Exercise has major role in maintaining normal function of our heart by keeping it active. Regular exercise such as walking, jogging or aerobic exercises are highly recommended to keep the heart healthy for a long time. Patients who have undergone treatment for Cardiovascular Diseases (CVD) such as heart valve surgery, bypass surgery and heart attack treatment find physical therapy rehabilitation programs intimidating. Lack of awareness of rehabilitation programmes for CVD makes patients sceptical about opting for it. Here is a complete analysis of CR for CVD patients to help you take the right decision.
Why is it necessary?
Heart diseases bring with them a number of functional limitations such as physical weakness, balance problems, reduced stamina induces fatigue even from regular chores such as grocery shopping and inability to climb stairs. The National Audit of Cardiac Rehabilitation – Annual Statistical Report 2010 observed that around half of patients suffering from CVD are diagnosed with secondary health problems. Around 30% suffer from lumbar pain and arthritis, 21% diabetes and approximately 16% of CVD patients suffer from respiratory diseases including asthma.
The Rehabilitation Programme
The rehabilitation programmes (RP) are majorly physiotherapy based with active and passive techniques involved. RPs have proved to be clinically effective in reducing recovery period and hospital time, reducing number of hospital readmissions, treatment of secondary diseases and improving the overall quality of life for patients. RPs are highly recommended for those who had an active lifestyle before the CVD treatment so that they can resume within minimum period of time.
The treatment plan includes two types of PT for the patient, depending on the level of involvement:
1. Passive Physical Therapy
- Comprehensive evaluation
Physical therapists evaluate patients to determine their endurance, strength, gait, posture, flexibility, balance and range of motion through various tests.
- Electrical stimulation
Electrical stimulation involves placing electrodes on the skin and targeting a muscle or group of muscles to cause a forceful contraction, increase blood supply and promote healing.
- Soft tissue mobilization
The treatment involves breaking up of soft tissue fibrosis with the help of special equipment or hand manoeuvres to stimulate healing.
- Activity modification
This is a part of occupational therapy which involves modifying the approach to an opposing activity which causes discomfort to the patient.
2. Active Physical Therapy
- Flexibility and stretching exercises
These exercises are included in the program to increase patient’s range of motion and overall flexibility which is limited after treatment. For example, bypass patients find it difficult to raise their arms after a certain limit.
- Endurance training
To fight fatigue, endurance training is provided so that you perform regular chores without getting tired.
- Gait and balance training
This depends on the preliminary evaluation and is provided for improper posture and balance while walking.
- Home exercise programs
Along with exercises at the rehabilitation center, your therapist may recommend (later in the program) self supervised exercises to be performed at home.
Your physical therapist is also responsible for diagnosing the secondary conditions caused by your CVD such as joint pain, arthritis, stroke and respiratory problems and providing therapeutic interventions for the rehabilitation program to go smoothly.
The rehabilitation program is a complex mix of various components such as diet, manual therapy, monitored exercises, home exercises, mental support and over all lifestyle changes.