Education Sessions

Scientific & Clinical Abstracts | Speaker Index | Education Sessions | Online Syllabus

Wednesday, October 2, 2013

6:00pm – 7:00pm 

105: AACVPR Guidelines for Cardiac Rehabilitation and Secondary Prevention Programs, 5th Edition
Karen Lui, GRQ Consulting, LLC; Jeffrey L. Roitman, Rockhurst University; Mark A. Williams, Creighton University School of Medicine
Track: Cardiovascular Rehabilitation & Clinical Cardiology
Join the editors for a “book tour” and discussion of the newly released edition of the AACVPR Guidelines for Cardiac Rehabilitation and Secondary Prevention Programs. This is the fifth edition of the guidelines, the most up-to-date and definitive resource for developing inpatient and outpatient cardiac rehabilitation programs.

Thursday, October 3, 2013

9:45am – 10:45pm

201: Integrating Cardiac Rehabilitation Strategies into the Oncology Setting: A Novel Framework for Disease Prevention in Cancer Survivors
Kim Dittus, University of Vermont; Susan Lakoski, University of Vermont; Patrick Savage, Fletcher Allen Health Care
Track: Cardiovascular Rehabilitation & Clinical Cardiology
Significant improvements in early detection and adjuvant therapy have resulted in substantial reductions in cancer-specific mortality. Unfortunately, key therapies used in the oncology setting can negatively impact cardiopulmonary health as well as physical and mental functioning. This session will describe the use of the cardiac rehabilitation model of secondary prevention and disease management for delivering care to cancer survivors to offset these potential risks.

202: Prioritizing Nutrition Therapy for Diabetes Care
Marion Franz, Nutrition Concepts by Franz, Inc.
Track: Nutrition & Behavior Change
Randomized controlled trials and outcome studies of diabetes nutrition therapy demonstrate decreases in A1C of 1 to 2 percent (range: 0.5 to 2.6 percent) depending on the type and duration of diabetes and level of glycemic control. Although nutrition therapy often focuses on control of glycaemia, not to be forgotten are optimal lipid levels and blood pressure goals. This session will prioritize four nutrition therapy strategies, state their expected outcomes, and discuss when to evaluate outcomes of nutrition therapy for diabetes to determine if goals have been met or if changes in diabetes medication(s) should be recommended. The session will also address areas of controversy related to macronutrient intake.

203: Be Fruitful and Multiply: How to Operationalize Multiple Rehabilitation Sites in an Integrated, Efficient, and Effective Fashion
Richard A. Josephson, Case Medical Center 
Track: Innovative Leadership
Rehabilitation is most appealing to prospective patients when it is geographically convenient, but small programs are often inefficient and difficult to justify financially. This session will describe a hub and spoke system that can efficiently and effectively launch and sustain multiple rehabilitation sites within an extended geographic region – while maintaining financial viability. This model has wide applicability and may allow existing programs to expand and serve many more patients.
204: Anxiety Treatment in Pulmonary and Cardiac Rehabilitation Patients
Andrea Bon-Wilson, St. Anthony Hospitals
Track: Nutrition & Behavior Change
A range of anxiety diagnoses are seen in cardiac and pulmonary patients and this session will equip healthcare providers with practical tools, techniques, and materials to assess and assist their patients. Among the resources provided will be simple tools to assess for anxiety; guidelines of when to refer and where to refer when a patient needs psychological intervention; and educational materials on understanding anxiety, to be shared with both the rehabilitation team and patients. Numerous techniques to assist the patient with anxiety will also be addressed, including breathing, relaxation, and meditation techniques to help patients with the physical activation and sleep disturbances that can come with anxiety; worry management techniques; and cognitive and mental thought-stopping techniques to help patients manage the thoughts that come with anxiety. Finally, the session will distinguish between anxiety that is becoming a problem for a patient’s health and normal anxiety symptoms that are a part of the emotional healing that comes with a health issue.

205: AACVPR Pulmonary Rehabilitation Registry Update
Gerene S. Bauldoff, The Ohio State University College of Nursing; Chris Garvey, Seton Medical Center
Track: Pulmonary Rehabilitation & Medicine; Program Management
The AACVPR Outpatient Pulmonary Rehabilitation Registry is designed to provide research-quality data and reporting mechanisms that present such a compelling argument for the benefits of pulmonary rehabilitation that physicians, hospital administrators, third-party payers, and government agencies will demand that patients participate. Attend this session for an update on the registry’s development and launch, including an outline of the patient information being collected and how programs can take part.

This session is supported, in part, by the California Society for Pulmonary Rehabilitation (CSPR).

