Exercise for Coronary Heart Disease Patients

Exercise for Coronary Heart Disease Patients

Coronary heart disease (CHD) is a term used to describe atherosclerotic heart disease, which involves the hardening and narrowing of coronary arteries that supply blood to the heart. This condition leads to reduced blood flow, causing myocardial ischemia, angina, and in severe cases, heart attack or sudden cardiac death. CHD is one of the leading causes of death and a major chronic disease affecting human health.

(1) Objectives of Exercise for Coronary Heart Disease Patients

Based on the progression of CHD and the characteristics of rehabilitation, CHD rehabilitation is divided into three stages internationally: the inpatient stage, the recovery stage, and the chronic stage. The inpatient stage (Phase I) refers to the period when patients are hospitalized for acute myocardial infarction or acute coronary syndrome. The primary rehabilitation content includes education and low-level physical activities. The recovery stage (Phase II) is the period from patient discharge to complete stabilization, usually about 5 weeks. The main rehabilitation focus is on gradually increasing physical activities to prepare for returning to work. The chronic stage (Phase III) refers to the phase when the patient's condition is in a stable state for a long period or the stage after Phase II for CHD patients, including old myocardial infarction, stable angina, and asymptomatic CHD. Exercise during the chronic stage is an effective means to promote recovery, prevent acute recurrence, and improve various bodily functions. Through exercise, patients can improve their lipid metabolism, prevent and alleviate the deposition of atherosclerotic plaques in blood vessel walls, promote collateral circulation, improve blood flow in ischemic areas, increase myocardial blood supply and oxygen delivery, enhance cardiac efficiency, reduce cardiac workload, and lower the risk factors for CHD. Exercise also helps in restoring physical strength, reducing the impact of various risk factors, preventing CHD recurrence, and improving the patient's quality of life and self-care ability to maximize their cardiac potential. Furthermore, it shifts the patient's focus away from the disease, mobilizes their internal positive factors, overcomes resistance to exercise, and enables patients to proactively understand the patterns of activity and rest, which aids in reducing or alleviating angina attacks.

(2) Key Points for Exercise in Coronary Heart Disease Patients

Firstly, the first two stages of CHD rehabilitation and treatment are managed by hospital and outpatient doctors. Patients need to follow medical advice for corresponding exercise. During the hospitalization and immediately after discharge, exercise mainly includes movements around the bed or bedside, such as sitting up, walking in the ward, and climbing stairs.

Secondly, the implementation of exercise during the stable period of the disease should also be conducted under the permission and guidance of a doctor. Before exercising, a functional test must be done to determine the safe and effective exercise intensity, ensuring the effectiveness of the exercise and preventing accidents.

Thirdly, during exercise, different types of exercises can be chosen based on the patient's subjective and objective conditions, emphasizing the coordination of whole-body movements. The exercise intensity should be well-controlled, and the patient should learn to adjust the intensity based on changes in heart rate and self-feeling during exercise. There should be no apparent fatigue or discomfort during exercise. Before exercise, a 3-5 minute warm-up should be done, and a 5-10 minute cool-down after exercise to allow the body to gradually adapt before and after exercise.

Fourthly, when choosing exercise activities, movements should progress from easy to difficult, simple to complex, and the exercise intensity should gradually increase, progressing step by step, and be consistent. Gradually, the body will adapt to the exercise, and the exercise effect will continuously accumulate until satisfactory fitness results are achieved.

Fifthly, within 2 hours before exercise, patients should avoid full meals or drinking stimulating beverages. After exercise, avoid taking a hot bath immediately to prevent a drop in blood pressure and heart arrhythmias. During exercise, to complement the exercise, patients should have a balanced diet, enhance nutrition, ensure sufficient sleep, and regularly observe the recovery of the disease to adjust the exercise plan at any time.

(3) Selection of Exercise for Coronary Heart Disease Patients

Everyday Physical Activities

Everyday physical activities such as household chores, shopping, etc., should be included as part of the exercise program to maximize the patient's ability to return to daily life and work.

Rhythmic Aerobic Exercise

Rhythmic aerobic exercise is the fundamental rehabilitation exercise for CHD patients. Common aerobic exercise activities include fitness qigong, slow walking, brisk walking, indoor treadmill running, stationary cycling, jogging, cycling, Tai Chi, and swimming.

Strength Training

Most CHD patients are encouraged to participate in strength training. During strength exercise, patients should perform slow and full stretching movements, avoiding tension and breath-holding. Patients should maintain regular breathing during exercise and pay attention to medical supervision. The main methods of strength training for CHD patients include static strength exercises and cyclic dynamic strength training. Static strength exercises can involve ankle joint static backstretch and static leg lift, gradually progressing to standing postures, squatting, and other exercises. The cyclic dynamic strength training can utilize resistance bands, light weights, or low-load equipment.

Comprehensive Exercises

Comprehensive exercises include relaxation exercises, medical gymnastics, and flexibility training, etc.