Speakers

Miss. Nora Fu

Ms FU had worked in various specialties in public outpatient, inpatient and day rehabilitation setting in different hospitals including the Queen Elizabeth Hospital, the Buddhist Hospital and the Grantham Hospital for since 1995. She had more than many years experience working in various cardiac rehabilitation setting, including coronary care unit, cardiac medical unit, out-patient and day rehabilitation for cardiac rehabilitation setting.

Ms FU obtained her Bachelor degree in Physiotherapy in The Hong Kong Polytechnic University in 1995, and obtained her Master of Science in Exercise and Nutrition Science in the University of Liverpool in 2004.

Ms FU was the team in-charge of the cardiac care unit and ambulatory cardiac rehabilitation since 2017, and became the department manager of physiotherapy in Grantham Hospital in 2022.

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Abstract

Exercise Prescription in Cardiac Rehabilitation-Range of Motion and Resistance Training

Range of motion(ROM) is the extent of osteokinematic motion available for movement activities. It improves upper and lower limbs ROM, improve pulmonary function, ease pain, improve mobility and self-care performance.

Table 1. Exercise prescription of ROM exercise 

Component

Recommendation

Frequency (F)

  1. ≥ 2-3 days/ week, ideally daily

Intensity (I)

  1. Hold to a position of tightness or slight/ mild discomfort (not pain)
  2. slow, controlled manner

Time (T)

  1. Gradually increase to 15-30 sec
  2. breathing normally
  3. Do 3-5 repetitions for each ex

Type (T)

  1. Static stretching
  2. major tendon and muscle groups

Data from ACSM (2018); Williams et al. (2007)

Resistance training cause muscles to contract against an external resistance. It increases muscle mass, muscle strength & endurance, ROM. Also, it improves cardiovascular disease risk factors and hasten return to vocational and recreational activities.

Table 2. Exercise prescription of resistive training

Component

Recommendation

Frequency (F)
  1. 2 or 3 nonconsecutive days/ week

Intensity (I)
  1. Use resistance that allow 10-15 rep without significant fatigue (RPE 11-13 on Borg 6-20 scale)
  2. Complete movement through as full a ROM as possible

Time (T)
  1.  1-3 sets per exercise, avoiding significant fatigue
  2. 8-10 different ex using all major muscle groups of the upper and lower body

Type (T)
  1. Free weights, weight machine, resistance band, pulley weight, dumbbell, light wrist and ankle weights
  2. Select equipment that is safe, comfortable, effective and accessible

Abbreviation: RPE: rating of perceived exertion; BP: blood pressure
Data from ACSM (2018); Williams et al. (2007)

Precaution during resistance training included avoiding breath holding and straining (Valsalva maneuver) by exhaling during the exertion phase of the motion and inhaling during the recovery phase. Moreover, maintain a secure but not overly tight grip on the weight handles or bar to prevent as excessive BP response.
Both range of motion and resistance training exercises are the two of cores in cardiac rehabilitation. They help patients speed up recovery, return to daily activity and improve quality of life. Exercise prescription and exercise progression should be tailored according to the specific need of patients. Furthermore, special cautions should be taken after sternotomy.

 

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