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cardiac rehab Cheat Sheet (DRAFT) by

met levels, stages of cardiac rehab

This is a draft cheat sheet. It is a work in progress and is not finished yet.

phases of cardiac rehab - inpatient

met
precau­tions
activities
monitoring
begins at met levels 1-2 target level is 3.5
No isometric exercises or muscle streng­thening work No overhead or lateral upper body activity No exercise if person has the following condit­ions: unstable angina, uncont­rolled arrhyt­hmia, acute myocardial infarction (heart attack), deep vein thrombosis (DVT), or severe aortic stenosis
Patient education in the following areas: ● Energy conser­vation ● Work simpli­fic­ation ● Risk factors ● Smoking cessation Light activity if regular pulse is 100 bpm or less
Take vital signs (blood pressure, pulse, respir­ation) at the beginning of each activity, at the peak of each activity, at the end of each activity, and 4-5 minutes after each activity.

stages of activity levels 1-3

stage 1
met level
adl restri­ctions
recrea­tional activities
exercise activities
I
1-1.4
Sitting up is allowed for short periods. Self-f­eeding, washing hands and face, bed mobility, transfers.
Sitting: Reading, radio, non-co­mpe­titive table games, light handwork.
Can exercise all extrem­ities in supine (10-15x, at a time). Can only sit to exercise neck and lower extrem­ities.
II
1.4-2.0
Sitting up is allowed as tolerated – no limita­tions to sitting. Sitting: Self-b­athing, shaving, dressing, grooming.
Sitting: Crafts, painting, knitting, sewing, mosaics, embroi­dery.
May exercise all extrem­ities but NO ISOMETRICS or streng­thening exercises are allowed. AROM to all extrem­ities, progre­ssively increasing number of repeti­tions. Walking at slow pace in room, as tolerated
III
2.0-3.0
Sitting: Showering in warm water. Sitting: Ironing, housek­eeping tasks with brief standing periods to transfer light items.
Sitting: card playing, crafts, piano, machine sewing, typing.
Sitting: wheelchair mobility limited distances Standing: AROM exercises to all extrem­ities, progre­ssively increasing number of reps. May include: balance exercises, light mat work with no resistance Walking on a zero gradient and comfor­table pace is allowed.
 

phases of cardiac rehab - outpatient

met
precau­tions
activities
monitoring
begins at 4-5 target is 5-6
Build up activity tolerance gradually May start graded weight training 2-4 weeks after the initial cardiac event
Continued patient education as in Phase I Practice work simpli­fic­ation and energy conser­vation techniques Gradual graded exercise Gradual graded weight training Home evaluation Work site evaluation if applicable May be referred to a work hardening program if needed
Continued monitoring of vital signs during and after activity

stages of activity levels 4-6

stage
met level
adl restri­ctions
recrea­tional activities
exercise activities
IV
3.0-3.5
Standing: showering in warm water, self, dressing, shaving, grooming, Light housek­eeping tasks while standing, using energy conser­vation – light vacuuming, dusting, sweeping, washing light clothing.
Bowling, slow canoeing, golf putting, light gardening -planting, driving.
Standing: all previous exercise, progre­ssively increasing number of reps and speed. May include balance and mat exercises with light resist­ance. Walking: unlimited, zero gradient, progre­ssing speed/­dur­ation for up to 15-20 min or target HR reached. May begin walking on a treadmill at 1 to 1.5 mph, at a 1-2% grade. Stairs: May begin slow stair climbing up to 2 flights. Cycling: up to 5 mph with no resist­ance.
V
3.5-4.0
Standing: washing dishes, washing clothes, ironing, hanging light clothes, making beds.
Slow swimming, light carpentry, golfing, light home repairs.
Sitting: More resistance may be added to exercises completed while sitting, up to 10 lbs. Standing: continue with previous exercises, progre­ssively increasing number of reps and speed. Walking: Unlimited, increasing speed up to 2.5mph, on level surfaces. Stairs: Increase tolerance. Cycling: up to 8 mph with no resist­ance.
VI
4.0+
Standing: showering in hot water, hangin­g/w­ringing clothes, mopping, stripping and making beds, raking.
Swimmi­ng-no advanced strokes, slow dancing, slow ice or roller skating, volley­ball, badminton, table tennis, light calist­henics.
Sitting: Exercising upper and lower extrem­ities, up to 10-15 lbs. Walking: increase speed to 3.5 mph. Cycling up to 10 mph, no resist­ance.
 

cardiac rehab - phase 3

met level
precau­tions
activities
monitoring
begins at level 5-6
Patient is educated in precau­tions and self monitors during activity.
Mainte­nance gym exercise program Weight training Cardio­vas­cular exercise
Mainte­nance gym exercise program Weight training Cardio­vas­cular exercise