Unlocking The Benefits Of Physiotherapy Cardiac Exercises | Boost Heart Health For A Vibrant Life

 

Maintaining a healthy heart is crucial for overall well-being, and cardiovascular exercises play a vital role in achieving this goal. Physiotherapy cardiac exercises, specifically designed to address heart-related conditions, offer numerous benefits that go beyond just strengthening the heart. In this blog, we will explore the various advantages of incorporating physiotherapy cardiac exercises into your routine and how they can improve your overall quality of life.

Enhancing Cardiovascular Health
Physiotherapy cardiac exercises focus on increasing cardiovascular endurance, which is essential for optimal heart health. Regular physical activity, under the guidance of a qualified physiotherapist, can improve heart and lung function, increase blood circulation, and reduce the risk of heart disease. Engaging in exercises such as walking, swimming, or cycling can improve the heart's ability to pump blood efficiently, thus reducing the strain on the heart and decreasing the risk of heart-related complications.

Managing Blood Pressure
High blood pressure is a significant risk factor for heart disease. Physiotherapy cardiac exercises can effectively manage blood pressure levels by strengthening the heart and improving blood flow. Aerobic exercises and resistance training have been shown to lower blood pressure and promote a healthier cardiovascular system. By regularly engaging in physiotherapy cardiac exercises, individuals can significantly reduce their dependence on medication and enjoy the benefits of natural blood pressure regulation.

Boosting Energy Levels
One of the often-overlooked benefits of physiotherapy cardiac exercises is the boost in energy levels they provide. When you have a healthy heart, oxygen-rich blood flows efficiently throughout your body, providing energy to your muscles and vital organs. Regular physical activity enhances your body's ability to deliver oxygen and nutrients, leading to increased stamina, improved endurance, and a general sense of vitality. Physiotherapy cardiac exercises can help combat fatigue and make daily activities feel less strenuous.

Weight Management
Maintaining a healthy weight is crucial for heart health. Physiotherapy cardiac exercises are an excellent tool for weight management and can aid in weight loss efforts. These exercises help burn calories, increase metabolism, and build lean muscle mass, which in turn helps individuals achieve and maintain a healthy weight. By shedding excess pounds and reducing body fat, the strain on the heart is alleviated, reducing the risk of cardiovascular complications.

Reducing Stress and Anxiety
The benefits of physiotherapy cardiac exercises extend beyond physical health and promote mental well-being. Regular exercise releases endorphins, known as the "feel-good" hormones, which elevate mood and reduce stress and anxiety levels. Physical activity stimulates the production of serotonin and dopamine, neurotransmitters that regulate mood and promote a sense of calm and relaxation. By incorporating physiotherapy cardiac exercises into your routine, you can experience a natural and effective way to combat stress and improve mental well-being.

Enhancing Quality of Life
Physiotherapy cardiac exercises contribute to an overall improvement in the quality of life. By improving cardiovascular health, managing blood pressure, boosting energy levels, and reducing stress, individuals can enjoy a more active and fulfilling lifestyle. Engaging in physical activity promotes independence, enhances mobility, and increases longevity. Regular exercise can also improve sleep patterns, enhance cognitive function, and strengthen the immune system, leading to a healthier, more resilient body.

Physiotherapy cardiac exercises offer a multitude of benefits that go beyond just strengthening the heart. By incorporating these exercises into your routine under the guidance of a qualified physiotherapist, you can enhance cardiovascular health, manage blood pressure, boost energy levels, manage weight, reduce stress and anxiety, and enhance your overall quality of life.

