Cardiac rehabilitation is the process by which a person who is suffering from ischaemic heart disease, or who has had a myocardial infarction (MI), is encouraged to achieve their full potential in terms of physical and psychological health. In order to be successful, cardiac rehabilitation must draw on the skills of many members of the healthcare team and involve a combination of education, psychological support, exercise training and behavioural change.
Although the mechanism by which it occurs is not yet fully understood, cardiac rehabilitation which includes a programme of structured exercise is now generally believed not only to improve morbidity but also to reduce mortality in patients who have suffered an MI. It has been thought for many years that all patients, regardless of gender or age, who have ischaemic heart disease and/or cardiac failure, might benefit from cardiac rehabilitation. For optimal effect, cardiac rehabilitation programmes should be structured and tailored to the individual patient following an initial assessment. Computer support systems have been shown to assist the decision-making process.
Cardiac rehabilitation is one of the National Priority Projects on the NHS's improvement agenda. The National Institute for Health and Clinical Excellence (NICE) outlines the clear benefits of these services, including improving survival and quality of life and reducing unplanned hospital admissions. The British Association for Cardiac Rehabilitation (BACR) specifically identifies the cardiac specialist nurse as a core member of the cardiac rehabilitation team. Intervention by a specialist nurse can substantially reduce the length of hospital stay, hospital costs and the risk of readmission to hospital for heart failure
We offer community based group rehab classes and personal training delivered by BACPR (British Association of Cardiac Prevention & Rehabilitation) qualified instructors. Take Heart Group Classes: Brighton - Stanley Deason, Peacehaven, Portslade, Preston Park
Phase 1: the initial stage following MI or cardiac event
Phase 2: the post-discharge stage
The early discharge period is the time at which the patient is the most vulnerable and psychological distress at this stage is a predictor of poor outcome and increased use of hospital services independent of the physical damage to the heart.[ Patients should be screened for anxiety and depression at this stage and should be treated with suitable non-cardiotoxic antidepressants if appropriate.
Phase 3: structured exercise and rehabilitation
Graded exercise is a vital component of cardiac rehabilitation, although it does not alter morbidity and mortality rates if offered in isolation. Aerobic low-to-moderate intensity exercise will be suitable for most patients who have been assessed as low-to-moderate risk. This form of exercise programme may generally be undertaken either at home or under supervision in the community, eg graded exercise programmes in leisure centres where staff have received basic life support training. One meta-analysis confirmed that light-to-moderate exercise in a group setting offered the greatest benefit in terms of improved quality of life. Exercise training for high-risk patients would normally be carried out in a hospital or other suitable venue able to provide facilities and staff trained in resuscitation should this prove necessary.
Graded exercise should be accompanied at this stage by other interventions tailored to meet the individual patient's requirements. Lifestyle changes should be encouraged and supported where appropriate, eg weight reduction, smoking cessation, retraining with a view to returning to work. This is likely to be accompanied by education concerning the cardiac condition and the reasons why changes in lifestyle might be desirable.
Phase 4: long-term maintenance
In order to be effective, physical activity and changes in lifestyle need to be maintained for the long-term. BSTHG provides community-based Phase IV exercise classes for cardiac patients designed to improve and maintain their physical, psychological and social wellbeing. These services include group exercise classes and personal training delivered by BACPR (British Association of Cardiac Prevention & Rehabilitation) qualified instructors. BSTHG provides weekly exercise classes in Brighton, Hove, Portslade, Peacehaven and Newhaven.
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