Exercise Prescription
The main goals
for exercise training in patients with HF are to reverse symptoms such as
fatigue and dyspnea on exertion and to reduce the risk for a clinical event (Keteyian et al., 2014, p. 226). The
exercise prescription should be tailored to fit each individual patient.
Aerobic type activities such as walking, cycling and recumbent stepping should be used. Intensity, duration and frequency should increase weekly as tolerated by the patient. Session duration can be lengthened by 1-5 minutes per session until a minimum of 30 minutes is reached. The 30 minutes can be done on one or multiple machines. For the patient who is vary deconditioned, 1-3 minutes of exercise with 1-3 minutes of rest in between might be appropriate in the beginning of exercise training (Keteyian et al., 2014, p. 226).
Resistance training can be added into the exercise prescription after the patient becomes comfortable with the aerobic portion of the program, usually within 2-4 weeks. Resistance training can be done twice a week with progressive intensity as the patient tolerates. Patients can perform 1- 2 sets of 10 - 15 repetitions per set, focusing on major muscle groups (Keteyian et al., 2014, p. 227).
Patients with HF are unique and challenging. These patients often have multiple comorbidities and difficult symptomology. Special considerations need to be addressed with the HF patient. With patients that typically have angina with exertion, the cardiac rehab staff needs to evaluate by heart rate when the angina occurs with exertion. The patients target heart rate should then be set 10 beats or more below the rate with which angina occurs. If the patient consistently has angina with any mild activity, the cardiac rehab staff should notify the patient’s physician. With the physician’s consent, the patient may take 1 sublingual nitroglycerine tablet 10 minutes prior to exercise (Keteyian et al., 2014, p. 227).
Reference:
Keteyian, S. J., Squires, R. W., Ades, P. A., & Thomas, R. J. (2014). Incorporating patients with chronic heart failure into outpatient cardiac rehabilitation. Journal of Cardiopulmonary Rehabilitation & Prevention, 34, 223-232. http://dx.doi.org/10.1097/HCR.0000000000000073
Aerobic type activities such as walking, cycling and recumbent stepping should be used. Intensity, duration and frequency should increase weekly as tolerated by the patient. Session duration can be lengthened by 1-5 minutes per session until a minimum of 30 minutes is reached. The 30 minutes can be done on one or multiple machines. For the patient who is vary deconditioned, 1-3 minutes of exercise with 1-3 minutes of rest in between might be appropriate in the beginning of exercise training (Keteyian et al., 2014, p. 226).
Resistance training can be added into the exercise prescription after the patient becomes comfortable with the aerobic portion of the program, usually within 2-4 weeks. Resistance training can be done twice a week with progressive intensity as the patient tolerates. Patients can perform 1- 2 sets of 10 - 15 repetitions per set, focusing on major muscle groups (Keteyian et al., 2014, p. 227).
Patients with HF are unique and challenging. These patients often have multiple comorbidities and difficult symptomology. Special considerations need to be addressed with the HF patient. With patients that typically have angina with exertion, the cardiac rehab staff needs to evaluate by heart rate when the angina occurs with exertion. The patients target heart rate should then be set 10 beats or more below the rate with which angina occurs. If the patient consistently has angina with any mild activity, the cardiac rehab staff should notify the patient’s physician. With the physician’s consent, the patient may take 1 sublingual nitroglycerine tablet 10 minutes prior to exercise (Keteyian et al., 2014, p. 227).
Reference:
Keteyian, S. J., Squires, R. W., Ades, P. A., & Thomas, R. J. (2014). Incorporating patients with chronic heart failure into outpatient cardiac rehabilitation. Journal of Cardiopulmonary Rehabilitation & Prevention, 34, 223-232. http://dx.doi.org/10.1097/HCR.0000000000000073
