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Cardiac Rehabilitation Presented by Chantelle van den Berg

Cardiac Rehabilitation Presented by Chantelle van den Berg MSc Physio, BSc (Hons) Physio (STELL), CPT 1 (APDL2) PHYSIOTHERAPIST – Busamed Paardevlei Private Hospital SASP NATIONAL EXECUTIVE COMMITTEE MEMBER. “ If exercise could be packed in a pill ,

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Cardiac Rehabilitation Presented by Chantelle van den Berg

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  1. Cardiac Rehabilitation Presented by Chantelle van den Berg MSc Physio, BSc (Hons) Physio (STELL), CPT 1 (APDL2) PHYSIOTHERAPIST – BusamedPaardevlei Private Hospital SASP NATIONAL EXECUTIVE COMMITTEE MEMBER

  2. “ If exercise could be packed in a pill, it would be the single most widely prescribed and most beneficial medication ” Sallis R (2014)

  3. DID YOU KNOW? Exercise is one of the best ways to control or reduce weight, and reduce the risk of heart disease, stroke & type 2 diabetes. Sources: Hu F et al. Physical activity and risk of stroke in women. JAMA. 2000; 283(22):2961- 2967. www.ncbi.nlm.nih

  4. 1 IN10PEOPLE IN SOUTH AFRICA ARE DIABETIC • World Health Organisation (2016) http://www.who.int/diabetes/country-profiles/zaf_en.pdf?ua=1

  5. 51.9% of South Africans are overweight and 25.6% are obese 67% increase in HPT cases 1990-2010 World Health Organisation (2016) http://www.who.int/diabetes/country-profiles/zaf_en.pdf?ua=1

  6. 2016: 210 heart disease deaths and130 heart attacks (M.I) PER DAY! World Health Organisation (2016)

  7. How much exercise does it take to burn off calories ? Time it takes to burn off calories in minutes: Walking at 5km/h | Running at 8km/h 26 min Walking Sugar Soft Drink | 139 Calories 12 min Running 31 min Walking Potato Chips| 171 Calories 16 min Running 31 min Walking Cereal | 172 Calories 16 min Running Source: RSPH | BBC

  8. How much exercise does it take to burn off calories ? Time it takes to burn off calories in minutes: Walking at 5km/h | Runnng at 8km/h 42 min Walking Chocolate Bar | 229 Calories 22 min Running 48 min Walking Blueberry Muffin | 265 Calories 25 min Running 1hr 22 min Walking Sandwich (chicken&bacon) | 445 Calories 42 min Running Source: RSPH | BBC

  9. If everyone walked briskly at 4.8 - 6.4 km/hr on most days of the week about 30% of deaths from cardiovascular disease would be prevented each year. Sources: Pate R et al. Physical activity and public health. JAMA. 1995;273(5):402-407. www.ncbi.nlm.nih.gov/pubmed/7823386 Wei M, Kampert et al.

  10. Walking at 4.8 km/hr for 5 hrs / week brings a 46% lower risk of heart disease and stroke, compared with non-exercisers. Sources: Hu F et al. Physical activity and risk of stroke in women. JAMA. 2000; 283(22):2961- 2967. www.ncbi.nlm.nih

  11. Blood Pressure is known as the SILENT KILLER 40-70year olds: Each 20mmHg increase in Syst.BP or 10mmHg Diast.BPDOUBLES the risk for a cardiovascular event Aerobic exercise lowers your blood pressure3.84mmHg for Syst.BP 2.58mmHg for Diast.BP

  12. This type of blood pressure reduction is associated with a 5-9% reduction in heart morbidity, and a 8% to 14% reduction in the risk of stroke. Sources: Cornelissen VA, Fagard RH. Effects of endurance training on blood pressure, blood pressure-regulating mechanisms, and   cardiovascular risk factors. Hypertension 2005 Oct; 46(4):667-75. www. ncbi.nlm.nih.gov/pubmed/16157788

  13. SPEAK TO A PHYSIOTHERAPIST OR BIOKINETICIST for an exercise program designed for your medical condition, ageandlevel of mobility. Full assessment of your health risks is necessary before commencing any exercise programme, especially if you suffered from a cardiac event

  14. Cardiac Rehab In Hospital 1-5 days (phase I) Post discharge 2-6 weeks (phase II) Out-patient programme6-12 weeks (phase III) FITT principles Moderate high-intensity cardio Combined resistance training Long-term maintenance Sources: Price KJ et al. (2016) A Review of Guidelines for Cardiac Exercise Programmes: Is There an International Consensus? www.journals.sagepub.com

  15. What is myHRmax & HRR? Exercise 60-75% of your HR Max (220-age) Betablockers – (20-30) Exercise 40-60% of HRR HRM – Resting HR 40% of HRR + Resting HR = minimum 60% of HRR + Resting HR = maximum Rate of Perceived Exertion (BORG 6-20)

  16. SIX MINUTE WALK TEST Should be able to walk 400-700m in 6min After C.A.B.G pre-discharge:319 ±105m (males) 229 ±99m (females) Recommend: 16 000 (M) & 15 000 (F) steps daily =1

  17. EXERCISE GUIDE World Health Organisation Guidelines Adults: 18-64 years Need to be active daily with specific cardio exercise minimum 3x/week30-60min moderate intensity brisk walking, dancing, swimming, cycling Muscle/bone strengthening and flexibility activities 2-3 days a week. Sitting less than 45minutes at a time!!!

  18. EXERCISE GUIDE Always warm up and cool down when you exercise! Warming Up Rises pulse rate in graduating and safe way, preparing the body, redistributing blood and increasing muscle temperature to help muscle action and relaxation Cooling Down Reduces risk of hypotension, helps bring heart rate down gradually, reduces catecholamines to resting levels (risk for arrhythmias after exercise)

  19. GET STARTED IN YOUR MOVE FOR HEALTH EXERCISE WHERE YOU ARE You do not have to be an athlete or sportsman/woman to be physically fit. Increase your incidental physical activity by modifying what you do everyday.

  20. Be active in and around the house and garden. • Get up and change the channel or volume on the TV instead of using the remote. • Take the stairs instead of the lift or escalator • Park further away from shops, walk! • When walking the dog, add an extra block or steep hill to your normal route. • Energetic, danceable music while you work encourages you to move more.

  21. MOVEMENT IS THE FOUNDATIONFOR GOOD HEALTH SO… KEEP MOVING

  22. THANK YOU! CHANTELLE VAN DEN BERG PHYSIOTHERAPY INC. MSc Physio, BSc (Hons) Physio BusamedPaardevlei Private Hospital Consultation Rooms UDS House, Suite 2 22 Gardner-Williams Avenue Paardevlei Estate (021) 851-0657 / 0718892356 www.paardevleiphysio.co.za The South African Society of Physiotherapy Tel (011) 615 3170 Fax 086 559 8237 / 086 679 0681 PO Box 752378, Gardenview, 2047 www.saphysio.co.za info@saphysio.co.za

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