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Medicine of
Cardiovascular Diseases
Rehabilitation Medicine of
Cardiovascular Diseases:
Etiology of CVD :
Medical Problem
Rehabilitation Problem:
Disability of mobilization
Restricted of daily activity.
Defect of Vocational
Defect in working
Defect in communication
Defect in psychosocial
OUTCOMES OF CARDIAC
REHABILITATION SERVICES
Protocols:
Classification of activities
Programs recipe
220 age ( Years ) = Frequency Heart MAX /
minute
ICCU / CVCU
Level III
Stadium II
Home
Level IV
Stadium III
Post Recovery
Level II
Ward
STADIUM I
A. Level I : In
1, 5 CAL
1,2 METS
( 1 2 METS )
3. Type of activities:
Change body position
Passive movement ROM AGA / AGB
Active movement ROM AGA / AGB
4. Intensity
Heart pulse target : 40 50 %
from maximal HEART RATE
TENTION SISTOLE 20 mmHG
TENTION DIASTOLE 10 mmHG
MONITOR SUBYEKTIF / OBJEKTIF SIGN
ABNORMALITY OF ECG
5. Frequency and Duration
5 times, 2-3 times a day
Duration 2 5 Minutes, take a rest 10 minute
B. Level II : In Ward
( 3 14 days)
Level II
C. Level III : At Home ( 2 8 weeks )
1. Approximate the capacity of the heart : Class II
2, 7 - 4
CAL
1,2 - 2,2 MET
2. Classification of Activities MODERAT
2, 5 3,5 METS
3. Type of activities
Previous exercise to be continued
Working exercise 2 MILE / hour
Take a bath in bathroom
Cycling without resistance
4. Intensity
70 80 % MHR
5. Frequency and Duration
Exercise
2 times/ day
Deconditioning 5 10 minutes
Duration
15 20 minutes
Cool down
5 minutes
STADIUM III
D. LEVEL IV : ( POST RECOVERY )
1. Approximate the capacity of the heart : Class I
4 6,6 CAL
3,2 - 5,3 METS
2. Classification of Activities
Severe
3, 5 5 METS
3. Base Program: STRESS TEST
4. Type Activities
According the result of STRESS TEST
Walking activities, gynamctic, cycling
Sexual intercourse can be considered
5. INTENSITY : According the result of STRESS TEST
6. Exercise every day
Duration
15 - 20 minutes
Or
25 - 30 minutes three times a week
ISOMETRIK CONTRACTION
HOLD BREATH
VALSAVA MANUVER
STEPPING UP
Stop Exercise:
Tension is not up nor down, or up more than
systole
20 mmHg/Diastole 10 mmHg.
Excess than hearth rate target.
Chest pain
Cyanosis, pale, vomiting
Hypotension, diaphoresis
Short of breath
ARITMIA
% INCREASE IN ENERGY
4.5
3.3-3.8
4.2-5.0
4.2-6.0
5.3
11.4
5.5
6.75