Q. I’m not able to understand, in exercise prescription for cardiac patients, how to determine the exercise/rest ratio for inpatient, outpatient cardiac patients.

A.

Cardiac Rehabilitation has come a long way from the initial ‘bed-rest’ approach used to treat ST-elevation myocardial infarction (STEMI) and advances in medical technology have led to a shorter duration of hospitalization.

Exercises have been seen to be beneficial for patients with coronary artery disease (CAD). However, vigorous exercises can have disastrous effects. Therefore, it is essential to have a gradation of exercises for a patient with CAD in order to prevent sudden cardiac complications during the exercise.

The American College of Sports Medicine (ACSM) recommendations for exercise intensity in phase 1 of Cardiac Rehabilitation among post MI (myocardial infarction) patients include, training the patient up to a heart rate of 120 beats per minute, guided by symptoms of chest pain and dyspnea (Borg’s rating of perceived exertion < 13) and interval training with bouts of exercises lasting from three to five minutes or as tolerated, interspersed with adequate rest periods in order to achieve an exercise / rest ratio of 2 : 1.

Ref; Babu A S, Noone M S, Haneef M and Naryanan S N. Protocol-Guided Phase-1 Cardiac Rehabilitation in Patients with ST-Elevation Myocardial Infarction in A Rural Hospital. Heart Views. 2010 Jun-Aug; 11(2): 52–56.