Another service provided by the department is Prehabilitation (Prehab), where patients are recruited early into an exercise programme before their surgery. With Singapore’s ageing population, the conventional way of starting rehabilitation only after an operation may face more complexities due to co-morbidities, frailty, and psychosocial factors. A research study demonstrated that preoperative exercise intervention significantly reduced post-operative pulmonary complications and decreased the length of hospital stay in older patients2.
Throwing fun and safety into the mix
Recognising that some patients find it challenging to adhere to standard exercise sessions, the team introduced exergaming to the repertoire of interventions at the outpatient service.
“With exergaming, we inject a fun element into an otherwise ordinary regime. Carefully selected video games were introduced to encourage large muscle activity and rigorous exercise, facilitating balance and strength training with an enjoyable twist compared to traditional methods,” shared Michael Khoo, Physiotherapist.
Benefits of cardiac rehabilitation
After a cardiac event such as a major surgery like coronary artery bypass grafting or smaller procedures like percutaneous coronary interventions (example, stenting), patients enrolled in a cardiac rehabilitation programme would experience a multitude of benefits. It helps to significantly improve their exercise capacity and cardiorespiratory function, and enhance their quality of life including physical functioning, emotional well-being, and social integration.
Research has also evidenced how cardiac rehabilitation is associated with lower cardiovascular mortality rates, fewer recurrent cardiac events, and reduced hospitalisations among patients with coronary artery disease3.
“The exercises seem overly strenuous or unnecessary after a cardiac event.”
Patients will be educated on when and how they can do their exercises and the suitable level of activity after a cardiac event. The intensity of exercises will also progress gradually.
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“I am physically well so I do not need cardiac rehabilitation.”
Despite being physically well, patients might still have cardiac risk factors (e.g. hypertension, diabetes) which may be improved through cardiac rehabilitation.
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"‘One Size Fits All’ so it does not benefit me."
The NHCS cardiac rehabilitation programme considers the patient's medical history, current condition, and personal goals to create a customised plan for optimal recovery.
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The NHCS cardiac rehabilitation programme is for NHCS patients and by referrals only.
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Typical programme for NHCS Cardiac Physiotherapy and Rehabilitation Services Patients:
Exercise sessions at NHCS
- Once or twice weekly for eight weeks
- One-to-one or group exercise class based on medical condition and functional ability
- Guided and supervised rehabilitation, including aerobic, flexibility and resistance exercises
Exercise sessions at home- Exercise safely and conveniently at home with instructions and guidance from cardiac physiotherapists for suitable patients.
Education- Attend virtual educational talks or one-to-one counselling and education sessions with nurses
REFERENCES
1. Ramos Dos Santos, P. M., Aquaroni Ricci, N., Aparecida Bordignon Suster, É., de Moraes Paisani, D., & Dias Chiavegato, L. (2017). Effects of early mobilisation in patients after cardiac surgery: a systematic review. Physiotherapy, 103(1), 1–12. https://doi.org/10.1016/j.physio.2016.08.003
2. Snowdon D, Haines TP and Skinner EH. Preoperative intervention reduces postoperative pulmonary complica- tions but not length of stay in cardiac surgical patients: a systematic review. J Physiother 2014; 60(2): 66–77.
3. Dibben, G. O., Faulkner, J., Oldridge, N., Rees, K., Thompson, D. R., Zwisler, A. D., & Taylor, R. S. (2023). Exercise-based cardiac rehabilitation for coronary heart disease: a meta-analysis. European heart journal, 44(6), 452–469. https://doi.org/10.1093/eurheartj/ehac747
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