REHABILITASI PENYAKIT JANTUNG

BAGIAN KARDIOLOGI & KV FKUNAND PUSAT JANTUNG REGIONAL RSUP DR M DJAMIL

DEFINISI REHABILITASI
Sejumlah intervensi yang diperlukan dalam upaya mengembalikan kondisi penderita sebaik mungkin secara fisik, psikologis dan sosial, sehingga penderita penyakit jantung kronis atau akut pasca perawatan dengan usaha sendiri mampu pulih dan kembali kepada lingkungannya secara memadai , termasuk prevensi sekunder.
*WHO,1964 **AHA,AACVPR,1999

REHABILITASI
Membuat pasien Pasca Infark Pasca SKA Pasca Bedah Gagal Jantung pulih kembali , berfungsi dengan normal mencegah komplikasi.

Rehabilitasi Jantung Masa Kini

RESTORATION REHABILITATION OVERCOME OR SOLVE OR RETURN TO THE BETTER OR BEST CONDITION OR PREVIOUS LIFE PHYSICALLY, PSYCHOLOGIC, SOCIALY, MARITAL, OCCUPATIONAL

DEFINISI REHABILITASI
1988 Public Health Service di America : Rehabilitasi jantung merupakan pelayanan yang komprehensif, program jangka panjang meliputi evaluasi medik, penyusunan program latihan, modifikasi faktor risiko, edukasi dan konseling. Upaya meminimalkan efek fisiologi dan psikologi dari proses penyakit, sehingga memberikan manfaat secara psikososial maupun status vokasional. Menurunkan risiko untuk kematian mendadak atau infark berulang, mengatasi keluhan kardiak, menstabilkan atau memundurkan proses aterosklerosis,

CARDIAC REHABILITATION Phase I (Inpatient / Prevent De-condition) 7 14 days, target 1.5 km 3 Mets Phase II (Ambulatory outpatient / Intervention) 4 8 weeks, target 3 km/3 min 6 Mets

Phase III (Maintenance and Secondary Prevention) 3 6 months

KOMPONEN INTI REHABILITASI JANTUNG

1. UKUR KONDISI PASEN 2. KONSELING NUTRISI 3. TATA LAKSANA BERAT BADAN 4. TATA LAKSANA TEKANAN DARAH 5. TATA LAKSANA LIPID 6. TATA LAKSANA DIABETES 7. STOP MEROKOK 8. TATA LAKSANA PSIKOSOSIAL 9. KONSELING AKTIFITAS FISIK 10. LATIHAN FISIK EXERCISE TRAINING

PROSEDUR BAKU TIAP KOMPONEN

1.EVALUASI 2. INTERVENSI 3. HASIL DIPERKIRAKAN

PENILAIAN PASEN
EVALUASI
RIWAYAT PENYAKIT, SEBELUM DAN SAAT INI , PROSEDUR MEDIS PCI,CABG, OP KATUP, KOREKTIF PENYAKIT PENYERTA ( STROKE, GINJAL,PAD ), FAKTOR RISIKO DM-HPERTENSI-LIPID ,FUNGSI VENTRIKEL PEMERIKSAAN FISIK ;LENGKAP ,TENSI, NADI, REGULAR-TIDAK, BEKAS LUKA OPERASI, ANGGOTA GERAK , FUNGSI KOGNITIF HASIL UJI LATIH , EKG 12 HANTARAN, TREADMILL TEST, 6 WT ,BORG SCLE

A CORNER STONE OF CARDIAC REHAB

EXERCISE TRAINING IN CARDIAC REHABILITATION

The exercise training is based upon socalled aerobic or dynamic exercise, designed to improve physical performance at both maximal and submaximal levels
Even with low intensity for stable Heart Failure

A mile stone of fundamental exercise program Changes in VO2 max with bed rest and training
I/min 50

MAKSIMAL OKSIGEN UPTAKE

50

40

40

30

30

20

20

10

10

0 0 21 10 20 30 40 50 60

Days
From : Saltin B, Blomqvist G, Mitchell JH, et al: Response to exercise after bed rest and after training. Circulation 37-38 (suppl.VII): I,1968

Mobility /Physically Active better than Immobility

PHYSICAL PERFORMANCE
Recommendation

Exercise training is recommended to improve physical performance (exercise tolerance, muscular strength and symptoms) Strength of evidence = 1

KOMPONEN INTI REHABILITASI JANTUNG

PHYSICAL ACTIVITY COUNSELING

EXERCISE TRAINING EVALUATION

INTERVENTION

EXPECTED OUTCOMES
Pasen paham tentang keselamatan latihan, mengetahui tanda& gaejala peringatan. Pasen meningkat tingkat kebugaran jassmani dan fleksibilitas, daya tahan dan kekutan otot. Keluhan berkurang, meningkat respon physiologis dan kondisi kualitas hidup lebih baik. Risiko Kardiovaskular dan mortalitas menurun sebagai akibat program rehabilitasi dan prevensi sekunder termasuk latihan fisik

Home exercise programs

Recommendation
A home exercise program is recommended for those patients who are unable to attend a group exercise program. A daily home walking program is recommended as a supplementary activity for all patients enrolled in a group program. Strength of evidence = 2

Psychological functioning

Recommendation
Exercise training is recommended to improve psychological functioning (anxiety, depression, wellbeing)

Strength of evidence = 2

IMPROVEMENT OF QUALITY OF LIFE

What is Quality of Life? Desire for better quality of life is what makes us human Everyone has a different perception of quality of life This perception changes over time (dynamic) Quality of Life: It is what makes us happy

TERIMA KASIH, PULIH KEMBALI DGN BAIK

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