CLASSICAL EXERCISE PROGRAM FOR OUT-OF-HOSPITAL REHABILITATION: The classical exercise program consists of the following three steps. Step 1: Preparatory activities. Warm-up exercises, mostly low-level aerobic exercise and static stretching, lasting 5-10 min. The purpose is to relax and stretch muscles, improve joint mobility and cardiovascular adaptations, help patients prepare for the high-intensity exercise phase, and reduce the risk of sports injuries by progressively increasing the blood flow to the muscle tissues and the joints’ readiness for exercise. Step 2: Training phase. Includes aerobic exercise, resistance exercise and flexibility exercise, etc., with a total time of 30-60 min. among them, aerobic exercise is the foundation, and resistance exercise and flexibility exercise are supplementary. 1, aerobic exercise: (1) types: commonly used aerobic exercise modes are walking, jogging, cycling, swimming and stair climbing, as well as walking, cycling and rowing completed on equipment. Jogging, cycling, stair climbing and swimming are not recommended for 1 month after discharge, and walking is recommended. The duration of each exercise is 10-60 min. (2) Duration: Patients experiencing cardiovascular events are recommended to start initial exercise from 15 min, including warm-up and relaxation exercise for 5 min each, and exercise training for 5 min/session, and increase the duration of aerobic exercise by 1-5 min per week, according to the patient’s level of fitness, purpose of exercise, symptoms, and the limitations of the locomotor system. (3) Frequency: exercise frequency 3~5 times/week. (4) Intensity: The minimum recommended intensity of aerobic exercise for patients to achieve cardiovascular health or fitness benefits is moderate intensity exercise (e.g., 40% to 60% of peak oxygen uptake, or heart rate values near anaerobic threshold, or 40% to 60% of maximal heart rate). It is recommended that patients begin exercise at 50% of peak oxygen uptake or maximal heart rate, and that the intensity of exercise progressively reaches 80% of peak oxygen uptake or maximal heart rate.The BORG Exertion Rating Scale recommends grades 11-13, and grades 14-16 may be accepted for a short period of time for patients who are at low risk for exercise. Exercise intensity is usually monitored using heart rate and self-perceived exertion. In addition to continuous aerobic exercise, intermittent exercise training, in which patients alternate between high-intensity and low- to moderate-intensity exercise, can improve the body’s functional reserve more quickly and more effectively than continuous exercise intensity methods to improve metabolic factors associated with cardiovascular disease [56]. In addition, exercise needs to be monitored by a cardiac rehabilitation physician. With the enhancement of the patient’s exercise capacity, in order to achieve the best exercise effect exercise prescription needs to be constantly adjusted, it is recommended that the patient’s cardiorespiratory exercise endurance be repeated before discharge, 1 month after discharge, and 3 months after discharge, and the exercise prescription be adjusted according to the results of the exercise test, and the patient’s cardiorespiratory exercise endurance can be assessed every 6-12 months in the future. 2.Resistance exercise. (1) Types: The form of resistance exercise for coronary heart disease is a series of medium-load, continuous, slow, large muscle groups and multiple repetitions of muscle strength training, commonly used methods are as follows: unarmed exercise training, including overcoming the self-body mass (eg, push-ups), supine stirrups, leg and back bending, crunches, lower back extensions and heel lifts, etc.; exercise equipment, including dumbbells, multifunctional combination trainers, grip strength machines, Exercise equipment, including dumbbells, multi-functional combination trainers, grip strength machines, abdominal strength machines and elastic bands, etc.; homemade equipment, including sandbags of different weights and 500 ml mineral water bottles, etc. Exercise equipment training is limited by space and funding, unarmed exercise training, elastic bands and homemade equipment are all equally effective forms of resistance training, which is conducive to the patient’s exercise training instruction at home or in the community. (2) Frequency: upper limb muscle groups, core muscle groups (including chest, shoulder, upper back, lower back, abdomen and buttocks) and lower limb muscle groups can be trained alternately on different days; 8~10 muscle groups can be trained each time, and each muscle group can be trained in 1~4 groups each time, starting from 1 group and progressing gradually, with 10~15 repetitions for each group, and resting for 2~3 min in between the groups. the elderly can increase the number of repetitions for each group (e.g. 15~25 repetitions The elderly can increase the number of repetitions per group (e.g. 15~25 repetitions/group) and reduce the number of training to 1~2 groups. (3) Time: Each muscle group should be trained 2~3 times a week, and the same muscle group should be practiced at least 48 hours apart. (4) Intensity: It should be noted that there must be 5~10 min of aerobic warm-up before training, and the recommended initial exercise intensity is 30%~40% of the maximal load of the upper limbs (i.e., the maximal weight that can be lifted by only one repetition under the condition of keeping the correct method and no fatigue), and the maximal weight of the lower limbs is 30%~40% of the maximal load of the upper limbs. The Borg score is a simple and practical method of assessing exercise intensity, with a recommended intensity of 11-13 points. Remember the correct breathing pattern during exercise, exhale when lifting and inhale when lowering, and avoid breath-holding movements. (5) Selection of the period of resistance exercise: If there is no contraindication, muscle activities within the range of joint movement and resistance training with 1~3 kg weight can be started in the early stage of rehabilitation to promote the patient’s physical ability to recover as soon as possible. Routine resistance training is defined as training in which the patient is able to lift ≥50% of a single maximal load, and it is required at least 3 weeks after percutaneous coronary intervention and should follow 2 consecutive weeks of medically supervised aerobic training; at least 5 weeks after myocardial infarction or coronary artery bypass grafting and should follow 4 consecutive weeks of medically supervised aerobic training; and should not be performed for 3 months after coronary artery bypass grafting. Medium- to high-intensity upper extremity strength training, so as not to affect the stability of the sternum and the healing of the sternal wound. 3, flexibility exercise. Elderly and cardiovascular disease patients with poor flexibility, so that the ability to reduce the activities of daily living, to maintain the upper and lower trunk, neck and hip flexibility is particularly important. Training principles should be carried out in a slow, controlled manner, gradually increasing the range of activities. Training methods: each part of the stretching time 6-15 s, gradually increased to 30 s, such as tolerable can be increased to 90 s, during the period of normal breathing, the intensity of the pulling sensation at the same time do not feel the pain, each action is repeated 3-5 times, the total time of 10 min or so, 3-5 times a week. 4, neuromuscular training. It includes balance, flexibility and proprioception training. Elderly people have an increased risk of falling, and it is recommended that neuromuscular training be an important part of comprehensive improvement of physical fitness and fall prevention for elderly patients with cardiovascular disease. Activity forms include tai chi, serpentine walking, one-legged standing and straight-line walking. Activity frequency: 2~3 times per week. Step 3: Relaxation exercise. Relaxation exercises are an essential part of exercise training. By allowing the intensity of the exercise to gradually decrease, it ensures redistribution of blood, reduces stiffness and soreness in the joints and muscle tissues, and avoids the risk of a sudden decrease in venous return leading to post-exercise hypotension and fainting. Relaxation can be a continuation of slow-paced aerobic exercise or flexibility training, and can last 5-10 min depending on the severity of the patient’s condition, with the longer duration of relaxation appropriate for more severe conditions.