HEART PHYSIOTHERAPY

WHAT IS HEART REHABILITATION (CR)?

Multidisciplinary cardiovascular training program with supervised physical exercise. Also:

  • Detection and control of cardiovascular risk factors (CV)
  • Clinical follow-up of heart disease
  • Optimization of adherence to pharmacological treatment
  • Psychological and social support, at individual and group level
  • Nutritional advice

WHAT ARE THE BENEFITS OF THIS PROGRAM?

  • Increased quality of life
  • Decreased cardiovascular events (angina, heart attacks, etc.)
  • Reduction of mortality from AMI
  • Increased life expectancy
  • Reduction of hospitalizations
  • Reintegration into normal life as before the illness
  • Improves therapeutic adherence
  •  

RISK FACTORS CV:

  • Sedentary lifestyle
  • Smoking
  • Cholesterol and dyslipidemia
  • HTA
  • Biabetes
  • Obesity or overweight
  • Stress

INDICATIONS

WHICH PATIENTS BENEFIT FROM CR?

-In general, all cardiopathic patients, especially:

  • Ischemic heart disease
    • Acute myocardial infarction (AMI)
    • Coronary heart disease: atherosclerosis
    • Coronary surgery
    • Angioplasty or STENT
    • Stable angina pectoris
  • Heart failure
  • Cardiomyopathies
  • Heart transplant
  • Stable valvulopathies
  • Pacemaker or DAI
  • Mechanical ventricular assist (prosthesis)
  • AVC
  • Pulmonary hypertension
  • Asymptomatic people  prevention (metabolic syndrome, family history, severe hypertension, …)

CONTRAINDICATIONS

• Absolutes:

  • – Aortic desiccating aneurysm
  • – Severe obstructive hypertrophic cardiomyopathy
  • – Severe pulmonary hypertension

• Temporary (can do PRC once stabilized)

  • – Unstable Angina
  • – Severe supraventricular or severe ventricular arrhythmias
  • – Decompensated pathologies
  • – Acute infectious processes (pericarditis, thrombophlebitis, bronchopneumopathy, oncological PCs)

WISE WHAT?

  • – Cardiovascular disease is the leading cause of hospital admission.
  • – They are the leading cause of death in the world according to the WHO.
  • – There is a high psychological impact
  • – Prolonged rest has a detrimental effect on recovery.
  • – The PRC has Class I and Level A scientific evidence that it is the highest level.
  • – There is up to 40% hospital readmission in the first year if no PRC is done.

CAN I HAVE SEX?

It is an activity that can be practiced with caution and always consult your doctor. Once the PRC is over, you will be able to resume your sexual activity as before.

DURATION

  • PRC Prevention
    • 4 weeks
  • PRC mild treatment
    • 8 weeks
  • PRC intensive treatment
    • 16 weeks

CR OBJECTIVES

  • Prevent disability resulting from heart disease in young people of working age and the elderly
  • Prevent CV complications, admissions and cardiac deaths

 

EFFECTS OF CARDIOVASCULAR PHYSIOTHERAPY

  •  Physical and Functional Capacity
  •  indirect forecast
    •  HDL cholesterol
    •  Blood pressure
    •  heart rate
    •  Triglycerides and LDL cabbage
    •  Obesity
    •  Diabetes incidence (DM II)
  •  direct forecast
    •  Blood capillarity and collateral circulation
    •  Item diameter coronary
  •  Improves endothelial function
  •  Motivation and security
  •  hospitalizations
  •  Mortality
  •  myocardial ischemia
  •  Control exertional angina
  •  anti-inflammatory action
  •  weight and stress
  •  thrombotic risk
  •  Fatigue and dyspnea

 

PHARMACOLOGY

  • Antiaggregants (ASA)
  • Statins
  • beta blockers
  • ACEI
  • ARA II
  • Diuretics (Aldosterone Antagonists)
  • Calcium Antagonists
  • Nitrates
  • Ivabradine
  • Ranolazine
  • anticoagulants
  • iSLGT2 and GLP1
  • Rapidly absorbed vasodilators (nitroglycerin)

 

TO START THE PROGRAM…

  1. Visit and recommendation of your doctor
  2. Evidence  Ergometry and Analytics
  3. Clinical interview in FisioBat

 

CARDIAC REHABILITATION PROGRAM (PRC)

2 sessions/week of 1h30′ with the physiotherapist:

–  Monitored physical exercise  with stationary bike combined with strength-resistance.

-We control throughout the session, while doing the exercises, the constants:

  • blood pressure
  • heart rate
  • oxygen saturation

–  Electrocardiogram in real time.

Totally safe and the patient always works within their cardiac range agreed with their doctor.

CAN I GO BACK TO WORK AND WHEN?

Not all jobs demand the same effort, nor do all hearts have the same capacity. It will depend on the results of the tests and the indications of your doctor. It has been shown that reincorporation to work decreases the appearance of depressions and other psychological disorders; and positively influences the prognosis of the disease.

 

CAN CHILDREN DO THE PROGRAM?

In FisioBat the CRP will be carried out from the age of 16 and always under the supervision of your doctor.

 

Bibliography

  • SEC: Heart Failure and Cardiac Rehabilitation Units
  • Editorial Panamericana: Cardiac Rehabilitation for Physiotherapists
  • Cardiac Rehabilitation Manual (Infanta Sofía University Hospital): Dr. Ignacio Plaza Pérez

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