 

Pre and Post Physiotherapy for Pediatric undergoing Cardiac Surgery

Cardiac Surgery is successfully performed on numerous Pediatric patients suffering from many different congenital heart defects. The frequency of heart surgery in children with congenital heart disease is very high, and the occurrence of pulmonary complications in post-operative heart surgery is equally common. Children also have postoperative pulmonary risks similar to adults. Since the complications like atelectasis and pneumonia are highlighted among them, it is important to make use of effective means to prevent, reduce or treat such complications. These complications are minimized by drugs, and by Physiotherapy. Positive results have been found after providing physiotherapy services in preoperative and postoperative pediatric cardiac surgery patients. This blog summarizes the efficacy of Pediatric Physiotherapy treatment through different techniques emphasizing the importance of early mobilization and ambulation and also promotes the application of physiotherapy pre and post-operative pediatric cardiac surgery.

 

PHYSIOTHERAPY

Physiotherapy in the pre-and postoperative period in pediatric cardiac surgery is used to reduce the risk of pulmonary complications like atelectasis, retention of secretions, and pneumonia. Physiotherapy interventions contribute to the appropriate ventilation and successful extubation.

 

Pre-operative Physiotherapy:

Physiotherapy techniques used are clearance, re-expansion, abdominal support, and guidance on the importance and objectives of physiotherapy intervention for parents.

 

Post-operative Physiotherapy:

Postoperative physiotherapy includes vibration in the chest wall, percussion, compression, manual hyperinflation, re-expansion maneuver, positioning, postural drainage, cough stimulation, aspiration, breathing exercises, mobilization, and acceleration of expiratory flow.

• After heart surgery, the child must be repositioned (approximately every two hours) throughout the day to ensure that the lungs stay well-expanded and free of mucous. This will also help the child to recover the movement. Whether the child is still on the breathing machine or is breathing by himself, the physiotherapist will check whether the lungs are clear of secretions. The physiotherapist will use techniques to help increase the air going to the lungs and to clear the secretions from the lungs. These techniques may include positioning, deep breathing exercise, chest percussion, and coughing.
• The child should start moving soon after the operation and the physiotherapist will help the child with sitting out of bed if the child is old enough, start walking in the first couple of days after surgery.
• Good positions post-operation includes turning the child onto the side, onto the back, holding him in the arms, and placing them into an infant seat. This will help the child recover sooner so that he can go home.
• Aspiration with the techniques of respiratory physiotherapy such as manual vibration, positioning, percussion, compression, manual hyperinflation, and postural drainage are found to be beneficial. Physiotherapy tends to produce improvement in pulmonary compliance, expiratory tidal volume, and pulmonary resistance.
• The treatment for atelectasis consists of physiotherapy, deep breathing, incentive spirometry, etc. However, sometimes, atelectasis is difficult to reverse and it is necessary to associate it with another method, respiratory physiotherapy, and inhalation of hypertonic saline solution with NaCl at 6% is recommended.
• Chest radiographs and four physiotherapy sessions lasting 20 minutes were performed daily, using maneuvers of bronchial hygiene, pulmonary re-expansion, postural drainage, and tracheal aspiration shows significant results. Immediately before and after physiotherapy inhalation of hypertonic saline solution with NaCl at 6% can be given.
• Breathing exercises are recommended in cases of atelectasis due to thoracic or upper abdominal surgery, because they improve respiratory efficiency, increase the diameter of the airways, which helps to dislodge secretions, prevent alveolar collapse, and facilitate the expansion of the lung and peripheral airways clearance.
• Significant increase in oxygen saturation and reduction in cardiac and respiratory rate after intervention with the increased expiratory flow in children with pneumonia has been proven and the physiotherapeutic technique for bronchial hygiene is found to be effective in improving lung function.
• When the presence of pulmonary complications is associated with other complications regarding the time of hospital stays, such as sepsis, pneumothorax, pleural effusion, and others, if the patient is treated by physiotherapy before and after surgery it shows a lower risk of developing such complications.

Post Surgery:

• Avoid activities that disturb the wound.
• Avoid lying on the tummy.
• Take care of the chest muscles and bones during any movement.
• Avoid lifting the toddlers under the arms. Lift the baby under the head/neck and bottom.
  
