Cardio Vascular & Pulmonary Rehabilitation
Cardiovascular disease and its contributing risk factors like diabetes and high blood pressure etc, holds a major share of mortality and morbidity due to noncommunicable diseases globally , The endangering fact is that India emerged as a world capital to these diseases due to increased number of cardiovascular disease causalities in the prime years of life with younger generation in particular, pushing patients into a vicious cycle that starts with decreased self confidence or depression leading to a compromise in physical performance which further leads to depression and the cycle continues. The healthy fact is that heart diseases are largely preventive and cardiac interventional procedure can be avoided with appropriate modifications taken in lifestyle measures and medications at the earliest.At progressive care we have individualized “State of Heart” cardiac rehabilitation programs that are customized, tailored and catered to individual needs and goals.Cardiac Rehabilitation program: for individuals who have had a cardiac event and undergone some kind of interventional procedure like stenting, Bypass surgery, Repair/Replacement of heart valves etc.Secondary prevention program: for individuals who are diagnosed with heart disease on routine examination but refusing to undergo interventional procedures like stenting or bypass surgery.Wellness and Primary prevention program: for individuals who are AT RISK of developing heart disease and with two or more of the following risk factors
- Age: men >40 years and women >50 years.
- Individuals with family history of heart disease.
- Individuals with uncontrolled diabetes and hypertension.
- Individuals with sedentary life styles.
- Abnormal cholesterol and lipid profiles.
- Smoking and alcohol consumption.
- Overweight and obese individuals with BMI more than 25.
What is cardiac rehabilitation?
“Cardiac rehabilitation refers to coordinated, multifaceted, interventions designed to optimize a cardiac patient’s physical, psychological, and social functioning, in addition to stabilizing, slowing, or even reversing the progression of the underlying atherosclerotic processes, thereby reducing morbidity and mortality”. (AACVPR -The American Association of Cardiovascular and Pulmonary Rehabilitation; AHA – American Heart Association)
Is cardiac rehabilitation really necessary?
Yes, it is really necessary. Every recent major evidence based guideline from leading institutions like American Heart Association (AHA) and the American College Of Cardiology Foundation have classified Cardiac Rehabilitation as a class 1 level recommendation (i.e., procedure/treatment should be performed/administered). Research proved that patients who underwent cardiac rehabilitation, showed a 20% reduction in total death and 26% in cardiac deaths when compared to those on usual medical care.
What are the advantages of Cardiac Rehabilitation?
With Cardiac Rehabilitation one can
- Reduce risk of mortality due to heart disease.
- Slow down the progression and even speed up the reversal of damaged heart vessels.
- Increase exercise tolerance and functional capacity thereby improving physical performance of the individual.
- Lower risk factors like cholesterol levels, blood pressure and keep them under control.
- Better control of sugar levels can be achieved in case of diabetes.
- Enhances a psychosocial well being and stress reduction.
- A boost in ones confidence level and early resumption to daily activities can be achieved at the earliest.
- Decrease the rate of hospitalization and absence from work.
Who needs cardiac rehabilitation?
Those who have had
- Myocardial infarction (Heart attack).
- Percutaneous coronary intervention like stenting.
- Coronary Artery Bypass Grafting (Bypass surgery).
- Heart valve replacement.
- Stable angina pectoris.
- Heart failure.
- Heart transplantation.
- Patients with chronic diabetes and hypertension.
Is there anyone who are not eligible for cardiac rehabilitation?
Yes, in spite of its beneficial effects for patients with heart diseases, cardiac rehabilitation inhibits a group of patients from joining the program.
- Unstable angina or chest pain at rest.
- Unstable heart failure.
- Patients with unrepaired heart valves.
- Rhythm disturbances of the heart that can’t be controlled with medications.
When does the program begin?
Program usually begins with in one to four weeks after the patients discharge from the hospital depending on the procedure underwent by the patient.