11:00am – 12:00pm
Featured Speaker Sessions

206: Secondhand Smoke and Acute Cardiac Events: A Global Epidemic
Richard D. Hurt, Mayo Clinic
Track: Cardiovascular Rehabilitation & Clinical Cardiology
The first Surgeon General’s report on the health effects of secondhand smoke was published in 1986. Since that time there have been thousands of articles that have expanded the public’s knowledge of the health effects of secondhand smoke. The cigarette industry, on the other hand, had extensive knowledge of the health effects of secondhand smoke, which it chose to keep secret while creating an elaborate PR scheme to obfuscate the public. The second Surgeon General’s report on secondhand smoke was published in 2006 with new findings on the acute effects of secondhand smoke on the cardiovascular system. Around the same time, the Department of Justice case against the cigarette industry concluded and Judge Gladys Kessler found the industry in violation of the Civil RICO Statutes and having deceived the public for decades about the harmful effects of secondhand smoke. In this presentation attendees will learn about the science of secondhand smoke particularly with its effect on the vasculature and the cigarette industry’s efforts to thwart public health over several decades.  New findings published in the last year or so will be shown about the positive effect that smoke-free workplaces can have on the incidence of acute myocardial infarction. 

207: COPD and Pulmonary Rehabilitation: The Year in Review 2013
Brian W. Carlin, Sleep Medicine and Lung Health Consultants
Track: Pulmonary Rehabilitation & Medicine
Review the top five research articles published in the fields of chronic obstructive pulmonary disease (COPD) and pulmonary rehabilitation in the past year, and discuss how the research findings can be implemented in today’s practice of pulmonary rehabilitation.

208: Opportunity Abounds: The Compelling Facts of the New Payment Models
Jody Hereford, Hereford Consulting Group Inc.; G. Curt Meyer, Mary Free Bed Rehabilitation Hospital
Track: Innovative Leadership
With so much evolving in the world of health care payment and organizational structure, it’s challenging to see the opportunity for cardiac and pulmonary rehabilitation programs. This presentation will provide the attendee with a comprehensive overview of accountable care payment mechanisms. Additionally, the attendee will participate in a case study presenting a transition from current pay for procedure to provision of care in an at-risk financial model.

1:30pm – 2:30pm

209: Kicking the ECG Addiction in Cardiac Rehabilitation
Mark Vitcenda, University of Wisconsin Hospital and Clinics
Track: Cardiovascular Rehabilitation & Clinical Cardiology
Most cardiac rehabilitation programs monitor a patient's electrocardiogram (ECG) during every session, but what is the scientific evidence behind this practice? Does the ECG provide information that cannot be obtained through other clinical means? Is ECG monitoring cost-effective? Does it provide value to the program, and more importantly, to the patient? This presentation will provide background on the reasons cardiac rehabilitation programs monitor the ECG during exercise and reasons we may want to re-evaluate this overused practice. Some alternate methods of ECG monitoring protocols will also be discussed.

210: Resistive Exercise Testing and Training in Pulmonary Rehabilitation
David Verrill, University of North Carolina at Charlotte
Track: Pulmonary Rehabilitation & Medicine
Assessing muscular strength and endurance is critical for measuring outcomes and meeting AACVPR Program Certification requirements for pulmonary rehabilitation programs. Training techniques for strength development are equally as important and must be performed safely and effectively to meet each individual patient's needs. This session will present state-of-the-art muscular strength and endurance testing and training techniques for participants of pulmonary rehabilitation programs, with attention also given to testing and training for patients with pulmonary hypertension and associated pulmonary diseases. The evidenced-based research justifying the use of tests such as the one-repetition max for assessment of muscular strength and the 30-second sit-to-stand test for assessment of muscular endurance will be explored, as will the pros, cons, validity, reliability, and safety factors of each testing technique. 

211: Don't Just Survive...Thrive! Starting a New Cardiac Rehabilitation Program
Bonnie L. Anderson, Vernon Memorial Healthcare
Track: Innovative Leadership; Program Management
Is your cardiac rehabilitation program new? Is it floundering? This session will offer simple but effective ways to build your bottom line and nurture your program into a thriving success. Topics to be covered include key market assessments, creating a strategic plan based on the assessments, thinking outside the box in resource utilization, and identifying additional revenue sources. Walk away with ideas that can be applied immediately to help create a more successful program.

212: Pharmacology of Smoking and Smoking Cessation Medication
Paul Oh, UHN - Toronto Rehabilitation Institute
Track: Cardiovascular Rehabilitation & Clinical Cardiology; Pulmonary Rehabilitation and Medicine
Explore strategies to manage important issues in clinical pharmacotherapy related to smoking and smoking cessation in the patient with cardiovascular disease. After providing an overview of basic pharmacology and metabolism with a focus on the hepatic cytochrome P450 system, the session's focus will shift to the pharmacology of cigarette exposure and how substances such as polycyclic aromatic hydrocarbons interact with hepatic metabolism and how nicotine acts on the nervous and vascular systems. The interaction between smoking and substances such as caffeine will be described, as will the interaction of smoking with other psychoactive compounds (e.g., antipsychotic agents). Finally, the session will address the pharmacology of common smoking cessation medications, with attention to potential pharmacokinetic and pharmacodynamic interactions that are relevant in the patient with cardiovascular disease.