  

Physiotherapy is included in the multidisciplinary team that contributes significantly to the better prognosis of Pediatric patients undergoing heart surgery, as it prevents and treats pulmonary complications using various techniques. The effectiveness of physiotherapy in reducing the risk and/or treating pulmonary complications caused by surgical procedures in children with congenital heart disease has been proven.

World Heart Day | Maintaining Your Heart Health by Physiotherapy

29th September 2022 is celebrated as World Heart day. This day is observed to cater and manage the needs of the increasing number of patients who have undergone cardiac surgery. Cardiac rehabilitation is a treatment process that is found to be effective for patients suffering from a heart attack, coronary artery disease, heart failure, angina, or heart surgery. Cardiac Rehab is a complex intervention that includes Physical activity, Exercise training, and Cardiovascular risk management to improve the well-being and functional capacity of patients with heart disease. The treatment involves various healthcare professionals including healthcare providers, nurses, and rehabilitation specialists. A physiotherapist is one healthcare professional who works with the patient during cardiac rehab and designs an exercise program for the patient. These exercise programs are personalized according to the patient's needs. In this blog, we will guide you through what are the potential benefits and goals at each stage that you can aim for, as you move through the recovery phase of your cardiac condition.

CARDIAC REHABILITATION USUALLY PROGRESSES THROUGH THESE 4 PHASES:

Phase I starts when the patient is still in the hospital. Rehabilitation exercises and regimens are recommended and supervised by the experts at the hospital.

Phase II is when the patient is discharged from the hospital, cardiac rehabilitation usually involves outpatient care.

Phase III starts when the patients are prescribed to continue the cardiac rehab exercises and regimens on their own at home.

Phase IV starts when the patient continues to follow the guidance on exercise and lifestyle. The patient proceeds independently with the current exercise training. He/she should receive regular check-ups to make sure that he/she is effectively managing the heart condition and thus avoiding any flare-ups.

Phase I or clinical cardiac rehab:

Patients with acute heart conditions, such as those recovering from a heart attack or heart surgery, may be referred to a cardiac rehab team while still in the hospital. Phase I cardiac rehab starts in the hospital, and the physiotherapist helps to recover basic functional mobility. The patient is taught to learn techniques to monitor the activity. This phase likely lasts between 2 and 5 days, depending on the patient's physical condition. The physiotherapist designs and carefully monitors the progress and limits the exercise program to get the patient back on his/her feet again. This initially involves just sitting up in bed, standing, and testing the range of motion, before moving to short walks around the hospital wing.

 

Phase II or outpatient cardiac rehab:

Once the patient leaves the hospital, he/she can engage in phase 2 cardiac rehabilitation in an outpatient physiotherapy clinic.  Though the patient must still be having difficulty with functional mobility.  The physiotherapist will closely work with the patient to ensure a smooth transition into outpatient rehab. The patient is monitored through lifestyle changes and as he/she begins to progress with the exercise regime.

 

Phase III Post-cardiac rehab:

Phase III cardiac rehabilitation is the next step in the physiotherapy rehab program. Phase III cardiac rehab involves more intensive exercises and activities while simultaneously monitoring vital signs, such as blood pressure and heart rate, which should remain stable while workloads are increased to ensure a safe transition into phase III cardiac rehabilitation.

 

Physiotherapy Evaluation

The physiotherapist conducts the initial evaluation of phase 3 cardiac rehab, by asking the patient to perform various tests and measures to assess the functional ability.  During the initial evaluation in phase 3 cardiac rehab, the physiotherapist may also choose to perform a specific outcome measure to provide an objective measure of functional mobility. Outcomes measures are also used during phase 3 cardiac rehab including the timed up-and-go test and the 6-minute walk test.

During phase III of cardiac rehab, the physiotherapist aims to help the patient become more independent and informed. The patient learns how to self-monitor his heart rate and exertion levels during exercise.

