Cardiovascular disease rehabilitation is not “one-size-fits-all.” It is a structured, progressive prescription that balances safety, symptom monitoring, and measurable improvements in aerobic capacity, muscular strength, and functional independence.

For students, the challenge is translating guidelines into a simple plan you can defend clinically. You need to know what to start with, what to watch, and how to progress without provoking ischemia, arrhythmia, excessive blood pressure responses, or undue fatigue.

In coursework and clinical write-ups, resources like https://writepaper.com/ can help you organize the rationale and present a clear prescription format. But the rehab plan itself still needs sound clinical logic: screen first, dose appropriately, and progress based on response rather than enthusiasm.

Below is a pragmatic template centered on three foundational exercises most students should know: walking (or cycling), sit-to-stand, and step-ups. These cover aerobic conditioning plus lower-limb functional strength, which correlates strongly with daily activity and fall risk.

Safety Screen and Contraindications Before You Prescribe

Before you prescribe any exercise, confirm the patient is medically cleared for activity and that you understand their diagnosis and procedure, such as myocardial infarction, PCI, CABG, heart failure, or valve surgery. Collect resting vitals, symptom history, medications (especially beta blockers), and red flags.

Key safety checks include:

• Resting heart rate and blood pressure, plus orthostatic changes
• Symptoms at rest: chest discomfort, dyspnea, dizziness, palpitations
• Recent decompensation: fluid overload, weight gain, worsening edema
• Wound status and sternal precautions if post-sternotomy
• Current risk stratification and any exercise test results if available

Stop exercise and escalate if there is chest pain, severe shortness of breath, syncope, new neurologic symptoms, or concerning rhythm changes. When in doubt, reduce intensity, reassess vitals, and refer back to the supervising clinician.

How to Set Intensity, Duration, and Frequency

Students often over-rely on heart rate targets. In real practice, heart rate can be blunted by beta blockers and distorted by anxiety, dehydration, anemia, or atrial fibrillation. Use a multi-signal approach:

• RPE (Rating of Perceived Exertion): Aim for light to moderate, often RPE 11–13 on the Borg 6–20 scale early on.
• Talk test: The patient should be able to speak in full sentences.
• Symptoms and vitals: Watch blood pressure response and recovery.

A starter dosing framework is 3–5 days per week of aerobic work, beginning with short bouts that accumulate to 10–20 minutes, then gradually building toward 30 minutes as tolerated. Add functional resistance training 2–3 nonconsecutive days per week, emphasizing technique and breathing to avoid Valsalva.

Exercise 1: Walking Prescription (Aerobic Base Builder)

Walking is the most accessible aerobic modality, scalable from hallway ambulation to treadmill intervals. It also translates directly to community independence.

Prescription example:

• Frequency: 4–5 days/week
• Intensity: RPE 11–13, talk test positive
• Time: Start 10–15 minutes total using intervals (for example, 2 minutes walk, 1 minute easy pace repeated)
• Progression: Increase total time by 10–20% per week if recovery is good and symptoms remain stable

Coaching cues: upright posture, relaxed shoulders, and smooth breathing. If the patient uses a device, prioritize safe gait mechanics over speed. Consider indoor walking for temperature extremes, as heat and cold can meaningfully alter cardiovascular load.

Exercise 2: Sit-to-Stand (Functional Strength Without Fancy Equipment)

Sit-to-stand targets quadriceps and gluteal strength, improves transfers, and is easy to standardize. It is also a good “functional test” embedded inside training.

Prescription example:

• Frequency: 2–3 days/week
• Dose: 2–3 sets of 6–10 reps
• Rest: 60–90 seconds between sets
• Intensity: Last 2 reps should feel challenging but controlled, no breath-holding

Progression options: lower the chair height slightly, add a brief pause at the bottom, or add load with a light dumbbell held close to the chest. Regress by using hands on armrests, raising seat height, or reducing reps.

Exercise 3: Step-Ups (Strength Plus Cardiovascular Demand)

Step-ups bridge rehab and real life because stairs are a common barrier after cardiovascular events. Step height and pace make this highly adjustable, but also easy to overshoot intensity if you are not careful.

Prescription example:

• Frequency: 2–3 days/week, often after walking warm-up
• Dose: 2–3 sets of 6–8 reps per leg
• Step height: Start low (10–15 cm)
• Intensity: RPE stays in the light to moderate range

Technique cues: full foot on the step, drive through the heel, control the descent, and keep the knee tracking over the toes. If balance is limited, use a rail lightly but avoid leaning heavily, which can reduce training effect and increase risk.

Progression Rules Students Can Defend in a Care Plan

Progression should be objective, incremental, and tied to response. Use these simple rules when documenting your plan:

• Progress one variable at a time: time, then frequency, then intensity
• Increase weekly volume gradually, often 10–20% if tolerance is good
• Require stable symptoms and normal recovery before increasing load
• If setbacks occur, reduce volume for 3–7 days and rebuild

Here is a practical checklist you can paste into a note:

• Add 2–5 minutes to walking time when RPE stays ≤13 and recovery is easy
• Add 1–2 reps to sit-to-stand sets before adding load
• Increase step height only after the patient controls the descent and maintains form
• Re-check resting and post-exercise vitals if medications or symptoms change

Monitoring, Documentation, and When to Refer

Students are expected to document clearly baseline vitals, the prescribed dose, patient response, and the next-step progression. Also note the education provided, such as warning signs and home safety.

Monitor:

• Pre, during, post symptoms (chest pressure, dyspnea, dizziness)
• Perceived exertion and talk test
• Blood pressure and heart rate response when appropriate
• Recovery time to near-baseline breathing and heart rate

Refer back to the supervising clinician or cardiology team if the patient develops new angina-like symptoms, unusual shortness of breath, syncope, rapid weight gain, or signs of fluid overload.

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