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Heart Wise Exercise Presented By : Dana Sipprell. Working towards a healthier heart physically and emotionally…. Today’s Agenda. Learning about Heart Health H ow to apply this knowledge. Heart Wise Program. Why Heart Wise

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heart wise exercise presented by dana sipprell

Heart Wise ExercisePresented By : Dana Sipprell

Working towards a healthier heart physically and emotionally…

today s agenda
Today’s Agenda
  • Learning about Heart Health
  • How to apply this knowledge
heart wise program
Heart Wise Program

Why Heart Wise

  • Less than 50% of Cardiac Rehabilitation (CR) patients continue to be sufficiently active after program completion
  • Up to 60% of patients post-cardiac event never attend CR

What Heart Wise Does

  • Encourages regular, daily aerobic exercise
  • Allows participants to exercise at a safe level & has progressive options to increase intensity if appropriate
  • Partnership between the YMCA and Toronto Rehab
checking in
Checking In
  • After each set of slides, I will ask a multiple choice question to make sure you are paying attention….
  • On the count of three, show the number of fingers that corresponds to what you think is the correct answer
blood flow in the body
Blood Flow in the Body
  • Resting Heart Rate
  • Maximum Heart Rate
  • Blood Volume (1/11th)
  • Cardiac Output Q=SVxHR
  • Exercise Response
  • Stroke Volume
  • Cardiac Output
checking in1
Checking in

What statement is correct regarding the heart

1. Your blood is 1/8 of your body weight

2. Your heart has four chambers

3. Your resting heart rate is best measured 10 minutes after exercise

4. Heart is from the latin word Hiarta, meaning strong

heart incidents include
Heart Incidents Include:

Angina

  • Reduced blood flow in arteries of heart
  • Medication to increase supply or decrease demand (nitroglycerin, beta blockers)
  • Stent or Angioplasty
  • Coronary Artery
  • Bypass
heart incidents include1
Heart Incidents Include:

Heart Failure

  • Weakened Heart

Muscles

  • Reduce Blood Pressure
  • Reduce Blood Volume
heart incidents include2
Heart Incidents Include:

Arrythmia

  • Nerve signals to

Heart not consistent

  • Pace Maker
  • Cardiac

resynchronization

therapy

heart incidents include3
Heart Incidents Include:

Valvular Heart Disease

  • Problems with valves
  • Valvular surgery
checking in2
Checking In

A restricted blood flow to the arteries that supply blood to the heart is known as:

1. Valvular Heart Disease

2. Heart Failure

3. Angina

4. Arrythmia

how the body is affected
How the body is affected
  • Physical Psychological

Functional Recovery

Smoking

Cessation

Return to

work

Blood pressure

control

Exercise

Anxiety/Depression management

Lipid and weight control

Stress management

Quality-of-Life

Glucose control

what can exercise do
What can exercise do?

Results

  • Regression of plaque
  • Improvement of fitness function
  • Development of collateral circulation
  • Psychological
minimizing the risk
Minimizing the Risk

The Flying Heart ! Pass the heart around and guess as many as you can!

  • Smoking
  • Diabetes
  • Hypertension
  • High Cholesterol
  • Obesity
  • Sedentary Lifestyle
  • Stress
  • Menopause
  • Age
  • Family History
  • Mix of Factors
checking in3
Checking In

Which of the following is not a risk factor for Heart Disease:

1. High HDL Cholesterol

2. Being of African American descent

3. Stress

4. Watching tv all day every day

drug therapy
Drug Therapy

AsaBetaStatiPril

  • Nitrates (vasodilation)
  • Antiplatelets (slow thrombosis)
  • Beta Blockers (dec HR)
  • Calcium Channel Blockers (electric)
  • Statins (decrease LDL)
exercise prescription fitt
Exercise Prescription - FITT
  • Frequency
    • 3-5 days per week
  • Intensity
    • Minimal level to induce training effect
    • Below threshold at which abnormal signs and symptoms develop
    • Development of a Threshold Heart Rate range with low and high end is useful for exercise progression
  • Type
    • Large muscle groups (walking, cycling, etc)
  • Time
    • 30-60 minutes per session
heart rate range
Heart Rate Range
  • Karvonen (HRR)

Lower THR = (peak HR – RHR)(0.6)+RHR

=(141-65)(0.6)+65

=110

Upper THR = (peak HR-RHR)(0.8)+RHR

=(141-65)(0.8)+65

=126

Heart Rate Range:110 bpm – 126 bpm

what to remember
What to Remember!
  • Heart Rate Guidelines
  • Medications
  • RPE & Symptoms
  • Progressive Disease
considerations for exercise
Considerations for Exercise
  • Large muscle groups exercised before smaller muscle groups
  • Complete repetitions rather than single maximum lifts (i.e. 1RMs)
  • Do not lift to the point of failure or to when a distinct Valsalva manoeuvre becomes necessary (usually at intensities higher than 80% of 1RM)
  • Progress loads according to patient ability either by an increase in reps OR weight, NEVER both
considerations for exercise1
Considerations for Exercise
  • Controlled movements with full ROM
  • Avoid straining or sustained tight gripping
  • Breath normally, no breath holding
  • Rest as needed, do not rush the ‘circuit’
  • Level of exertion should not exceed the level of recommended for aerobic exercise
  • Avoid overhead lifts, i.e. overhead press, military press
  • Stop exercising if warning signs or symptoms occur, especially dizziness, palpitations, undue shortness of breath or angina
progressions
Progressions
  • Essential in order to see results in muscular strength and muscular endurance
  • Keeps you motivated
  • Adds variety to your work-out
how to progress
How to Progress
  • Should begin when you are able to perform 2 sets of 10 repetitions comfortably
  • Gradually increase the number of repetitions from 10 -15 (may take 2 to 3 weeks)
  • Then increase the weight by 2-5 lbs and reduce the repetitions back to 10
  • The last repetition of a set should not be any higher than 14 on the RPE scale
case studies
Case Studies

Role Play!

In your color groups, role play how you would work with the participant you are given.

case study no 1
Case Study No. 1

Name: Sally

Age: 65

Heart Incident : Angina attack, 6 weeks ago

Medications : Nitroglycerin to dilate blood vessels

Previous Exercise : Before incident used to walk dog every day for 10 min. After incident has been walking on treadmill for 20 minutes, 3 times a week.

Peak Heart Rate: 160

Resting Heart Rate: 55

Sally wants to join the YMCA and start taking a Walkfit Class. As her instructor, what recommendations and precautions do you have for Sally?

case study no 2
Case Study No. 2

Name: Robert

Age: 72

Heart Incident : Arrhythmia, 3 months ago

Medications : Calcium Channel Blockers & Pace Maker

Previous Exercise : Never exercised before but has been riding bike for 15 minutes 3 times a week and has been doing a basic weight training routine with hand weights

Peak Heart Rate: 170

Resting Heart Rate: 50

Robert comes for a mYfitness appointment and wants to start building strength and losing weight. As an IC instructor, what can you recommend for Robert.

case study no 3
Case Study No. 3

Name: Steve

Age: 50

Heart Incident : Heart Failure, 1 year ago

Medications : Beta Blockers & Statins

Previous Exercise : Marathon Runner for 30 years

Peak Heart Rate: 190

Resting Heart Rate: 30

Steve has been teaching fitness classes at the YMCA for 10 years and was always in great shape. One year after his heart incident, he wants to return to teaching. What are your recommendations and precautions for Steve as his fellow instructor?

the end
The End…

Questions…..