213: The Latest Nutrition Heart Guidelines: Practical Applications
Georgia Kostas, Nutrition Consultant
Track: Nutrition & Behavior Change; Program Management
What are the most recent nutrition guidelines released this year by ATP IV for lipid-lowering, JNC 8 for hypertension, AHA for preventing heart disease and stroke, and the latest obesity guidelines? Do you know how to apply and teach these guidelines with everyday tips that make the guidelines manageable, realistic, and easier to follow? This session, taught by a practicing cardiovascular and preventive medicine dietitian with 25 years' experience in diet counseling at the Cooper Clinic in Dallas, will share tips to help your patients meet the new goals and achieve better health results.

This session is supported, in part, by an educational grant from the Tennessee Beef Council.

2:45pm – 3:45pm

214: What’s New? An Overview of the New 2013 AHA/ACC Heart Failure Guidelines
Donald Casey, New York University Medical Center
Track: Cardiovascular Rehabilitation & Clinical Cardiology
In this session, an overview of the newly published ACC/AHA Clinical Practice Guidelines for Heart Failure will be reviewed, with special emphasis on care coordination and how to develop a robust, evidence-based plan of care for every patient with chronic heart failure. In addition, a review of the latest quality performance measures for heart failure will also be reviewed in detail. The conundrum of heart failure readmissions will be cast in a new light with some proposed new solutions.

215: Importance of Integrating Falls Prevention Strategies into Pulmonary Rehabilitation
Jeffrey Alexander, A.T. Still University
Track: Pulmonary Rehabilitation & Medicine
Falls are the main cause of injury death among older adults, the most prevalent cause of nonfatal injuries and hospital admissions for trauma, and in 2010, resulted in $30 billion in direct medical costs (CDC, 2012). Due to the systemic effect of chronic obstructive pulmonary disease (COPD), older adults with COPD may be at even greater risk for falls than their healthier counterparts. This session will review current literature regarding increased falls risk and the mechanism for such among older adults with COPD, then based on that literature, present the rationale for integrating falls prevention strategies into pulmonary rehabilitation (PR). Ways to integrate falls prevention into PR, including relevant assessments, awareness and education, and various multifaceted interventions (e.g., exercise, home modification), will be also presented. The presentation will conclude with a discussion about developing a support group to help PR programs implement falls prevention interventions.

216: Nutrition Strategies for Weight Management, and Behavioral Interventions to Make Them Work
Maria L. Buckley, The Miriam Hospital; Karen Collins, American Institute for Cancer Research
Track: Nutrition & Behavior Change
Review epidemiological data around the prevalence of obesity in the United States and examine weight management strategies for the cardiopulmonary population. This session will outline research-based nutrition strategies for weight management, such as adjusting calorie density, differentiating appropriate responses to emotional and physical hunger, planning meals, and using snacks wisely. Participants will then discuss practical, empirically supported behavioral strategies for implementing these changes in eating behaviors, including techniques to improve self-efficacy, urge management, cognitive coping, and self-monitoring.

217: AACVPR Program Certification 2014
Kimberly D. Beyer, Columbia St. Mary's; Bonnie L. Anderson, Vernon Memorial Healthcare
Track: Program Management
AACVPR Program Certification is the only peer-review accreditation process designed to review individual cardiovascular and pulmonary rehabilitation programs for adherence to standards and guidelines developed and published by AACVPR and other professional societies. AACVPR-certified programs are recognized as leaders in the field of cardiovascular and pulmonary rehabilitation because they offer the most advanced practices available. Are you ready to take your program to the next level? This session will review the 2014 certification process and discuss the requirements page by page of the application. Participants will also hear the most common reasons for denial of certification. Programs seeking AACVPR Certification for the first-time and those renewing their certification are invited to attend.

218: Beginning Investigator Oral Presentations
These scientific abstracts are finalists for the 2013 Beginning Investigator Award. Presenters are within five years of their latest degree and have not published in a peer-reviewed journal as the primary investigator. One presentation will be selected by the AACVPR Research Committee as the recipient of the Beginning Investigator Award, to be presented at the Annual Meeting.

  • Hemodynamic Responses to Combined Endurance and Resistance Exercises in Hypertensives
    Raphael M. Ritti Dias; Annelise L. Meneses; Cláudia L. Forjaz; Paulo F. Lima; Rafael M. Batista; Maria F. Monteiro
  • The Impact of Inpatient-provider Discussions on Enrollment in Cardiovascular Rehabilitation: Say What?
    Sanam Pourhabib, BSc; Caroline Chessex, MD; Shannon Gravely, PhD; Tiziana Rivera, RN, MSc, GNC (C); Judy Murray, MScPT; Sherry L. Grace, PhD
  • Effectiveness of Hospital Versus Home-based Cardiac Rehabilitation on Left Ventricular Ejection Fraction in Post-PTCA Patients: A Randomized Controlled Trial
    Mohammad H. Haddadzadeh, PhD; Arun G. Maiya, PhD; R. Padmakumar, DM, DNB; Shirish S. Borkar, MCH, DNB; Vivek G. Raman, DM; Tom Devasia, DM; Bijan Shad, DM; Fardin Mirbolouk, DM; N. Sreekumaran Nair, PhD; Vasudev Guddattu, MSc
  • Participation in Cardiac Rehabilitation Programs Among Veterans
    David W. Schopfer, MD; Steven Takemoto, PhD; Kelly Allsup, BS; Daniel E. Forman, MD; Mary A. Whooley, MD

