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By Nanette Wenger

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Additional resources for Cardiac Rehabilitation: A Guide to Practice in the 21st Century (Fundamental and Clinical Cardiology)

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Both moderate and vigorous habitual physical activity have been associated with reduced risk for fatal cardiac events in people with CVD or at high risk for CVD; however, uncertainty exists regarding the minimal and optimal intensity and duration of exercise required to reduce CVD mortality. Data also are inadequate as to the role of physical activity status or exercise training in primary or secondary prevention of stroke. In evaluating the safety of exercise cardiac rehabilitation, it was the Consensus Panel's judgment that the risk of death was very low during medically supervised exercise programs; however, it was recognized that previously sedentary individuals with poor functional capacity were at higher risk than other CVD patients for fatal complications during exercise.

Several important goals of cardiac rehabilitation are also enumerated: improved functional capacity, improved or lessened activity-related symptoms, reduced disability, and identification and modification of coronary artery disease risk factors in an effort to reduce subsequent cardiovascular-related morbidity and mortality. THE NATIONAL INSTITUTES OF HEALTH CONSENSUS DEVELOPMENT PANEL ON PHYSICAL ACTIVITY AND CARDIOVASCULAR HEALTH This consensus conference emphasized that more than 10 million Americans have cardiovascular disease and that increased physical activity appears to benefit these patients.

Of 61 cardiovascular events reported during the exercise training of cardiac patients, at least 44 (72%) occurred during either the warm-up or cool-down phases (20). Conditioning Phase The endurance or stimulus phase serves to directly stimulate the oxygen transport system and maximize caloric expenditure. This phase should be prescribed in specific terms of intensity, frequency, duration, and mode of exercise training (Fig. 5). Intensity The prescribed exercise intensity should be above a threshold level required to induce a "training effect," yet below the metabolic load that evokes abnormal signs or symptoms.

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