11 and 13
• - walking, cycling, arm ergometer
• - increasing by 5 minutes per week to 30 to 40
  minutes of exercise

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Exercise PrescriptionMaintenance

• - 5 to 6 times per week
• - moderate intensity, 11-13 on the RPE scale,
  talk test best values obtained from a stress
  test 60-80 of heart rate reserve (Karvonens
  Equation)
• - walking, jogging, cycling, swimming, paddling,
  rowing, cross country skiing, snowshoeing,skating
• - 30 -60 minutes

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Resistance Training

• Light weight training for muscle endurance is
  appropriate for cardiac patients
• 3 months post event
• start with light weights and increase gradually
• does not replace an aerobic workout
• increases muscle tone and maintains mass to
  maintain muscular power