Activity guidelines for early subacute and high-risk cardiac patients

Research in exercise physiology indicates that energy cost can only be used as a rough index in the selection of activity for cardiac patients because it does not accurately predict the cardiac stress associated with any given activity for any given individual. A framework is presented in this paper for occupational therapy assessment of function in the cardiac patient based on determination of cardiac stress with activity through skilled clinical observation employing telemetry EKG, auscultation, and blood pressure recording. Clear activity guidelines are then formulated, using a scientific data base and including modification of activity to reduce cardiac stress. The procedure for skilled clinical observation of function in cardiac patients is described and data are presented from the use of this procedure to evaluate early subacute and high-risk cardiac patients during self-care in an acute hospital.