In the cardiovascular rehabilitation centre I work, we conduct aerobic exercise on recumbent bicycles, controlling heart rate. We also lead gym sessions that consist in dynamic global movements and analytic muscle reinforcement but don't monitor heart rate. Would it be preferable to control intensity during gym by measuring HR?
It will be of help if a patient develops any arrythmia during exercise which often happens and one cannot forsee. One should also have a backup for resuscitation measures and arrythmia management which we call as a crash trolley. All machines are checked for working daily before starting the day and drugs regularly fir expiry date.
Yes, specifically to forsee any arrythmia. A back up with a crash trolley with cpr drugs and defib should be checked every morning before starting the day
Hi there
It's an interesting dilemma. I no longer work in this field but when I did we used to avoid using HR to monitor exercise for a couple of reasons-
1. Many patients were on medications such as beta-blockers which artificially limit HR and make it unsuitable for guaging exercise intensity
2. The purpose of the rehabilitation sessions in Phase 2 was to enable and equip patients to self-monitor their activity and symptoms in the general community. If they are to successfully exercise out of the gym environment you don;t want them reliant on external monitoring or a number (HR) but on knowing their own body's response to activity and how that feels.
The only time we would use HR would be to show people (who weren't beta-blocked) that when they were feeling this level of exertion (using a Borg RPE scale) then their heart was doing a particular HR. Again, a tool to reinforce the idea that they need to listen to their body.
Of course I agree with Ankush above that you need to have appropriate safeguards in place- just don;t lose sight of the goals of Phase 2 CR!
I'd be interested in any counterpoints to this view.
Regards
David
First of all, it must be clarified that the time on the phase II is very relative and there is much disagreement about it. How long is the phase II? In my book, published in Brazil, entitled Cardiovascular Therapy: Evaluation and management of cardiac rehabilitation ", I chose to divide the phase II in Phase IIA and Phase IIB, because there is much disagreement about the time of it.
To answer your question, I would say that the HR monitoring whenever possible should be done for the safety of the patient and the control made by the therapist. However, in this phase a lot of patients are using beta-blockers and the HR is limited by the dose of the drug, also if the patient is in functional classes I and II show lower risk of cardiac problems during exercise, therefore the HR control can be smaller.
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