3:55pm – 4:35pm

219: Michael L. Pollock Established Investigator Award Recipient Presentation
Carl “Chip” Lavie, John Ochsner Heart and Vascular Institute
Track: Cardiovascular Rehabilitation & Clinical Cardiology
Taking Cardiac Rehabilitation to the Next Level
Formal cardiac rehabilitation (CR) and exercise training programs improve levels of cardiorespiratory fitness and psychological risk factors such as depression and correlate with improvements in survival. Despite the evidence, however, a very low percentage of candidates are actually attending formal CR programs after major coronary events. Discuss strategies to improve delivery of CR and how to extend the benefits of this therapy to primary prevention, including corporate wellness efforts.

220: Thomas L. Petty Distinguished Pulmonary Scholar Award Recipient Presentation
Bartolome R. Celli, Brigham and Women’s Hospital
Track: Pulmonary Rehabilitation & Medicine
Arm Exercise: Rationale and Efficacy in Rehabilitation of Patients with COPD
One of the most important characteristics of humans is their creative use of upper extremities. To achieve that, humans adopted the biped position and by doing so have surrendered the contribution of the shoulder girdle muscles to ventilation. Although the strength of the upper extremity muscles is relatively preserved compared with that of the lower extremities in patients with COPD, the shoulder girdle and arm dysfunction brought about by the hyperinflation characteristic of patients with COPD is detrimental to the performance of activities of daily living. The use of upper extremity muscles is often associated with considerable dyspnea, because the arm muscles are also accessory muscles of respiration. Endurance training of the upper extremities is thus an important component of pulmonary rehabilitation, and its effectiveness has recently been demonstrated in a randomized clinical trial. Review the role of the shoulder girdle and arm muscles in respiration and arm positioning, and discuss the role of arm exercise in pulmonary rehabilitation.

Friday, October 4, 2013

8:00am – 9:30am

301: Cardiorespiratory Fitness Registry: What It Is and Why It’s Important
Leonard Kaminsky, Ball State University; Carl "Chip" Lavie, John Ochsner Heart and Vascular Institute
Track: Cardiovascular Rehabilitation & Clinical Cardiology; Program Management
Cardiorespiratory fitness is one of the strongest predictors of cardiovascular disease and total mortality, and is also strongly associated with other important health and functional outcomes. The American Heart Association published a Policy Statement in Circulation, “Forecasting the Future of Cardiovascular Disease in the United States,” on the need for a national registry for cardiorespiratory fitness. This presentation will provide an overview of the rationale for the development of this registry and provide an update on the status of the registry’s development. 

302: Maximum Productivity: A Strategy for Time Management and Time Budgeting
Randy Anderson, E3 Professional Trainers
Track: Innovative Leadership
What if you could get more done without working more hours? What if you could devote more time to the truly important things in your life? What if you could reduce your stress by regaining control of your time and schedule? This session will address principles of time budgeting and time management that can make these things possible. Attendees will reassess their perspective of time and how they value it; examine specific actions they can take to be more efficient in prioritizing and working through their daily to-do list and responsibilities; and learn how to create a calculated, proactive plan for allocating their time.
303: The Future Role of Cardiopulmonary Rehabilitation in Quality Care
Marjorie L. King, Helen Hayes Hospital; Randal J. Thomas, Mayo Clinic
Track: Innovative Leadership
Quality of care—its delivery and outcomes—is increasingly important in today’s ever-changing world of medical care.  This session will overview current activities and future directions related to improving quality of care through cardiac and pulmonary rehabilitation services, and will highlight ways that programs can work within their healthcare communities to incorporate cardiac and pulmonary rehabilitation services within quality improvement initiatives.

This session is supported, in part, by an educational grant from the New York State Association Cardiac and Pulmonary Rehabilitation (NYSAC&PR).

304: mHealth in Rehabilitation: mPower or mPediment?
Carly Goldstein, Kent State University; Joel Hughes, Kent State University; James Rosnek, Summa Health System
Track: Nutrition & Behavior Change
In 2012, 46 percent of Americans reported using a smartphone, and there is tremendous interest in harnessing the capabilities of smartphones to improve health. Hence, mobile-health (mHealth) is a rapidly growing field of healthcare. Some mHealth technologies are already widely distributed, such as consumer apps for diet, exercise, and medical information. Some of the mHealth technologies and systems relevant to Phase II and III cardiac rehabilitation (CR), however, do not yet exist. This presentation will review the literature and discuss approaches to mHealth in CR, from delivery of CR using mHealth technologies (e.g., telehealth for community-based CR) to a patient’s personal use of consumer health apps. The speaker will share his own work using mHealth with patients with heart failure and encourage dialogue among participants about their experiences with mHealth in CR contexts. Both the potential and pitfalls of mHealth in CR will be considered as the group collectively identifies opportunities and challenges.

