1. Low-risk patients: unmonitored exercise can be performed;
2. Intermediate-risk patients: intermittent monitoring is required;
3. High-risk patients: cardiac rehabilitation exercise must be performed under strict continuous dynamic monitoring.
If acute chest pain, pallor, cold sweat, nausea, vomiting, dizziness, or increased blood pressure, accelerated heart rate, or abnormal joint or muscle pain occurs during exercise, stop exercising immediately and seek medical attention.
1 Purpose of cardiac rehabilitation exerciseThe purpose of cardiac rehabilitation exercise is to improve the functioning level of the heart, change the natural course of the disease, reduce the incidence of heart failure and the rate of death, and improve the quality of life. Studies have confirmed that the purpose of cardiac rehabilitation can be achieved through comprehensive measures such as reducing risk factors, improving lifestyle and exercise training[2].2 Methods of rehabilitation trainingThe main forms of exercise for patients with HF are medical walking, pedaling, abdominal breathing, tai chi, qigong, relaxation therapy, medical gymnastics, etc. The training process should be gradual and progressive. The training process should be gradual, avoiding over-training, and the exercise mode and exercise volume should be selected according to the patient's condition and function.2.r et al[3,4] reported the 6-minute walking exercise test for the first time, and concluded that it was a safe, simple, and most commonly used fixed-time exercise test, which was able to independently indicate the morbidity and mortality of patients with LV insufficiency.3.r et al[3,4] reported the 6-minute walking exercise test as a safe, simple, and most commonly used fixed-time exercise test. Patients were asked to walk for 6 minutes on a flat surface as far as they could, and were categorized into 4 grades according to the walking distance, i.e. grade 1: distance <300m, grade 2: 300~374.9m, grade 3: 375~449m, and grade 4: distance >450m. Different grades represented the corresponding cardiac functions and suggested different prognoses. The study proved that the 6-minute walking exercise test is the most suitable exercise mode for chronic HF patients, which is close to the patients' daily life, can reflect the patients' exercise ability and cardiac function status, and can be used as an index to evaluate whether the drug treatment can improve the patients' exercise ability and quality of life. Pan Demao [5] proposed a graded exercise program for 34 HF patients with reference to the 6-minute walking exercise test, which is shown in the table. Table 16-minute walking exercise test for 34 HF patients proposed graded exercise program activity group cardiac function graded exercise content energy level (METS) Ⅰ Ⅳ 1) Immediately after the stabilization of the condition, passive exercise, moving the shoulders, elbows, knees joints, each time 5 ~ 10min, 1 ~ 2 times / day. 2) to help get out of bed to sit on the sofa or straight-backed chairs, the beginning of the 10 ~ 30min, 1 ~ 2 times / day, gradually increase the time. 3) help get out of bed to sit on the sofa or straight-backed chairs, beginning of the 10 ~ 30min, 1 ~ 2 times / day, and gradually increase the time. 4) to help patients to sit on the couch or straight-backed chairs, starting 10~30min, 1 ~ 2 times / day, gradually increase the time. 3)Help to get out of bed to eat and wash face.1~2.5 Level II Grade III 1)Standing at bedside and walking slowly indoor.2)Walking 100m/times indoor,2times/day,change clothes by self,sit to defecate,take a warm bath.2.5~33~4 Level II Grade II 1)Walking 500m/times by corridor,2times/day,going up one flight of stairs,2times/day,able to defecate in sitting position by self,take a bath standing up.2)Walking 1000m/times,1~2times/day,help to get out of bed to sit on couch or straight-backed chair,start 10~30min,1~2times/day, gradually increase the time.3)Help to get out of bed to eat and wash face.1~2.5 Grade II Grade II Grade II 1)Standing at bedside and slow walking indoor. ) Walking 1000 meters / times, 2 times / day, or cycling 15min, 2 times / day, feasible tai chi, aerobics and other general recreational activities.4 ~ 55 ~ 62.2 Abdominal breathing training Coats et al [6] found that 17 HF patients after 8 weeks of cross, controlled exercise training, abdominal breathing training is also a method of rehabilitation therapy for HF patients. Abdominal breathing exercise can massage the stagnant liver and spleen, reduce visceral stasis, improve visceral function and blood rheology, reduce venous thrombosis and prevent pneumonia. During abdominal breathing, maximal inspiratory volume, maximal cardiac output and output per beat increase significantly, resistance of body circulation decreases significantly, heart rate variability increases, and high-frequency component of heart rate variability increases, which shows that the index of phytoneurological function improves.2.3 Medical gymnastics and taijiquanWhen the cardiac function recovers to grade II or less than grade II, the person can perform whole-body rhythmic gymnastics and taijiquan exercises. When doing medical gymnastics and taijiquan, the exercise intensity should be moderate, the movement should not be overly forceful, and there should be moderate rhythm, i.e., it should not be too fast or too intense. Breathing should be smooth, there should be no closed air phenomenon, so as not to produce the Valsalve effect, aggravate the heart heart load. 2.4 Warm therapy according to Japan's "Medical Tribune" reported [7], set the appropriate water temperature, bath time of the warm bath or sauna, can reduce the peripheral vascular resistance, increase the volume of cardiac outflow, so as to improve the state of blood circulation. After analyzed by cardiac ultrasound, electrocardiogram, cardiac catheterization, and expiratory measurement, the bath can achieve the purpose of vasodilatation and improvement of blood circulation. The test results showed that 10 minutes of 41℃ water bath or 15 minutes of 60℃ sauna bath did not cause burden to the patients and had the best effect. The author analyzed the immediate effect of 26 cases of idiopathic dilated cardiomyopathy and 8 cases of ischemic heart disease patients receiving warm therapy. The average age of the patients was 58 years old, left ventricular ejection fraction was 25%, NYHA classification belonged to class II in 2 cases, class III in 19 cases, and class IV in 13 cases. The patients were dressed as soon as possible after getting out of the bath using a semi-sitting type automatic elevating bathtub.