Rehabilitive Kardiologie

Thirty chapters written by renowned scholars, researchers and clinicians from the field of cardiopulmonary rehabilitation, offering readers both a broad overview of the field and an in-depth analysis of contemporary issues facing practitioners.

The increasing frequency of coronary diseases, the still insufficient results of prevention have brought physicians to try to reduce as much as possible the con sequences of ischaemic heart disease. Coronary units and new treatments have some what reduced the dramatic complications of the acute phase; but after the latter, evil effects of the disease remain at the physiological, psychological and social level. It is the aim of rehabi~itation to analyze these problems, to reduce them or to solve them whenever possible. When this conception of "complete coronary care" took the lead, the necon ditioning effects of heart disease and of immobilization on physical conditi ons were emphasized: physical training programmes were prepared and their main lines and physiological effects are now fairly well known. But it was soon obvious that the psychological problems raised by the patient and his environment 'are equally important. Their approach is however much more difficult and their treatment particularly complex. So, the Council on Rehabilitation of the International Society of Cardiology is really grateful to Professor Dr. HALHUBER and Dr. Dr. STOCKSMEIER for giving the opportunity to specialists to discuss together this particular aspect of coronary disease. The discussions have been devoted to the methods of approaching the patient as well as to the therapeutic aspects and the role of psychologists in the rehabilitation programmes: some papers have been devoted also to the possible role of the personality as a risk factor in the development of the disease.

Cardiac rehabilitation is of key importance to ameliorate long-term morbidity and mortality resulting from cardiac intervention. However, much of the current literature is dense, unwelcoming and academic in style and format. For those physicians understanding the scope of cardiac rehabilitation there is a need to distill the guidelines and various management options available to them into a concise practical manual. Up until now, all references have looked at the general options, but there is definite need to investigate the practicalities of individual patient groups. This book fulfills the need for practical guidance among all professionals involved in the management of these patients, from residents and fellows of cardiology and internal medicine, surgical teams, physiotherapy professionals, critical care physicians and family medicine practitioners.

In recent years, research has demonstrated that exercise programs can benefit patients with chronic obstructive pulmonary disease (COPD) and patients with congestive heart failure (CHF). Yet many physicians do not refer such patients to any kind of exercise or rehabilitation program. Advances in Cardiopulmonary Rehabilitation examines the history of how pulmonary and cardiac diseases have been treated and shows how that history tends to constrain contemporary thinking in spite of significant advances in treatment. -Why do only a small percentage of eligible patients enroll in cardiopulmonary rehab programs? -What percentage of patients can be helped, and in what ways? -What are the most cost-efficient allocations of scarce financial resources for cardiac and pulmonary patients? The contributors to this book address these questions and provide answers that are challenging and often quite surprising. The First Québec International Symposium on Cardiopulmonary Rehabilitation was held in Québec City in May 1999, bringing together experts from around the world to discuss every aspect of cardiopulmonary rehabilitation. Editors Jean Jobin, PhD, François Maltais, MD, Pierre LeBlanc, MD, and Clermont Simard, PhD, selected the most groundbreaking papers presented at the conference and expanded on several of them for this reference. The book offers review articles and some original research. The editors' comprehensive introduction and conclusion provide an invaluable synthesis and overview of current understanding and future directions for cardiopulmonary rehabilitation. Whether you are a clinician, a researcher, an educator, or an administrator, Advances in Cardiopulmonary Rehabilitation will give you -an understanding of how trends in cardiopulmonary rehabilitation during the past century affect current practices, -hard data that will help you determine the best practices in cardiopulmonary rehabilitation, -data that will enhance your ability to treat patients you may have assumed were untreatable, and -a clear overview of recent research in cardiopulmonary rehabilitation. Part I explains not only what has happened in the past, but how past and current practices may influence the future. Part II offers thorough scientific reviews of pharmacological treatment for CHF and COPD. Part III, offers the clearest discussion available--accompanied by extensive data--of how to decide who should be referred and who should not. Part IV discusses peripheral muscle limitations and dysfunction. Part V addresses risks and benefits for different kinds of patients, home exercise programs for COPD patients, interactions between exercise and left ventricular remodeling, and effects of temperature extremes on people with cardiovascular disease. Part VI explains how cardiopulmonary illness, as well as various rehab approaches, affect a patient's psychosocial health, and examines economic evaluations of rehab programs. Part VII deals with factors that affect quality of life and how to measure outcomes of treatment in terms of quality of life. Finally, part VIII looks to the future--what is likely to happen in the areas of technology, pharmacology, psychosocial factors, and self-help care. This well-researched volume (more than 2,200 bibliographical references) is essential for anyone who deals with cardiac or pulmonary patients. This is the only single volume that probes the scientific, clinical, economic, and even psychosocial frontiers of cardiac and pulmonary rehabilitation.

This detailed reference provides practical strategies and a scientific foundation for designing and implementing cardiac rehabilitation services to relieve the symptoms of cardiovascular disease patients through exercise training and risk reduction and secondary prevention, improve quality of life, and decrease mortality. Emphasizes multidisciplinary care that includes exercise training, behavioral interventions, and education and counseling regarding lifestyle changes and other aspects of secondary prevention! Written by world-renowned physicians, nurses, exercise physiologists, psychologists, dietitians, educators, and counselors in the field, Cardiac Rehabilitation presents evidence-based medicine as the cornerstone of clinical cardiology practice discusses interventions that limit the physiological and psychological effects of cardiac illness offers guidelines that enable elderly patients to maintain self-sufficiency and functional independence describes means of social and workplace reintegration evaluates policies for maintaining high-quality care, efficacy, and safety in an atmosphere of diminishing resources explains the role of managed care in moving rehabilitative care into the home, workplace, and other nontraditional sites assesses new interactive technologies that aid in tracking patient data gives pragmatic recommendations for the delivery of cardiac rehabilitative care in the next millenium and more! Advocating integrated, high-quality, consistent cardiac rehabilitation services for the well-being of patients recovering from a variety of cardiovascular problems and procedures, Cardiac Rehabilitation is ideally suited for all medical professionals working in this field.

The aim of this textbook is to give guidance in prevention, lifestyle counselling and rehabilitation for cardiologists, other physicians and many different categories of health professionals in cardiac rehabilitation teams.

This book contains the proceedings of a conference organized by the Klinik Hohenried at the Evangelische Akademie in Tutzing under the patronage of the International Society of Cardiology - Council on Rehabilitation - from Febr. 12-14, 1981. The purpose of the meeting on Current Problems in Cardiac Rehabili tation was to come closer to answering the questions posed in the fol lowing pages, and to make some opinions about cardiac rehabili tation less contoversial. To comment briefly on the interesting question of why opinions in the field of cardiac rehabilitation seem more controversial than in other fields of cardiology, we would like to propose the following explanation: 1. Lack of personal experience and lack of special training in cardiac rehabilitation are a major source of misunderstandings and differ ences of vocabulary between cardiologists engaged in clinical practice and in rehabilitation. 2. Emotional problems in accepting a new kind of partnership between coronary patients and their physicians and a "nihilistic attitude" towards therapy of behaviour play an important role in the scepti cism of cardiologists. 3. Fear of an expensive "overmedication" (I. Illich) is another argu ment concerning rehabilitation.