Do you have any symptoms of pain in your legs or buttocks when you walk? Does the pain disappear quickly when you stop walking? If your answer is yes to either of these questions, you might be having peripheral arterial disease (PAD), a narrowing of the blood vessels in the lower legs. PAD causes pain, cramping, burning, limping and a tired feeling in the legs even when walking a short distance. For PAD patients, the degree of disability is similar to that of heart failure.Consult your physician for possible screenings or tests used to diagnose PAD, and ask about treatment options to slow its progression. The latest medical evidence shows that an exercise program called vascular rehabilitation will be a beneficial part of the treatment by slowing down of PAD disease process. Prestigious institutions like American Heart Association and the American College of Cardiology recommend combating PAD with a supervised walking program.“So, why walk with PAD when you can walk away from it!!”
What is vascular rehabilitation?
Vascular rehabilitation is a specially designed program using exercise and education to improve vascular health to slow down the progression of peripheral arterial disease. The prime focus of the program is to improve individual fitness levels, educating a patient on lifestyle modifications that help to cope with the symptoms of PAD, improve mobility, and manage various factors that may increase your risk for cardiovascular disease.At progressive care, our dedicated physiotherapists with advanced degrees and experience in cardio vascular and pulmonary physiotherapy will design an exercise and educational program that Is tailored and individualized to the felt needs and fitnes goals of the patients, and your physician will be notified regularly about your progress.
Who are the candidates that can benefit from vascular rehabilitation?
Candidates for vascular rehabilitation include individuals who have had at least one of the following:
- Intermittent claudication (leg discomfort) when walking
- Diagnosis of peripheral arterial disease (PAD)
- Arterial revascularization procedures such as surgery, angioplasty or stent
- High risk factors associated with vascular disease (high cholesterol, high blood pressure, diabetes and tobacco use)
Advantages of Vascular Rehab
- The Vascular Rehabilitation at progressive offers many benefits, including:
- Improving walking distance (endurance) in patients with intermittent claudication.
- Improving quality of life and stress management.
- Increasing muscular endurance and strength.
- Reducing risk of PAD progression, thereby reducing cardiovascular risk factors.
- Reducing the chance of further hospitalization.
- Reducing the risk of having another stroke or transient ischemic attack (TIA).
What’s the frequency and duration of the program?
The frequency of the program is two to three times a week and the duration of the program is usually four to eight weeks and program may include one monthly visit up to one year depending on the disease severity.
Diseases of the respiratory tract, whether acute or chronic , accounts for one third of all physician consultations and it’s also estimated that regardless of the immediate cause of the admission one third of the hospitalized patients have a problem with their respiratory system globally. The numbers in India would be much higher. Pulmonary disease affects the ability of physical performance including the activities of daily living due to a decrease in the exercise capacity depending on the type and severity of the disease. This is further amplified and aggravated by physical activity leading to dyspnea and fatigue which initiate the perpetuating process of anxiety, activity avoidance and landing up in a progressive disability.
What is Pulmonary Rehabilitation?
Pulmonary rehabilitation is a structured, “evidence-based, multidisciplinary, and comprehensive intervention for patients with chronic lung diseases who are symptomatic and often have decreased daily life activities.” (ATS- American Thoracic Society/ERS- European Respiratory Society statement on pulmonary rehabilitation)At Progressive Care we have an outpatient pulmonary rehabilitation program that is customized and tailored to individual client/patient needs, which includes education and exercise that help to manage breathing problems, increase stamina (energy) , decrease breathlessness and thereby improve well being of the patients with chronic lung diseases.
What are the benefits of pulmonary rehabilitation?
- Improve your quality of life i.e., Helps you function better in your daily life.
- Increase your exercise ability.
- Decrease the symptoms of your disease or condition.
- Help you manage anxiety and depression.
Who should have pulmonary rehabilitation?
Any individual who have a chronic pulmonary disease affecting their functional status and therefore a compromise in their quality of life are suggested for pulmonary rehabilitation. Patients with chronic obstructive pulmonary disease, asthma, bronchiectasis, cystic fibrosis, pulmonary fibrosis, neuromuscular disease and patients with a lung volume reduction surgery will benefit from participating in a pulmonary rehabilitation program.
Who shouldn’t have pulmonary rehabilitation?
Patients with following conditions are not suggested for pulmonary rehabilitation.
- Severe cognitive impairment.
- Severe psychotic disturbance.
- A relevant infectious disease.