305: Legislative and Regulatory Update for Cardiac and Pulmonary Rehabilitation Programs in 2013
Karen Lui, GRQ Consulting, LLC; Phillip Porte, GRQ Consulting, LLC
Track: Program Management
Review national pulmonary and cardiac rehabilitation coverage and payment considerations, including recent changes in Medicare regulations and future directions, and how this affects program operation. Both local Medicare coverage issues and commercial insurance trends of national significance will be discussed. Participants will also hear about actions taken by AACVPR on behalf of members regarding Medicare regulations for cardiac and pulmonary rehabilitation.

9:45am – 10:30am

306: General Session: L. Kent Smith Award of Excellence Recipient Presentation
Jody Hereford, Hereford Consulting Group Inc.
What Business Are You In?
With the passage of the Affordable Care Act in 2010, we’re living into some of the biggest social legislation since the passage of the Social Security Act in 1935 and the creation of Medicare in 1965. With payment mechanisms rapidly changing, we’re also beginning to see a shift where preventive care will become the new cultural norm. What implications does this have for traditional cardiac and pulmonary rehabilitation, and what opportunities does it offer for those willing to look at an adaptive reuse of the services we provide? Explore the significant opportunities we have to impact preventive care, from primary to tertiary, especially when it comes to the most expensive populations: those living with chronic illness. 

10:45am – 11:45am

307: Incorporating Functionally Based Exercises in Cardiac Rehabilitation Programs
Michael Puthoff, St. Ambrose University
Track: Cardiovascular Rehabilitation & Clinical Cardiology
Patients in cardiac rehabilitation present with complex medical histories that can lead to deconditioning, loss of muscle performance, activity limitations, and participation restrictions. Additionally patients in cardiac rehabilitation may be recovering from surgical procedures, adjusting to new medications, and/or have recent hospitalizations; all factors that contribute to decline in muscle performance, mobility, and function. Exercise has repeatedly been shown to lead to improvements in these areas in a range of patient populations, including those with cardiovascular diseases. Functionally based programs focused on increasing muscle performance and challenge balance through static and dynamic training have the strongest evidence in leading to meaningful improvements. This session will focus on assessment tools to identify patients with deficits in function, demonstrate progressive exercises that can be used to address declines in function, and offer tips on implementation of functionally based exercises into a cardiac rehabilitation program.

308: Harmonica Therapy for Pulmonary Disease: Ventilatory Muscle Training
Dennis Low, Santa Clara Valley Health & Hospital System; Vivian Low, MPH, RN-BC, FPCNA, El Camino Hospital; Missy Von Luehrte, El Camino Hospital
Track: Pulmonary Rehabilitation & Medicine
El Camino Hospital began harmonica therapy in 2004 to offer pulmonary patients a fun way to practice ventilatory muscle training. The focus on blowing and drawing through reeds during harmonica play also mimics the inhalation and exhalation technique for pursed lip breathing. Inhaling and exhaling through the instrument provides a focus on the use of the diaphragm muscle, which in turn, improves breathing for the patient. In addition, the social support and cognitive stimulation involved in harmonica therapy address the challenges of depression and isolation that often present with COPD patients. In this participatory session, attendees will learn how the harmonica – a small, convenient instrument that requires no musical experience – promotes diaphragmatic breathing and can improve quality of life.

309: The Road to Healthy Eating: Different Eating Patterns as Roadmaps
Karen Collins, American Institute for Cancer Research
Track: Nutrition & Behavior Change
What makes eating “healthy”? Research increasingly now looks beyond the health impact of individual food choices to how choices combine into eating patterns that affect heart disease and overall health. Since a health-promoting eating pattern can only work if it is followed, the challenge is to help people create eating patterns that satisfy their unique personal food preferences, calorie needs, health issues, and lifestyle choices. Food choices can be combined into an infinite number of healthful, predominantly plant-based eating patterns (although these patterns can be categorized into a few basic approaches, such as vegetarian, low-fat, and Mediterranean-style patterns). This presentation will review the evidence to compare different research-based approaches to healthy eating, and discuss tips for making each one healthy, delicious, and doable.

This session is supported, in part, by an educational grant from the New York State Association for Cardiac and Pulmonary Rehabilitation (NYSAC&PR).

310: Do We Have News for You! AACVPR Professional Certification Is Coming
Larry F. Hamm, George Washington University; Karen Lui, GRQ Consulting, LLC
Track: Program Management
Many healthcare disciplines have their own credentialing processes that identify professionals working in the discipline as possessing a certain level of knowledge, skills, and abilities. Cardiac rehabilitation has never had such a process, but that is about to change. AACVPR is developing a new credential for healthcare professionals working in cardiac rehabilitation that is based on core competencies and program core components. This session will provide an overview of the core competencies and their relationship to the program core components and the certification examination, then introduce the rationale and process for the new AACVPR professional certification.

