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Cardiac precautions for non-acute inpatient settings
B J Fletcher1, S Dunbar, J Coleman
1Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, Georgia.
Summary
Cardiac rehabilitation guidelines for physically disabled patients with coronary artery disease can be liberalized. Exercise testing revealed safe ranges for heart rate and blood pressure, allowing for more activity progression.
Area of Science:
- Cardiology
- Rehabilitation Medicine
- Exercise Physiology
Background:
- Traditional cardiac precautions in rehabilitation are often conservative for physically disabled patients with cardiovascular disease.
- This may limit appropriate activity progression in non-acute inpatient settings.
Purpose of the Study:
- To evaluate exercise capacity and hemodynamic responses in physically disabled patients with coronary artery disease.
- To develop more liberalized activity guidelines for cardiac rehabilitation.
Main Methods:
- An adapted Schwade Arm Ergometer Protocol was used for exercise testing in 64 male patients (mean age 62.4 years).
- Continuous heart rate monitoring and intermittent blood pressure measurements were recorded.
- Electrocardiographic changes were monitored for ischemia.
Main Results:
- Patients reached a mean peak heart rate of 115 bpm and peak systolic/diastolic pressures of 169/89 mm Hg.
- Ischemic electrocardiographic changes occurred in only 4 patients.
- Achieved hemodynamic ranges support adjusted activity guidelines.
Conclusions:
- Current cardiac precautions may be overly restrictive for this patient population.
- Exercise testing provides a basis for developing safer, more liberalized activity guidelines for cardiac rehabilitation in physically disabled individuals.