CMFT offers a hospital based cardiac rehabilitation programme within the Platt 1 Rehabilitation Unit gym at Manchester Royal Infirmary (MRI). Ideally it commences two to four weeks after your heart event (there may be a waiting list in the short term).
Manchester Royal Infirmary is a tertiary centre, whereby patients access our services from around the region. Although we recommend a referral back to local cardiac rehabilitation programmes, we will accept patients from across the region into our programme based on choice as long as the GP agrees to this.
You may be referred into the cardiac rehabilitation programme by the CMFT ward staff, specialist nurses and consultants. Referrals are also accepted from GP’s and other hospitals.
Patients included
We include patients with the following conditions:
- Myocardial Infarct (MI)
- Revascularisation procedures including angioplasty, coronary artery bypass surgery
- Valve repairs / replacements
- Heart Failure
- Heart Transplant
- Adult Congenital Heart Disease
- Pacemaker
- Implanted Cardiac Defibrillator
- Angina
Initial assessment
You are invited to attend an individual assessment which takes approximately 1hr 15mins with one of the members of the cardiac rehabilitation team. During the assessment you can discuss your event and recovery, risk factors and make plans for the future including for secondary prevention. We mayoffer you a submaximal exercise test during the assessment itself to assess your baseline fitness. The assessment aims to identify and prioritise your goals.
Following an assessment of your needs, you will be offered to attend our comprehensive cardiac rehabilitation programme; options include:
- Exercise, education, psychological intervention
- Education and advice only
- Psychological intervention only
- Group exercise only
- Home exercise programme
- Pedometer walking programme
- One to one exercise
- Written information
Exercise class
You are offered the opportunity to attend up to eight exercise sessions (once a week for eight weeks)
Exercise sessions run from 10.30am to 12:00pm on Monday or Wednesdays in Platt 1 Rehabilitation gym, MRI.
The exercise session is a group based session of people with various heart conditions and of mixed abilities. All patients are prescribed an individualised exercise programme specific to their needs. This is determined though a sub maximal functional assessment, assessment of other medical issues and identification of individual goals.
Many people are lacking in confidence following their hospital stay and are unsure how much activity they should be doing. The aim of the exercise programme is to educate you how to return to activities or exercise safely, through working at the appropriate level, and experiencing the normal response to exercise.
Response to the exercise session is assessed through monitoring your heart rate, self reported perceived exertion, blood pressure responses as well as observation. As your fitness improves the exercise prescription is progressed accordingly.
The exercise session comprises of:
- Prescreen, including measurements of heart rate and blood pressure
- 15 minute graduated warm up
- 10 minute exercise circuit completed twice
- 10 minute cool down
- Refreshments
Patients complete individualised progressive, supervised exercise.
Patients are excluded if they have:
- Severe valve disease
- Unstable angina
- Acute heart failure (within the past 3 months)
- Uncontrolled hypertension, hypotension
- Significant uncontrolled non cardiac disease e.g. respiratory, diabetes.
- Severe musculoskeletal/neurological disorders.
Once these conditions have been stabilised, these patient groups can then access the Cardiac Rehabilitation service.
Reference: Association of Chartered Physiotherapists in Cardiac Rehabilitation – ACPICR Standards for physical activity and exercise in the cardiac population (2009)
Education
- Education and relaxation sessions follow on from the exercise session and run from 12:00pm – 12:45pm and are held in the Platt 2 meetings room.
- The sessions are interactive and aim to provide education as well as answering queries which you may have
Education topics include:
- Why exercise – A talk on why it is important to exercise, the latest recommendations and structure of a safe exercise session.
- Heart disease – Explanation of heart conditions including treatments and investigations. This talk will also help you understand the various risk factors which can contribute to heart problems.
- Relaxation 15 minute relaxation session concentrating on breathing techniques. The opportunity to discuss with any cardiac rehab team member your individual progress, any concerns and set yourself some short term goals to achieve.
- Stress – Identifying the signs and symptoms of stress and how you may use coping strategies to reduce this risk factor.
- Medication – All your questions answered on why it is necessary to take heart medications, how they work and potential side effects.
- Food issues – The dietician will talk through the principles of healthy eating and the eatwell plate.
- Skills for lifestyle change – How to make and maintain changes in your life for the good of your heart and general health.
Having a heart problem can be an anxious time. We assess and support any patient concerns.
Cardiac Rehabilitation includes
The benefits of cardiac rehabilitation include:
- Reduce death from heart disease by 26 – 36%
- Reduces unplanned admissions to hospital by 28 – 56%
- Improved quality of life
- Improved functional capacity
- Regain confidence -to support return to social and vocational activities.
- Psychological recovery – In the months following a heart attack, up to 30% of patients may have clinically significant levels of anxiety, and up to 20% may have a significant degree of depression.
- Improved management of social issues such as returning to employment
- Helps people to change poor health habits and live a healthy lifestyle
Achieving the physical activity guidelines will reduce cardiovascular events by 30%, the risk of heart attack by 40%, and the total risk of CHD by 50% and that’s just for cardiovascular diseases!
Reference: BACPR Cardiovascular disease prevention and rehabilitation 2012
In this section