Authors

• Žaklina Muminović — Poliklinika za prevenciju kardiovaskularnih bolesti i rehabilitaciju, Zagreb, Hrvatska — ORCID: 0000-0001-6037-7537
• Mario Ivanuša — Poliklinika za prevenciju kardiovaskularnih bolesti i rehabilitaciju, Zagreb, Hrvatska — ORCID: 0000-0002-6426-6831

Abstract

The Outpatient Cardiovascular Rehabilitation Program (AKVR) is a component of secondary prevention of cardiovascular diseases. It is present in large urban areas and is tailored to patients who are indicated such a type of rehabilitation. The AKVR program is conducted in teams by applying interdisciplinary and transdisciplinary approach. Bachelor of Physiotherapy is an important team member and he conducts the physiotherapy treatment (FT) under the supervision of a cardiologist and in agreement with a physiatrist. Following the cardiovascular risk stratification, FT treatment starts by identifying the objectives aimed at the improvement of the patient’s functional capacity, psychological stabilization, preparation for social reintegration and recovery of work capacity. It is continued by conducting the high quality and comprehensive FT assessment (subjective and objective SOAP, ICF) that includes anthropometric measurements and therapeutic education of a patient and his/her family members. In addition, discomforts are identified and recorded, thereby recognizing a need for further diagnosis accompanied by mandatory documenting all stages and aspects of the FT treatment. An individual intervention program by using FT procedures, starting from therapeutic exercises, interval training, riding a modern rehabilitation computer-controlled bicycle to education on the guidelines and laws of the physical activity, the importance of proper breathing, relaxation techniques, posture improvement, etc is determined. Patients are rehabilitated either in groups or individually according to the professional rules and the protocol on teamwork, accompanied by continuous telemetric monitoring of the electrocardiogram that monitors the exertion tolerance and clinical status. A final FT assessment and evaluation is made following the program conducted. All the procedures are documented in the patients’ records and are calculated in accordance with diagnostic and therapeutic procedures in secondary healthcare prescribed by the Croatian Health Insurance Fund. (1-4) Bachelor of Physiotherapy will by applying professional, cognitive, social and communication skills perform various forms of FT program in the Department for Outpatient Rehabilitation of Institute (**Table 1**). He insists on the fact that movement is a medicine, and that continuous physical activity is essential to the health. ### TABLE 1: Forms of physiotherapeutic interventions in the Department for Outpatient Rehabilitation of Institute for the Prevention of Cardiovascular Diseases and Rehabilitation, Zagreb. | | **Group** **AKVR** | **Individualized** **AKVR** | **Individual** **AKVR** | **Physical exercises organized in the afternoon** | **Public Health** **Actions** | | --- | --- | --- | --- | --- | --- | | Warming-up & flexibility | + | +/- | +/- | + | +/- | | Movement coordination | + | + | + | + | +/- | | Interval training | + | + | +/- | + | +/- | | Cooling down | + | + | +/- | + | +/- | | Medical equipment for active rehabilitation | + | + | + | + | + | | Computer-controlled rehabilitation bicycle | + | - | - | + | - | | Electrocardiogram monitoring | + | + | + | - | - | | Monitoring of vital signs and general condition | + | + | + | +/- | - | | Monitoring Borg scale of perceived exertion | + | + | + | +/- | - | | Monitoring of breathing, posture and positioning | + | + | + | +/- | +/- | | Therapeutic education | + | + | + | +/- | +/- | | Duration of the program | 12 weeks | 12 weeks | 12 weeks | At the patient’s choice | During the time of the action | | Number of organized medical gymnastics sessions a week | 3-5 | 2-3 | 1-2 | 2 | - | [†] AKVR = outpatient cardiovascular rehabilitation

Keywords

cardiovascular rehabilitation, physiotherapy treatment

DOI

Literature

1. Ivanuša M, Narančić Skorić K, Glavaš Vražić S, Kruhek Leontić D, Heinrich K, Mažuran Brkljačić L, et al. Outpatient Cardiovascular Rehabilitation in Croatia. Cardiol Croat. 2015;10(1-2):28–42. https://doi.org/10.15836/ccar.2015.28
2. Muminović Ž, Brkljačić Mažuran L, Dražić-Balov J, Glavaš Vražić S, Ivanuša M. I am active, therefore I am: physiotherapy interventions in cardiovascular rehabilitation. Cardiol Croat. 2016;11(10-11):548–9. https://doi.org/10.15836/ccar2016.548
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