In the past, exercise therapy has been widely employed as the basis of cardiac rehabilitation, but reviews have not shown great benefit.1 Attention is now turning to models which help the patient to learn to defend the integrity of his internal milieu in the face of an external environment which is challenging, uncertain and rapidly changing. This discussion paper describes the Charing Cross Model, its psychophysiological basis, practice and implications for occupational therapy.
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References
1.
NixonPGFAl-AbbasiAHKingJCFreemanLJ.Hyperventilation in cardiac rehabilitation. Holistic Med1986; 1: 5–13.
2.
SowtonE.The treatment of angina pectoris. Practitioner1979; 223: 471–76.
3.
DubosR.Man adapting. New Haven: Yale University Press, 1980.
BaroldiGMarianiFFalziG.Degree of coronary artery obstruction at autopsy in patients with coronary heart disease compared with ‘control’ population. In: MaseriAKlassenGALeschM, eds. Primary and secondary angina pectoris. New York: Grune and Stratton, 1978: 57–69.
MacAlpinRN.Contribution of dynamic vascular wall thickening to luminal narrowing during coronary arterial constriction. Circulation1980; 60 (2): 296–301.
14.
OlivaPB.Pathophysiology of acute myocardial infarction. Annals Int Med1981; 94 (2): 236–50.
15.
MarzilliMGoldsteinSTrivellaMGPaulumboCMaseriA.Some clinical considerations regarding the relation of coronary vasospasm to coronary atherosclerosis; a hypothetical pathogenesis. Am J Cardiol1980; 45: 882–86.
16.
FreemanLJNixonPGF.Reoperation for angina after previous aortocoronary bypass surgery. Br Heart J1985; 54 (5): 552.
SmithHCFryePiehlerJM.Does coronary artery bypass surgery have a favourable influence on the quality of life? In: RahimtoolaSH, ed, and Brest AN, ed-in-chief. Controversies in coronary heart disease. Cardiovascular clinics. Philadelphia: FA Davis, 1983: 253.
19.
PetchMC.The progression of coronary artery disease. Br Med J1981; 283: 1073–74.
20.
JenkinsCDStantonBEKleinMDSavageauJAHarkenDE.Correlates of angina pectoris among men awaiting coronary artery bypass surgery. Psychosom Med1983; 45 (2): 141–53.
FreemanLJNixonPGF.Time to rethink the clinical syndrome of angina pectoris? — implications from ambulatory ST monitoring. Quart J Med1987; 62 (237): 25–32.
23.
RaabW.Cardiotoxic biochemical effects of emotional-environmental stressors — fundamentals of psychocardiology. In: LeviL, ed. Society stress and disease. London: Oxford University Press, 1971: 331–37.
24.
NixonPGFBethellHJN.Preinfarction ill health. Am J Cardiol1974; 33: 446–49.
25.
HenryJP.Mechanisms by which stress can lead to coronary heart disease. Postgrad Med J1986; 62: 687–93.
26.
FriedmanMRosenmanRH.Type A behavior and your heart. London: Wildwood House, 1974.
27.
FreemanLJNixonPGF.Emotional state and coronary artery disease: a literature review. Holistic Med1987; 2: 145–54.
28.
KaterCEBiglieriEG.Adrenocortical disease and hypertension. In: SleightPFreisE, eds. Cardiology I, hypertension. London: Butterworths, 1982: 145.
29.
HenryJP.Coronary heart disease and arousal of the adrenal cortical axis. In: DembroskiTMSchmidtTHBlumchenG, eds. Basel: Karger, 1983: 365–81.
30.
SterlingPEyerJ.Biological basis of stress-related mortality. Soc Sci Med1981; 15E: 3–42.
31.
KingJC.Hyperventilation: a therapist's point of view. J R Soc Med1988; 81: 532–36.
32.
LumLC.The syndrome of habitual chronic hyperventilation. In: HillOW, ed. Modern trends in psychosomatic medicine. London: Butterworths, 1976: 196–230.
33.
OswaldI.The benefit of sleep. Holistic Med1987; 2: 137–39.
34.
NixonPGF.Coronary heart disease and its emergencies. Practitioner1973; 35: 1–12.
35.
LeyR.Panic attacks during sleep: a hyperventilation—probability model. J Behav Ther Exp Psychiatry1988; 19 (3) (in press).
36.
HarrisonGAPalmerCDJennerDReynoldsV.Similarities between husbands and wives in rates of catecholamine secretion. Annals of Human Biol1980; 7 (4): 379–80.
37.
MoldolfskiH.‘Psychogenic rheumatism’ of the ‘fibrositis syndrome’. In: HillOW, ed. Modern trends in psychosomatic medicine. London: Butterworths, 1976: 187–95.
38.
CousinsN.Anatomy of an illness as perceived by the patient. New York: WW Morton, 1979.
39.
LeyR.Panic attacks during relaxation and relaxation induced anxiety: a hyperventilation interpretation. J Behav Ther Exp Psychiatry (in press).
40.
NixonPGFCarruthersMETaylorDJEBethellHJNGrabauW.British pilot study of exercise therapy: II. Patients with cardiovascular disease. Br J Sports Med1976; 10: 54–61.
41.
SteinhartMJ.Emotional aspects of coronary artery disease. Current concepts. Michigan: The Upjohn Company, 1984.
42.
BraunwaldE.Coronary spasm and acute myocardial infarction: new possibility for treatment and prevention. N Engl J Med1978; 299: 1301–1303.