Phase 3 cardiac rehabilitation mostly involves exercises. The physiotherapist prescribes specific exercises to improve the overall tolerance and endurance level for the activity. The exercises include working on a stationary bike, treadmill walking, flexibility, and upper and lower body strength exercises. Before starting phase III, the physiotherapist should ensure that the patient is fully capable of monitoring his/her exercise and activity intensity. These techniques may include checking the heart rate, using the Borg scale, or using a heart rate monitor to assess exercise intensity while working out. The therapist also teaches the patient simple talk test to monitor their activity level.

As the patient progresses through phase 3 cardiac rehab, the physiotherapist will prescribe more independent exercises and activities. Usually, the patient spends 3 to 4 weeks participating in phase 3 cardiac rehabilitation This is done to prepare the patient for phase 4 cardiac rehabilitation, independent exercise, and lifestyle modifications. The physiotherapist will ensure that the progress is safe through the program with the ultimate goal to move on to independent exercises in phase 4 cardiac rehabilitation.

 

Phase IV or Maintenance:

After the completion of the previous three stages of cardiac rehabilitation, the patient is well aware of the heart condition and how best to manage it. Independent exercise and conditioning are essential to maintain optimal health and prevent the possibility of future cardiac problems. While phase IV is an independent maintenance phase, the physiotherapist helps to make changes in the ongoing exercise routine to help achieve physical fitness and wellness. Phase 4 essentially continues for the rest of their life.

By working closely with the concerned physiotherapist and participating fully in the four phases of cardiac rehabilitation, the patient can increase the chances of returning to optimal health quickly and safely.

 

Cardiac Rehabilitation | Best Exercises after Heart Surgery

After the cardiac surgery, patients usually experience pain in the chest area, fatigue, and decreased exercise tolerance till recovery. So to enhance the process of recovery and promote independence, Physiotherapy plays a very crucial role. In this blog, we will be discussing the benefits of physiotherapy in patients who have undergone cardiac surgery.

 

Cardiac Surgery

Cardiac surgery is done if a person has coronary artery, ventricular aneurysms, rhythm disorders, or valve disease. Symptoms of the cardiac problem include shortness of breath, chest pain, sleep apnoea, palpitation, Types of cardiac surgeries include angioplasty, CABG, valve replacement, and pacemaker.

 

1: Angioplasty:

A thin flexible tube with a balloon at the tip is inflated at the narrowed section of the artery to widen the narrowed vessel. A stent is then left in place to keep the artery widened.

2: CABG:

Coronary artery bypass graft (CABG) is done by using a blood vessel graft taken from the chest, leg, or arm to bypass the blocked or narrowed coronary artery.

3: Valve Replacement:

Valve replacement involves removing the damaged valve and replacing it with an artificial valve made of human tissue or carbon fiber.

4: Pacemaker:

The pacemaker is an electrical device that helps to regulate the heartbeat.

 

Benefits of Physiotherapy

Physiotherapy helps to promote cardiovascular fitness and independence by designing a graduated exercise program to enhance functionality.

• Reduces pain.
• Reduces fatigue.
• Increases joint range of motion.
• Increases cardiovascular fitness and endurance.
• Increases muscle strength.
• Trains for transfers, like getting out and into the wheelchair, bed, and toilet.
• Promotes activities of daily life like climbing stairs, walking.
• Promotes independence.

Cardiac Rehabilitation Exercises Consist of 3 Parts

• Warm-up or stretching exercises
• Cardio exercises
• Strengthening exercises
• Cool-down exercises

Before starting blood pressure and heart rate are checked, warm-up is done for 15 minutes, then start the main exercise end with the cooldown exercise for 10 minutes and again check the blood pressure and heart rate.

 

Warm-up:

Always warm-up for 15 minutes with light exercise e.g. walking, marching on the spot, or low-level cycling, followed by stretching of the muscles, that reduces the risk of injuries.

