Cardiac Rehab PP High Lights

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amills1
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246604
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Cardiac Rehab PP High Lights
Updated:
2013-11-12 20:43:33
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Cardiac Cardio PTA 210
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  1. What is max VO2
    Measure of a body's capacity to use O2
  2. Aerobic conditioning is
    Increase in the capacity of a muscle to utilize O2
  3. ATP-PC system
    • energy is stored in muscle cell
    • high power, quick bursts of intense activity
    • short duration
    • no O2
    • fast twitch type IIB
  4. Anaerobic glycolytic system
    • Glycogen is fuel source
    • no O2 required
    • synthesis of ATP in muscle
    • lactic acid produce
    • moderate power and duration, interval training
    • fast twitch type IIa and IIb fibers
  5. Aerobic System
    • Glycogen, fat, and protein fuel sources
    • O2 required
    • ATP resynthesized in cell mitochondria
    • long duration, low power
    • slow twitch type I and some fast type IIa
  6. What are METs
    • Metabolic equivalent
    • O2 consumed per kilo of body weight per min
    • 1 Met= 3.5 mL/kg
  7. Light activity level
    • 2-5 kcal/min
    • 1.6-4 METS
    • Strolling to walking, light housework, golf with cart
  8. Heavy activity level
    • 7.5-10 kcal/min or 7-8 METS
    • Jogging at 5mph, bicycling 11-13mph
  9. Type 1 Fibers
    • slow twitch, slow response
    • high myoglobin/mitochondria
    • high oxidative capacity
    • used for endurancce
  10. Type IIB
    • Fast twitch, fast response
    • low myoglobin/few mitochondria
    • high glycolytic capacity
    • used for power
  11. type IIA
    • Between type I and IIB
    • Used for aerobic and anaerobic
  12. Cardiac output, HR, systolic BP; all these ___ in response to exercise
    Increase
  13. Respiration, tidal volume, alveolar ventilation, blood flow to working muscles, extraction of O2 from each liter of blood; all these ____ in response to exercise
    increase
  14. Resting HR and exercise HR, BP, and myocardium O2 consumption ___ in response to a training program
    decrease
  15. Blood volume, cardiac output, O2 extract, max VO2 all ___ in response to a training program
    increase
  16. Respiratory changes in response to training
    • Larger lung volume
    • Greater alveolar-capillary surface area
    • Decreased rate of respiration at same level of O2 consumption
    • Increased ventilation efficiency
  17. Muscular changes in response to training
    • hypertrophy and increased capillary density
    • increased mitochondria
    • increased myoglobin
    • increased glycogen sparing
    • decreased reliance on ATP-PC system
  18. Body fat %, cholesterol, and triglycerides __ with training
    decrease
  19. heat acclimatization, strength of bones, tendons, and ligaments ___ with training
    increase
  20. Typical cardiac rehab DXes
    • MI
    • CABG
    • Angioplasty
    • Valve replacement
    • Cardiac transplant
    • Chronic stable angina
    • CAD patients after medical clearance
  21. This is used to measure VO2 max, ECG changes during increasing work loads, Dx for patients with overt or latent heart disease, determine exercise level, evaluate patient response to exercise program
    stress test
  22. Stress test  procedure
    • Multiple stages, 4-6
    • Bike, steps, or treadmill
    • multiple intervals 3-6 mins each
    • monitor EKG, HR, BP
    • measure CO2
  23. Reasons to terminate stress test
    • progressive angina
    • large drop in systolic with increased work
    • lightheadedness, pallor, cyanosis, nausea
    • abnormal ecg
    • excessive increase in bp
  24. Exercise program intensity
    • Overload principle
    • specificity prinicple (emphasis on that training to increase that particular ability)
    • 60-90% of max HR¬†
    • 60-80% max VO2
    • Duration 20-30 mins @ 70%
  25. Exercise program frequency
    3-4 times per week
  26. Range of METS
    • 1-11
    • Light work: 1.6-3.9
    • Heavy work 6-7.9
  27. Affects of warming up
    • increase muscle temp
    • decreased chance of musculoskeletal injury
    • decreased occurence of ischemic ECG changes
  28. Continuous training
    • Submaximal throughout for 20-60 mins
    • Most effective for healthy individual
  29. Interval training
    • exercise with a prescribed rest interval 30sec-2min
    • less demanding than continuous
    • if healthy improves strength/power>endurance
  30. Circuit training
    • Series of exercises repeated over maybe several times
    • May use large and small muscles
    • Improves strength and endurance
  31. Circuit interval training
    • combine circuit and interval for aerobic/anaerobic effects
    • decrease production of lactic acid
  32. Purpose of cool-down and stretching
    • Prevent pooling of blood
    • prevent fainting
    • replacement energy stores
    • rid body of metabolic waste
    • prevent MI, arrhythmias or other C-V complications
    • about 5-10 mins
  33. Cardiac Rehab Phase I
    • Begins following stabilization of patient in hospital (3-5 days)
    • Address lifestyle choices
    • Initiate self-care activities
    • Supervised ambulation
    • Instruction in continued rehab
    • Goals: Self-care, ADLs, and household amb
  34. Cardiac rehab phase II
    • At d/c or 6-8 later
    • Lasts 8-12 weeks usually out patient
    • Increase aerobic exercise capacity beginning with low level exercise progressing slowly with supervision
    • Symptom limited stress test may determine exercise intensity (3-6 METS)
    • Duration 10-15 increasing 30-60, TIW
    • Circuit-interval training common
  35. Cardiac rehab phase III
    • Self monitored HR exercise
    • Staff monitored BP (no telemetry)
    • Increasing levels of intensity to tol 6-8 METs
    • Continuation of exercise on own with check ups

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