311: Oral Scientific Abstract Presentations: Cardiac Rehabilitation Physiology
Track: Cardiovascular Rehabilitation & Clinical Cardiology
Hear short presentations on a variety of scientific topics in the area of cardiac rehabilitation. The following abstracts will be presented:

  • Cardiac Rehabilitation Enhances Glutathione (GSH) Antioxidant System in Subjects with Ischemic Heart Failure (IHF), and Subjects with Coronary Artery Disease (CAD)
    Ahmed S. Elokda, PT, PhD
  • Remission of Recent-onset Type 2 Diabetes Mellitus with Exercise and Weight Loss
    Patrick D. Savage, MS, FAACVPR; Annis Marney, MD; Kimberly Evans, RD; Philip A. Ades, MD, MAACVPR
  • Impact of Cardiac Surgical Intervention on Successful Weight Loss of Overweight and Obese Cardiac Rehabilitation Patients
    Michelle La Londe, MA; Lynn Shaffer, PhD; Jesse Hickerson, MBA; Gregory Lam, MD; Anne Albers, MD; Daniel Mudrick, MD, MPH; Richard J. Snow, DO, MPH; Teresa Caulin-Glaser, MD
  • Is the Efficacy of External Counter Pulsation (ECP) Enhanced with Concomitant Phase II Cardiac Rehabilitation (CR)?
    Patricia Lounsbury, RN, BSN, MEd; James K. Johnson, RKT, MEd; Christina Clair, BS, MS; Ahmed S. Elokda, PT, PhD; Ellen Gordon, MD

1:00pm – 2:30pm

312: Scientific and Clinical Poster Presentations

Posters will also be available for viewing throughout the Exhibit Showcase Hours, 10:30am to 3:00pm.

3:00pm – 4:30pm

313: Tackling Obesity in Cardiac Rehabilitation
Carl "Chip" Lavie, John Ochsner Heart and Vascular Institute; Francisco Lopez-Jimenez, Mayo Clinic; Quinn Pack, Mayo Clinic; Patrick Savage, Fletcher Allen Health Care
Track: Cardiovascular Rehabilitation & Clinical Cardiology
Obesity is a risk factor for heart disease and is increasingly prevalent in cardiac rehabilitation (CR). Yet current treatment outcomes are poor, and many questions remain unanswered regarding the appropriate diagnosis and treatment for obese patients in CR. This session will explore the obesity epidemic, obesity as a risk factor for heart disease, and the current outcomes in CR, then delve into the effects of exercise on body composition, the limitations of BMI in diagnosing obesity, the quandary of the obesity paradox, methods to improve the treatment of obesity, and the potential role of bariatric surgery in CR. Specific attention will be given to discussing the limitations of our current knowledge and the need for additional studies assessing whether weight loss should be recommended to obese patients attending CR.

314: Limitations to Exercise in COPD: Dynamic Hyperinflation, Muscles, or Both
Eileen Collins, UIC/Hines VA Hospital
Track: Pulmonary Rehabilitation & Medicine
The primary causes of exercise limitation in patients with COPD are a matter of ongoing debate, but there seems to be growing consensus that the limitations are caused by both dynamic hyperinflation and peripheral muscle dysfunction. This session will provide a physiologic overview of the processes of dynamic hyperinflation and muscle dysfunction and review recent literature on the treatment of both. The session will conclude with the practical application of this information in pulmonary rehabilitation programs.

315: Improving Program Efficiency to Optimize Utilization and Reimbursement
Steven Keteyian, Henry Ford Hospital; Murray Low, Stamford Hospital; Karen Lui, GRQ Consulting, LLC; Kimberly Whitley, Samaritan Health Services
Track: Innovative Leadership
Scientific evidence, emerging technologies, and new reimbursement models are important reasons for every cardiac rehabilitation program to evaluate how and why its services are provided. This session will present research that demonstrates meaningful outcomes, delivery strategies that enhance patient and program outcomes, and insurance plans that value preventive interventions.

316: Motivational Interviewing to Promote Lifestyle Change
Lola A. Coke, Rush University College of Nursing
Track: Nutrition & Behavior Change
Practice the principles of motivational interviewing (MI) in this interactive session. The presentation will describe the phases and principles of this communication technique, then employ case-study vignettes in order to critique MI in practice with patients who need to change their lifestyles. A brief synopsis of the MI literature will also be included to address the efficacy of MI in changing lifestyle behaviors.

317: Simple Solutions to Ease the Certification Confusion
Bonnie L. Anderson, Vernon Memorial Healthcare; Kimberly D. Beyer, Columbia St. Mary's; Gayla A. Oakley, Boone County Health Center
Track: Program Management
Whether your program has gone through the AACVPR Certification process before or is getting ready to for the first time, this presentation will offer practical information and tools to ease the process. This session will review the pages of the certification application that cause the most difficulty and offer solutions for tackling them. They will discuss requirements regarding staff competency, individual treatment plans, medical emergency policies/procedures, exercise prescription, and emergency preparedness, and will talk about the tools and resources available to assist in the measurement and collection of required outcomes. Attendees can expect to return to their programs equipped to navigate the AACVPR Program Certification process.

