Written by KURA Guest Writer: Doris Lu-Anderson, PhD, E-RYT500, I-CAYT
Exercising is essential for a healthy lifestyle. Longevity increases when people go from being sedentary to doing a little exercise every day. For example, premature death rates are decreased by 20–30% only by switching from a sedentary lifestyle to having a daily 20–30 minutes (Ornish & Ornish, 2019) exercise program. For cardiac patients, exercise programs will vary based on individual conditions. It was estimated that exercise training alone reduces total mortality by 27% and cardiovascular mortality by 31% (Squires et al., 2018). Therefore, keep moving and exercising to maintain an optimal lifestyle!
What is the Difference Between Physical Activity and Exercise?
Physical Activity is any bodily movement with a significant increase in energy expenditure. It can include activities such as walking dogs, gardening, and cleaning the house. Exercise is also a type of physical activity, but it is more structured, planned, and has repetitive movements enhance physical fitness (e.g., flexibility, balance, endurance, strength) (Oxford Heart Centre, n.d.). To improve your well-being, we need a combination of both physical activity and exercise.
What are the Benefits of Exercise for A Cardiac or High-Risk Patient?
Exercise helps cardiac patients to recover from their health condition and to prevent diseases. Oxford Heart Center and Squires et al., have a list of summaries regarding health-related benefits:
- Increased cardiorespiratory fitness level
- Improved onset of chest pain/discomfort (Angina)
- Improved cholesterol levels
- Improved blood sugar control
- Lower anxiety and depression
- Improved ability to perform daily activities
- Fewer visits to the doctor and hospital
- Reduced dependence on cardiac drugs
- Reduced mortality
- Improved feelings about being able to cope after a heart attack or surgery
- Improved quality of life
What Should be Included in the Cardiac Rehabilitation Program Exercise Program?
Cardiac patients need to follow their doctor’s recommendations for cardiac rehab. Medical staff, therapists, clinical exercise physiologists, exercise specialists, caregivers are all part of the cardiac rehabilitation team.
According to Squires et al. (2018), aerobic and resistance exercise training is a keystone for early outpatient cardiac rehabilitation and offers impressive benefits to patients. Paced walking, cycling on a stationary bicycle, and light resistance training are common in the cardiac exercise program. Flexibility is also included in the cardiac rehabilitation program because a lack of flexibility in the lower back and posterior thigh regions may be associated with an increased risk for the developing chronic lower back pain. Exercise programs for the elderly should focus on proper stretching, especially for the upper and lower trunk, neck, and hip regions (Myers, 2020). Fitness principles-Frequency, Intensity, Type, and Time/Duration (FITT) are commonly used as a guideline to set up recommended activities. All components of an exercise prescription should be customized to match the condition of the patient.
Usually, a minimum of 20 continuous minutes of exercise per session is recommended within structured programs; It is okay if patients need to take a few breaks. Structured programs are often designed with a frequency of 2–4 sessions per week. However, it is essential to exercise continually, even after the scheduled cardiac rehabilitation program is completed (Myers). Ideally, patients should stay active most days of the week.
Traditional Center-Based Cardiac Rehab Setting (CBCR) vs. Home-Based Cardiac Rehab (HBCR)
The safety and effectiveness of the traditional medically supervised, center-based cardiac rehab (CBCR) model, is well established. It is useful in reducing hospital readmissions, secondary events, and mortality in patients with cardiovascular disease (Thomas et al. 2019). Unfortunately, the impact of CBCR is limited due to many reasons: the level of cardiac disease, underserved populations, and insurance, just to name a few.
According to Thomas et al., some other programs offer HBCR or a combination of CBCR and HBCR. The majority of HBCR exercise protocols offer variable support via telephone calls or home visits from a physical therapist, exercise physiologist, nurse, or electrocardiographic monitoring.
Today, most health professionals are taking advantage of advanced technology and are developing more user-friendly electronic devices to deliver effective home-based cardiac rehab so that patients can even exercise and change their lifestyle at home. People will soon have access to comprehensive care and rehab program even at home. The health industry is ready, and the question is, are you?
Myers, J. (2020). Physical activity and exercise. In American Cardiovascular and Pulmonary Rehabilitation [AACPR](Eds.). Guidelines for cardiac rehabilitation programs (6th ed.) (pp.61–68). Human Kinetics.
Ornish, D., & Ornish, A. (2019). UnDo it. Ballantine Books.
Oxford Heart Institute (n.d.). Cardiac rehabilitation exercise program (Blackbird Leys): Information for participants. https://www.ouh.nhs.uk/patient-guide/leaflets/files/091011cardiacrehableys.pdf
Squires, R. W., Kaminsky, L. A., Porcari, J. P., Ruff, J. E., Savage, P. D., & Williams, M. A. (2018). Progression of exercise training in early outpatient cardiac rehabilitation. Journal of Cardiopulmonary Rehabilitation and Prevention, 38, 139–146.
Thomas, R. J., Beatty, A. L., Beckie, T. M., Brewer, L. C., Brown, T. M., Forman, D. E., Franklin, B. A., Keteylan, S. J., Kitzman, D. W., Regensteiner, J. G., Sanderson, B.K., Whooley, M. A. (2019). Home-based cardiac rehabilitation: A scientific statement from the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology. Circulation, 140 (1), 69–89.