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Therapy for the Heart, from the Heart: Exercise Physiology at Cardiac Rehab

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6
Dec

When meeting someone for the first time, the conversation inevitably leads to the question, “So, what do you do for a living?” My standard reply is that I work in cardiac rehabilitation. Not surprisingly, most people are not familiar with cardiac rehab. This usually leads to a discussion of heart disease and the Fletcher Allen Cardiac Rehabilitation program. If my new friend is still conscious, it is not unusual for them to ask, “So, you must be a nurse?” When I say I’m an exercise physiologist, the result is generally blank stares and more questions including, “what is an exercise physiologist?”

So now you’re wondering, what is an exercise physiologist? An exercise physiologist focuses on the body’s short and long-term adaptations in response to various exercise conditions. Most physiologists are interested in the effect of exercise on “pathology” or the study and diagnoses of diseases. An exercise physiologist’s goal is to develop programs that help individuals reduce or reverse the progression of chronic disease including: coronary and vascular disease, obesity, diabetes, chronic obstructive pulmonary disease, and neuromuscular conditions.

At Cardiac Rehabilitation, our focus is on the effects of exercise in regards to the cardiovascular system. Exercise can be viewed as a medicine that needs to be dosed in the right amount. Along with your medications, it helps improve heart function and modify risk factors associated with heart disease. In short, you can think of exercise as therapy for the heart, with side effects including weight loss, increased endurance, lower blood pressure and cholesterol, reduced stress, and greater confidence. Furthermore, one of our primary goals is to increase strength and endurance so you can complete normal daily activities without limitations.

A little “stress” can be a good thing…
Typically, we begin treating patients following hospital discharge for:

  • myocardial infarction (heart attack)
  • angioplasty with coronary stent placement
  • persistent stable angina (chest pain while exercising)
  • open heart surgery: including coronary artery bypass grafting and heart valve replacement

How do we provide exercise prescriptions when each individual enters with a different background? To start, every patient performs a stress test and consults with our medical staff. Watch this video to see how we perform stress tests at Cardiac Rehab.

This test allows us to see how your heart responds to exercise. We can then determine your peak heart rate, blood pressure, and maximal exercise capacity. This provides us with the important information we need to develop a safe starting point for an exercise program. As you get in better shape and increase your strength and endurance, we will continue to increase the time and intensity of your exercise to help reach your goals for the program.

Experts in safe, effective care

Often people will ask if it is safe to participate in an exercise program with a heart condition. At Fletcher Allen we hold a national certification from the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) that recognizes our commitment to providing high quality patient care. For nearly 30 years, the Medical Director of our cardiac rehab program has been Dr. Philip Ades, an internationally recognized expert in preventive cardiology with numerous scholarly articles, including a publication in the prestigious New England Journal of Medicine. He has been at the forefront of preventive cardiology and has helped developed cardiac rehabilitation protocols and authored text books regarding patient care.

In addition to Dr. Ades, we have a multidisciplinary team including nurses, physical therapists, exercise physiologists, dieticians, nurse practitioners, and physician assistants. Each staff member contributes an expertise that enables us to address each patient’s medical condition while developing safe individual exercise prescriptions and risk factor education.

Keep it up!

After a heart problem has been identified, it is critical that patients commit themselves to lifestyle changes in order to modify their risk factors. Unfortunately, bypass surgery or angioplasty only provides a temporary “fix.” In reality, not modifying cardiovascular risk factors can lead to further progression of heart disease. Need additional motivation for participating in cardiac rehab and regular exercise?

  1. Patients completing cardiac rehab have a 20-25% reduction in mortality from heart disease.
  2. Exercise lowers blood pressure and “bad cholesterol”.
  3. Exercise increases “good cholesterol” and endurance.
  4. Exercise reduces stress and anxiety.
  5. Exercise increases your sense of well being, both physically and emotionally.

For best results, Dr. Ades says “you only need to exercise on the days that you eat.” Check out some great exercise tips from Dr. Ades – and speaking of eating, his heart-healthy cookbook.

Getting back to the original conversation, what do I do for a living? I work within a unique area of the world of health care. I’m able to contribute to a great medical care team that works with patients to help themselves get healthy, avoid future heart problems, and improve their quality of life.

Maybe I should just say that at the start?

Jason Rengo, M.S., is a senior exercise physiologist at Fletcher Allen’s Cardiac Rehabilitation program.

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