4:45pm – 5:45pm

318: See You in Seven: New Programming in Cardiac Rehabilitation
Heather Shuster, Genesis HealthCare System
Track: Cardiovascular Rehabilitation & Clinical Cardiology; Program Management
The American College of Cardiology and Hospital to Home have gathered expertise and experience around the "See You In Seven" (SY7) program, which is proven to reduce unnecessary hospital readmissions and improve transitions of care for patients with congestive heart failure, acute myocardial infarction, and percutaneous transluminal coronary angioplasty. The goal of SY7 is for all patients discharged with these diagnoses to start cardiac rehabilitation within seven days of discharge. The program allows the organization to take a proactive stance to reduce readmissions, establish a continuum of care, and increase patient compliance. In this session, hear a first-hand experience of implementing SY7 and other initiatives that can support and further its success.

319: My Patient Doesn’t Want to Change – Is It Them or Is It Me?
Michael V. Burke, Mayo Clinic
Track: Nutrition & Behavior Change
The relationship between a healthcare provider and patient can be the foundation for meaningful health education and behavior change planning, or it can be the root of patient dissatisfaction with the healthcare system. Discuss communication strategies that research shows to be most effective in helping patients have a good healthcare experience and in supporting positive behavior change. Participants will also explore how bias and misunderstanding can increase discord in patient care relationships, and will walk away with resources for improving their communication competence.

320: Integrating Nutrition into the Individual Treatment Plan
Deborah Krivitsky, Massachusetts General Hospital
Track: Nutrition & Behavior Change
Medical nutrition therapy is a critical component of a comprehensive care plan for patients with cardiovascular disease. Examine six individual treatment plan goals – weight control, lipid management, blood pressure control, blood glucose control, exercise prescriptions, and psycho-social considerations – and the role nutrition plays in each. The session will also discuss how to integrate nutrition counseling into core planning.

321: Small Programs: Quality Comes in Any Size
Gayla A. Oakley, Boone County Health Center
Track: Program Management
Cardiopulmonary rehabilitation programs can provide quality services regardless of size, but small programs often face some unique challenges. Discover creative steps to face those challenges with your small program in this discussion of staffing, schedules, patient referrals, and ancillary services.

322: AACVPR Cardiac Rehabilitation Registry Update
Mark Vitcenda, University of Wisconsin Hospital and Clinics
Track: Cardiovascular Rehabilitation & Clinical Cardiology; Program Management
Through a combination of presentation and question-and-answer, this session will highlight recent updates, hot topics, and data from the AACVPR Outpatient Cardiac Rehabilitation Registry. Participants will discuss how to participate in the registry, data entry, and reporting features, as well as the role of the registry in program management.

Saturday, October 5, 2013

8:00am – 9:30am

401: The Total Artificial Heart Patient: Building the Bridge from Implant to Transplant
Holly A. Bright, Mayo Clinic Arizona; Christopher Pierce, Mayo Clinic; Linda L. Staley, Mayo Clinic
Track: Cardiovascular Rehabilitation & Clinical Cardiology
Total Artificial Heart (TAH) patients benefit from this advancing technology since it allows them to recover physical function so that they are in better condition to receive a donor heart. These patients may even return home while waiting for transplantation. The challenge for healthcare professionals is to provide a seamless continuum of care for patients in end-stage heart failure on mechanical circulatory support to bridge them to heart transplantation. The importance of regular physical exercise throughout this continuum is vital. This presentation will define the process of implantation and function of the TAH, the transitional nursing care coordination from inpatient to outpatient status, and the physical rehabilitation of these TAH patients as they move through the continuum of care. The collaboration of the perfusionist, the nursing coordinator, and the cardiac rehabilitation professional in this presentation exemplifies the real-life integration of care for the TAH patient.

402: COPD: Pulmonary Rehabilitation as a Tool for Keeping the Patient at Home Following an Exacerbation
Brian W. Carlin, Sleep Medicine and Lung Health Consultants; Dan Easley, Klingensmith HealthCare
Track: Pulmonary Rehabilitation & Medicine
Thirty-day readmission rates for patients who are hospitalized with a COPD or CHF exacerbation approach 25 percent in many areas of the United States. In the future, reimbursement for such readmissions will be limited. An effective management program for these patients involves treatment of the underlying disease as well as the associated comorbidities and includes both hospital and out of hospital management programs. This session will discuss the comorbidities associated with COPD then describe the up-to-date results of an outpatient transition of care program that has resulted in a significant reduction in the 30-day readmission rates to 5 percent for patients following hospitalization for a COPD exacerbation. The session will conclude with strategies for the use of pulmonary rehabilitation as part of this transition of care program.

403: Motivating Cardiopulmonary Rehabilitation Patients
Donald Shaw, Midwestern University
Track: Nutrition & Behavior Change
At the 1991 AACVPR Annual Meeting in Long Beach, California, a session titled “Motivating Cardiopulmonary Rehabilitation Patients” shared video footage featuring humorous moments of patients participating in the St. Thomas Hospital (Nashville, Tennessee) Phase II cardiac rehabilitation program. A brief oral presentation of select motivational principles preceded each video clip. The video was well-received, and since that time, additional clips have been added to the original program. As the 2013 AACVPR Annual Meeting heads to Nashville – home of the original production – it seems altogether fitting that the updated version be shown. Hear both enduring and new principles of motivating cardiopulmonary patients.

