Describe the Frequency of low-risk coronary patients?
For many low-risk coronary patients, particularly those following myocardial revascularization procedures, rehabilitation often begins shortly after discharge from the hospital; many enter immediately what has traditionally been considered a Phase III program, that is, without intervening super-vision in a Phase II component.
Approximately 70 per cent of current survivors of myocardial infarction under age 70 years and many patients following uncomplicated myocardial following discharge from the hospital (free of myocardial ischemia a1 exercise testing, significant ventricular arrhythmia, and/or significant left ventricular systolic dysfunction).For these carefully selected low-risk patients, both medically directed home exercise and supervised exercise training have resulted in comparable improvements in functional capacity , without reported complications of home exercise training. These alternate approaches (home-based programs) to rehabilitative care include planned communication and management by rehabilitation nurses and other specially trained personnel.
At the opposite end of the disease severity spectrum are elderly coronary patients; those with significant comorbidity; high-risk patients with continuing ischemia, compensated heart failure, or serious arrhythmias; those with complications of myocardial infarction or CABG; and those with severe angina pectoris. These patients require closer surveillance of their exercise training for extended time periods The requirements, duration, and complexly of exercise surveillance are based on the patients clinical and risk factor status, as well as the patient's needs for exercise training.
The optimal approach combines a home-based walking program with intermittent monitored exercise sessions at the cardiac-rehabilitation center, exercise counselling, and periodic reassessment of risk factors. Older patients and those with severe deconditioning who may need more complex regimens of revascularization procedures are at low risk for proximate cslrdiovascular events interval and resistance training benefit from on-site supervision of exercise. As with weight-loss programs, a detailed exercise diary of home-based exercise increases compliance.
The frequency of exercise training in the 35 demised controlled trials varied between two and seven times per week. The most common frequency was three times per week the weekly frequency of exercise did not relate to improvement in exercise tolerance.