We often say that exercise should not be excessive, in fact, rest should not be excessive. For some special people and special circumstances, too much rest is harmful instead.
Recently, there have been a few "special" patients in the clinic who are not very energetic because they have rested too much.
One of the patients, who had two stents placed, asked, "I used to like to go for a walk in the morning and at dusk, but after I had the stents done at the end of last year, I didn't dare to go out for fear that the stents would fall off. Now my body feels worse and worse and my meals have dropped quite a bit." Another heart attack patient asked me, "Since I had a heart attack last year I've tried to be as inactive as possible, giving up the square dancing I used to do all the time, and even paying attention to going up and down the stairs. But I always feel uncomfortable and have no energy." The **** same thing for these two patients is that they were completely insulated from exercise after their illness/surgery, and they were on bed rest at every opportunity, and as a result, their physical fitness deteriorated after a long period of rest.
The question arises: must patients lie down after heart attacks and stents?
Life is movement! This saying is true, both healthy and sick people should choose the right exercise depending on the situation. Therefore, heart attack patients and patients who have stents put in need to exercise as well.
How to exercise after stenting
The first thing to do is to reassure the patient in this article that he is "worried".
It should be noted that there are a number of people in similar situations in the clinic who have questioned the issue of stent "dislodgement". In fact, this is superfluous, if because of the fear of falling off to reduce the activity or even do not exercise is not scientific. First of all, most of the interventional stents are made of special alloy materials, which have very good support and corrosion resistance, and their molding function is also very reliable; secondly, the stent is set tightly on the inner wall of the blood vessel through high pressure during the interventional procedure. Second, the stent is tightly set on the inner wall of the vessel by high pressure during the interventional procedure, so it is rare to hear of rust, collapse, or significant displacement of the stent placed in the patient.
This shows that the stents themselves are very safe and do not fail unexpectedly with exercise. So what are the benefits of exercise for stent patients? Taken together, reasonable exercise for stent patients can reduce postoperative stenosis of recanalized blood vessels, reduce platelet aggregation, increase fibrinolysis, eliminate nervousness, and ultimately improve cardiac function and prevent secondary infarctions.
Exercise after stenting should be evaluated by a professional physician, and the "exercise load test" is an important monitoring index. Through detailed assessment and risk stratification, the doctor will formulate an "exercise prescription" based on individualized principles. (Patients with unstable angina, cardiac function class IV, uncontrolled severe arrhythmia, and uncontrolled hypertension should be deferred from exercise rehabilitation)
Generally speaking, post-stenting exercise rehabilitation should be done in stages: 1. During hospitalization. Exercise rehabilitation should be carried out under cardiac and blood pressure monitoring, and the time to get out of bed should be determined according to the severity of the disease. If the condition is mild, you can walk around indoors when you are 24 hours old, but if the condition is serious, you need to stay in bed for 4-5 days or even longer. Choose in-hospital activities that are lightweight, such as walking; 2. Within 1-6 months after discharge from the hospital. If you have recovered well after surgery and your body is relaxed, you can do some mild aerobic exercise (walking, jogging) and impedance exercise (lifting dumbbells) etc. in a gradual manner. Warm up before activity and relax after activity for 30-90 minutes; 3. After 1 year of stenting. The out-of-hospital long-term rehabilitation phase should form a stable and regular exercise habit, such as cycling and square dancing. In order to ensure the stability of the condition, patients should go to the hospital for review on time.
PS: Many patients ask that after one or two years of stenting their body feels very good, so they want to play soccer or basketball, in my opinion strenuous sports should still be avoided as much as possible.
Overall, the intensity of exercise after stenting should not be too high, and comfort should be the standard. Theoretically, as long as the patient can tolerate it, the intensity can be slowly increased. However, if chest tightness, shortness of breath, asthma, chest pain and fatigue occur during exercise, the activity should be stopped immediately.
How to exercise for heart attack patients
"I've had a heart attack for a year, can I run?" "I've had a heart attack before, can I never exercise again?" Such questions are common in outpatient clinics.
Despite the fact that a large number of heart attack patients are often induced by excessive exercise intensity, research has found that appropriate exercise after a heart attack is conducive to the establishment of myocardial collateral circulation to alleviate the condition, while prolonged bed rest will lead to further deterioration of cardiac function. However, the choice of exercise for patients with heart attack should be gradual, and different exercise programs should be adopted at different times:
1. Heart attack period (within 48 hours of the onset of the disease): low activity, mainly upper and lower limbs passive exercise, especially to avoid elevating the lower limbs, so as to avoid the return of blood flow to the heart to aggravate the burden;
2. Acute late stage (the onset of the disease 3 to 7 days): the patients who have been out of the danger of the disease can be appropriate to increase the amount of exercise, under supervision and supervision, to increase the amount of exercise. Increase the amount of exercise, under the supervision of simple walking exercise;
3. Early discharge (heart attack 3 months after discharge): the rehabilitation period after discharge, need to attending physician according to the patient's level of risk to stratify, through the cardiopulmonary exercise test to detect the patient's anaerobic metabolic threshold, and then determine the intensity of exercise;
4. Stabilization period (heart attack after 3 months): the patient's condition is more stable, can be performed 3 times a week. Stabilization period (after 3 months of infarction): the patient's condition is relatively stable, and the patient can exercise 3 to 5 times a week, and the intensity can be increased slowly, with regular review.
At present, it is advocated that patients with myocardial infarction should focus on aerobic exercise, i.e., the human body in the case of adequate oxygen supply to exercise, such as jogging, swimming, walking, gardening, square dancing and playing tai chi, etc., and anaerobic exercise, such as sprinting, basketball, push-ups, etc., should be avoided as much as possible.
For many stable heart attack patients, they can monitor their "heart function" to arrange the intensity of exercise.
For many stable heart attack patients, they can monitor their heart function to arrange the intensity of exercise. Here is a 6-minute walk test:
Select a 30-50-meter promenade or open road and measure the distance you walk as fast as you can in 6 minutes (and back). Normal healthy people can walk 400-700 meters, mild cardiac insufficiency walk 426-550 meters, moderate cardiac insufficiency walk 150-425 meters, less than 150 meters is severe cardiac insufficiency. Good heart function can be more exercise, bad less exercise. If the process of chest tightness, shortness of breath, dizziness and nausea and other uncomfortable symptoms, we must immediately stop the activity.
For heart attack patients, what time to exercise is also a matter of concern. Many people say that the morning sun activity is the best, in fact, not, this time is more likely to break out sudden death, so early morning activity is not the most preferred, afternoon or evening is better.
In March of this year, the journal JACC published a study from Norway, assessing the relationship between changes in the intensity of physical activity and mortality in patients with coronary heart disease. The study included 3,307 patients with coronary artery disease in total***, and 1,493 patients died during the 30-year follow-up period. The study found that maintaining a low or high activity intensity reduced the risk of death compared with patients who did not exercise.
More than a century ago, patients with serious heart disease were required to be absolutely bedridden. With the passage of time, that understanding has been rejected. An earlier study from Sweden on the relationship between exercise and heart failure found that people who walked or bicycled for at least 20 minutes a day were 20 percent less likely to have heart failure than those who were active for less than 20 minutes. Not coincidentally, the American College of Cardiology also issued a recommendation to the public "150 minutes of moderate exercise per week". This shows that proper exercise is really good for cardiovascular health.
Of course, there is a lot to be said for how cardiac patients in recovery should exercise, and that lies in timely and accurate risk assessment and personalized exercise programs. This means that what kind of patient does what kind of exercise, and the length of the exercise is as precise as possible. This is how to get the most out of exercise.