 

Stretching Exercises Include:

 

1: Upper back stretch

Lock the fingers together with the arms stretched in front. Lower the head forward to look at the floor with feet moving. Hold the stretch for 10-15 seconds.

2: Chest stretch

Place the hands on the lower back. Gently move the elbows towards each other by keeping the back straight and feet moving. Hold the stretch for 10-15 seconds

3: Calf stretch

Press the heel of the back leg into the floor till a gentle stretch is felt in the back of the lower leg. Adjust the position by moving the back foot further back and the hips forward in case the stretch is not felt. Hold the stretch for 10-15 secs for each leg.

4: Hamstring stretch

Stand and lean forward slightly with one leg in front of the other and hands-on the hips. Slightly bend the back leg, straighten the front leg. Lean until a stretch is felt in the back of the leg placed. Hold for 10-15 seconds. Repeat on the other leg.

5: Front of thigh stretch

Put the left hand on the wall for support. Lift the right knee in front and hold the right ankle. Keeping the back straight, push the hip forward until a gentle stretch is felt. Hold the stretch for 10-15 secs and repeat with the other leg.

5: Pulse raising activities

During the last 5 minutes of warm-up, pulse-raising activities at a slightly higher intensity like walking, marching, cycling, etc are done. This helps to increase the heart rate and prepares the person for the main exercise session.

 

Cardiovascular Exercises:

After a warm-up and stretching exercises, cardio exercises are started. These exercises strengthen the heart muscles and help them to pump harder and faster. These aerobic exercises include:

• Stationery biking
• Elliptical machine exercising
• Jumping rope
• Walking
• Jogging
• Running
• Swimming
• Dancing
• Playing sports like soccer, tennis, basketball, etc.

 

Strengthening Exercises

Strengthening exercises keep the body in shape and increase the strength for daily activities like opening a jar or carrying groceries.

 

1: Monitoring the exercise level

One should ensure that the body is not pushed too hard during the rehabilitation program, there are various ways by which this can be checked, so that the exercises are done safely and effectively, under the supervision of a trained physiotherapist.

2: Measuring your heart rate (pulse)

Heart rate is the no, of times the heart beats per minute. It is an indicator of how hard the patient is working. During exercise the heart rate increases to fulfill the demand of working muscles to supply blood and oxygen.

The heart rate can be palpated between the tendons in the middle of the wrist and the bone on the outside of the up-turned arm, about 1 inch from the base of the thumb.

• Gently place the index and middle fingers over the area, feeling a slight pulse in the heart pushes blood around the body.
• Count the number of beats that are felt for 15 secs.
• Multiply this by 4 and this will give, how many times per minute the heartbeats, this gives the heart rate.
• The heart rate should be measured soon after each exercise before it starts to slow down

There is a recommended heart rate range when the exercise is started. The target heart rate is just a guide. Certain medications, like beta-blockers, affect the way the heart rate responds to exercise. It might not increase much. In case the top end of this range is reached there is no need to worry just reduce the level.

3: Effort score

Another way of measuring how hard the exercise is, measure the level of effort and give it a score of between 1 and 10.

During the stage of recovery moderate, somewhat strong exercise is recommended, if the effort level is strong, then the exercise is too hard and needs to slow down. The exercise level should be checked and kept within comfortable limits.

4: Talk test

This is another simple way of assessing how hard the exercise is. This test can be done by asking the person to talk, if the person is able to speak in complete sentences, then the exercise level is correct. Shortness of breath or gasp indicates that exercise is too hard and needs to slow down.

 

COOLDOWN:

Cooldown exercises are done for 10 minutes to bring the body back to its resting state, this reduces the risk of dizziness or fainting that can occur due to a sudden drop in blood pressure as a result of suddenly stopping exercise. Stretching during the cool down also helps to reduce muscle soreness that may be caused by the activity. The cool-down exercise should be performed at a slower speed.

 

Wear soft-soled shoes, tracksuits and keep a bottle of water by the side.