| Aerobic Progression | Resistive Exercise | Monitoring |
Week 1-3 | Walking - stop and go start with 1/4 mile, and work up to 1/2 mile | body movement in planes of action of actual training range of motion | *target HR *blood pressure *level of perceived exertion |
Goals: increase functional abilities without causing increased pain, improving flexibility, and finding the right schedule to guarantee success.
Month 2-4 | Walking program increasing time and terrain Introduction to aerobic machines 2-3 days per week | Light dumb bells and resistance exercise bands - work on increasing intensity and stations Month 3 - include work on major muscle groups on strength machines | Target HR (during and post exercise) Level of perceived exertionMonitor blood pressure once per day
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Goals: improve abilities by 10-25% in time on aerobics, overall strength, and make necessary changes in schedule to secure success in adherence.
Month 4-6 | Regular exercise 3-5 days per week in an individual or group walking, machine, or classroom activity at 55-75% of VO2 | 2-3 days per week of general strength work using major group stations (chest, hips, back, thighs, shoulders) and dumb bell/band exercises for smaller muscle groups | Monitor laboratory blood lipid levelsTarget HR Resting BP once per day |
Goals: improvement in flexibility in shoulders, low back, and hip region. Expand types of exercises performed to boredom is minimal. Improvement in strength by an additional 5-10%.
Month 6-8 | 3-5 days of 30 minute aerobic conditioning | 8 strength stations performed for major muscle groups 2-4 sets of 10-15 reps on each | HR BP RPE |
Goals: Maintain a constant program. Find unique and creative ways to keep on a scheduled training regime.
Month 8-10 | Coninue 3-5 days of 30 minute training | 10-12 strength stations for major and minor muscle groups | HR RPE |
Month 10-12 | 3-5 days of 30-45 minute training, aerobic classes, movement, stress reduction | strength stations, aquatic resistance, increase use of dumb bells and free weights | HR RPE |
Goals: Annual medical exam to see changes in lipid status, body weight, aerobic capacity, and other indices that may have improved as a result of regular conditioning.
Changes in Cardiac Rehab Practices
Out-patient based programs
The past two years have seen a shift from the traditional cardiac rehab setting (hospitals, clinics, etc.) to a more out-patient program. There are cardiac programs in health clubs under the title of post-rehab (or After Care, post Med Care, etc.). These programs are staffed by exercise physiologists who are ACSM certified, or physical therapists who have all or part of their practice within the health club. The advantage to this program is a larger facility, more equipment, long term membership contract (at a lower price than initial treatment), and a non-clinical environment to exercise in.