404: Grand Ole Excuses in Diabetes Self-management: Reducing Your Frustration and Increasing Your Patients’ Positive Health Behaviors
Lucy Rathier, The Miriam Hospital
Track: Nutrition & Behavior Change
Although self-management is the cornerstone of diabetes control, many providers experience frustration in getting their patients to adopt relevant health behaviors. Diabetes self-management depends not only on the technical skills needed to perform regimen behaviors but also on an individual’s level of motivation to engage in and maintain the self-management of their disease. Developing effective and efficient strategies to promote self-management of diabetes is important in order to prevent serious complications, and patient-centered approaches improve the provider's effectiveness, patient satisfaction, and health outcomes without an increased burden of time and cost. This session will use examples drawn from actual patient encounters to demonstrate strategies to facilitate diabetes self-management in clinical encounters. Motivational interviewing techniques such as reflections to reduce resistance, querying extremes, and giving health feedback will be shared.

405: Oral Scientific Abstract Presentations: Cardiac Rehabilitation Programming
Track: Cardiovascular Rehabilitation & Clinical Cardiology
Hear short presentations on a variety of scientific topics in the area of cardiac rehabilitation. The following abstracts will be presented:

  • Knowledge Level of Cardiovascular Disease Risk Factors in Adults Who Have Participated in a Cardiac Rehabilitation Program
    Pamela Bartlo, PT, DPT, CCS; Dawn M. Hayes, PT, PhD, GCS
  • Outcomes of Cardiac Rehabilitation in Women After Major Cardiac Interventions
    Vishal Mundra, MD; Gwen Moudry; Steven Henquinet, CM
  • Predictors of CR Utilization Following a Coronary Intervention
    Michelle La Londe, MA; Lynn Shaffer, PhD; Jesse Hickerson, MBA; Gregory Lam, MD; Anne Albers, MD; Daniel Mudrick, MD, MPH ; Richard J. Snow, DO, MPH; Teresa Caulin-Glaser, MD
  • Utilization of a 12:00 Walk Test to Predict Peak VO2 in Phase II Cardiac Rehabilitation Patients
    Jayme L. Rock-Willoughby, DO; Debra Boardley, PhD, RD/LD; Dalynn T. Badenhop, PhD
  • Text-messaging Program Improves Outcomes in Outpatient Cardiovascular Rehabilitation
    Patricia Lounsbury, RN, BSN, MEd; Ellen Gordon, MD; William Clarke, PhD; Ahmed S. Elokda, PT, PhD
  • The Value of Detecting Asymptomatic Signs of Myocardial Ischemia in Outpatient Cardiac Rehabilitation (CR)
    Patricia Lounsbury, RN, BSN, MEd; Jennifer M. Bunning, BA; William Clarke, PhD; Ahmed S. Elokda, PT, PhD; Ellen Gordon, MD

9:45am – 10:45am
Featured Speaker Sessions

406: Physical Activity, Fitness, and Cardiac Rehabilitation: The Year in Research
Murray Low, Stamford Hospital
Track: Cardiovascular Rehabilitation & Clinical Cardiology
This session will review important articles published in 2012 and 2013 that professionals who treat patients with cardiovascular disease should be familiar with and understand in order to improve patient care. Participants will understand the scientific basis for delivery of cardiac rehabilitation as a powerful therapeutic modality for primary and secondary prevention of cardiovascular disease; review recently published scientific literature related to the role of physical activity and physical fitness as significant predictors for total and cardiovascular mortality; analyze the interactions of physical activity and cardiorespiratory fitness with multiple indicators of physical and mental health; and discuss the scientific basis for increasing the current quantity of prescribed physical activity for cardiac rehabilitation patients.

This session is supported, in part, by an educational grant from the Connecticut Society for Cardiac Rehabilitation (CSCR).

407: Report on Pulmonary Education Program: What the PR Centers and Patients Have to Say
Scott Cerreta, COPD Foundation
Track: Pulmonary Rehabilitation & Medicine
The Pulmonary Education Program (PEP) is designed to assist patients after graduation from rehabilitation through two main components: one, high-quality educational materials for pulmonary rehabilitation (PR) center staff and patients and two, the optional On Track with COPD ongoing support program. On Track with COPD utilizes COPD Associates (people who are living with COPD) to call patients monthly for 24 months following graduation from a PEP-qualified PR program. COPD Associates offer motivation and coaching support through a telephone-based callback system. This session will recap results from the first six months of patients enrolled in On Track with COPD.

408: Transforming Clinical Skills into Leadership Skills
Barry A. Franklin, Beaumont Health Center
Track: Innovative Leadership
This session will focus on the behavioral skills and strategies of highly successful leaders, with specific reference to lessons that the speaker has learned over the past 35 years, including leadership experiences with varied professional organizations, including AACVPR, ACSM, and AHA. Specific strategies to be discussed include: the importance of active association involvement in developing your leadership skills, how "service to others" leads to personal and professional growth and development, and some of the most critical elements of leadership – honesty, integrity, trust, communication, vision, courtesy, personableness, and routinely demonstrating organizational standards.


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