Give cardiac rehab patients tailored exercise programmes, says Scottish guideline

^{The guideline recommends individualised and tailored interventions for cardiac patients} 

This is one of the recommendations in an updated Scottish Intercollegiate Guidelines Network (SIGN) guideline on cardiac rehab, published on 26 July.

Aimed at physiotherapists and other health professionals, it provides evidence-based recommendations for best practice in the rehabilitation of patients with heart disease.

Fiona Brownlie, a specialist physio at Ninewells Hospital, Dundee, and Caroline Wilson, a specialist physio at Glasgow Royal Infirmary, were part of the guideline’s development group.

Speaking on behalf of the Association of Chartered Physiotherapists in Cardiac Rehabilitation, (ACPICR), Mrs Brownlie told Frontline: ‘The key message, from a physiotherapy perspective, is the need for individualised and tailored interventions for cardiac patients and a recognition of the many comorbidities this patient group presents with.

‘We need to have one-to-one assessments with patients and deliver exercise programmes in a range of settings, depending on what’s best for them.

‘That may mean a patient attends hospital or community-based exercise classes, which is the more traditional approach. Or they have a home exercise programme, which might be more suitable if it’s too far for them to travel to a class, or if they prefer to exercise alone. We have to accept that not everyone wants to exercise in a group setting.’

Quality of life and return to work

Other recommendations in the guideline include that

• goal setting and self-monitoring should be considered for cardiac rehab patients, to help adherence to physical activity
• aerobic and resistance exercises should be considered as part of an exercise prescription

‘Exercise is key in reducing cardiovascular mortality, reducing hospital admissions and improving quality of life, so it’s important that we do what we can to get engagement from patients,’ said Mrs Brownlie.

‘And we can support patients who have the potential to return to the workplace, by ensuring that the exercise prescription simulates anticipated activity in the workplace.’

Physio-led relaxation sessions

Mrs Brownlie added that physiotherapists could be involved in the psychological screening of cardiac rehab patients who have anxiety and depression.

‘Physios can also be involved in low tier psychological help, such as supervised relaxation sessions,’ she said.

Author: Robert Millett