WS-1-01-02
CLINICAL PRACTICE GUIDELINE CARDIAC REHABILITATION
N.K. Wenqer, E.S. Froelicher, L.K. Smith, et al (U.S. Agency for Health Care Policy and Research, Rockville, Maryland, USA)
The Clinical Practice Guideline "Cardiac Rehabilitation," released in 1995 by the U.S. Agency for Health Care Policy and Research, characterizes cardic rehabilitation as comprehensive long-term services involving medical evaluation; prescribed exercise; cardiac risk factor modification; and education, counseling, and behavioral interventions. The most substantial documented benefits of cardiac rehabilitation include improvement in exercise tolerance, improvement in symptoms, improvement in blood lipid levels, reduction in cigarette smoking, improvement in psychosocial well-being and reduction of stress, and reduction in mortality. The Clinical Practice Guideline also highlighted alternate approaches to the delivery of cardiac rehabilitation services, other than traditional supervised group interventions, for carefully selected, clinically stable coronary patients.
WS-1-01-03
CONTEMPORARY CARDIAC REHABILITATION: ROLE OF EXERCISE TRAINING
Barry A. Franklin (William Beaumont Hospital, Royal Oak, Michigan, USA)
The treatment of coronary artery disease has evolved from simple lifestyle modification in the mid-to-late 1960s, largely focused on early ambulation and exercise training, to an array of costly medical and surgical interventions that too often fail to address the underlying causes -- high-fat and cholesterol diets, cigarette smoking, hypertension, and physical inactivity. Intensive measures to control hyperlipidemia with diet, drugs, and exercise, especially in combination, have now been shown to stabilize or even reverse the otherwise inexorable progression of atherosclerotic coronary artery disease. Added benefits include a reduction in anginal symptoms, decreases in exercise-induced myocardial ischemia, fewer recurrent cardiac events, and diminished need for coronary revascularization. This presentation will focus on the role of exercise training in the treatment of patients with heart disease, with specific reference to functional capacity, cardiac function, coronary risk factors, psychosocial well-being, and morbidity/mortality. Pathophysiologic outcomes, special patient populations, and the safety of exercise training will also be discussed.
