Exercise Therapy：Prescription Framework (ACSM Guidelines)

● Aerobic Training: 30–60 min/session at 50–70% HRmax or 40–80% HR reserve (3–5 sessions/week for 6–12 weeks). Modalities include treadmill walking, cycling, and elliptical training to enhance VO₂ peak and endothelial function.

●Resistance Training: 2–3 sessions/week targeting major muscle groups (2–3 sets × 10–15 reps at 40–70% 1RM). Utilizes elastic bands, pneumatic machines, and bodyweight exercises to improve musculoskeletal strength and metabolic demand.

● Flexibility/Mobility: Dynamic stretching pre-exercise and static stretching post-exercise; Tai Chi/Baduanjin protocols for balance and proprioceptive enhancement.

● Neuromuscular Integration: 5–10 min warm-up (dynamic activation) and cool-down (myofascial release) phases to optimize hemodynamic adaptation.

Respiratory Muscle Training

● Diaphragmatic Breathing: 10 min bid with real-time ultrasound biofeedback.

●Threshold Loading: 20 reps/set, 2 sets/day via POWERbreathe® devices (30–60% MIP) to reduce dyspnea and improve ventilatory efficiency in COPD-comorbid patients.

Enhanced External Counterpulsation (EECP)
Mechanism: Diastolic phase sequential compression (250–300 mmHg) of lower extremities augments coronary perfusion pressure (CPP) by 25–35%.

● Protocol: 35–60 min/session, 5 sessions/week × 7 weeks

● Indications: Refractory angina (CCS Class III-IV), microvascular dysfunction.

● Outcomes: 6-minute walk distance ↑18%, SAQ score ↑22% (RENEWAL Trial data).

Extracorporeal Shockwave Therapy (ESWT)
Mechanism: Low-intensity (0.09 mJ/mm²) radial shockwaves induce angiogenesis via VEGF/NO pathway activation and mitochondrial biogenesis.

● Protocol: 9 sessions over 3 months (3 sessions/week × 3 weeks).

● Applications: Viable myocardium regeneration in ischemic cardiomyopathy, endothelial repair post-PCI.

● Efficacy: MPI-SPECT demonstrated ↑25% myocardial perfusion; METs ↑1.5–2.0 post-treatment.

This systematic approach ensures risk-adapted, physiology-driven rehabilitation, targeting both functional recovery and long-term secondary prevention.