When someone experiences a cardiac event such as a heart attack or heart surgery they often worry when—or if—they can get back to living normally. In honor of American Heart Month this February, we rounded up some commonly asked questions about cardiac rehabilitation.
Cardiac rehabilitation (cardiac rehab) is a proven effective tool for helping an individual recover from a cardiovascular event and make the necessary lifestyle changes to reduce the chances of further heart problems.
According to the American Heart Association many people of all ages who have heart conditions can benefit from cardiac rehabilitation. But despite the fact that cardiac rehab increases the chance for survival for people with heart disease, it is commonly underused in the U.S. due to low patient referral and a lack of public awareness of its importance.
What is cardiac rehab?
Cardiac Rehab is a professionally supervised program of exercise, education and counseling that’s designed to help an individual recover from a heart attack, heart surgery, or heart procedures such as angioplasty and stenting. It’s also used to aid patients with chronic heart conditions such as angina and is now approved for congestive heart failure.
Cardiac rehab is divided into 3 (and sometimes 4) phases encompassing both inpatient and outpatient care. Phase I is usually inpatient program and can start when they are in the hospital or when transferred to an acute rehabilitation hospital like Burke. It involves limited daily exercise and patient and family education.
Phase II of cardiac rehab generally takes place after a patient is discharged from the hospital and it is done in an outpatient setting under close medical supervision. The goal of outpatient cardiac care is to help heart patients regain strength and full, active lifestyles, reduce cardiac symptoms and prevent the occurrence of future cardiac problems. Participation in Phase II requires a doctor’s prescription, but a patient doesn’t necessarily need to have completed Phase I before being referred to a Phase II outpatient program. During Phase II, a patient is closely monitored as they gradually increase their activity level.
Phase III, which also requires medical clearance and Phase IV are devoted to long term maintenance of a patient’s new, healthier lifestyle.
What are the benefits of cardiac rehab?
Patients who attend cardiac rehab programs tend to recover faster, improve their overall health and quality of life, and reduce their risk factors for heart disease. They learn how to be active more safely, lower stress and make lifestyle changes—such as quitting smoking and losing weight—that lead to stronger heart health. In cardiac rehab, a patient gets the expert support and guidance they need to help change these old habits into new healthy ones. Meeting other people in cardiac rehab can also help a patient realize they’re not alone and help them feel less depressed and anxious and, therefore, more confident as a result.
What happens in cardiac rehab?
In cardiac rehab, a patient works with a team of health professionals that may include doctors nurses, exercise specialists, physical therapists, nutritionists/dieticians, and mental health specialists.
After a heart event or surgery, many people are afraid to exercise or be active. They may have never exercised before and don’t know how to begin. The cardiac rehab team will help a patient start slowly, at a comfortable pace, and monitor their progress as they work up to a level that’s good for their heart.
At Burke, the Cardiopulmonary Rehabilitation Program offers both inpatient and outpatient care. During Phase I, patients engage in non strenuous activities involved in self care, such as shaving, bathing and dressing, and light exercise such as walking for short distances several times a day. Patients and their families are also provided with information about making heart-healthy lifestyle changes.
After discharge from the hospital, Burke patients are encouraged to participate in the Phase II Outpatient Cardiac Rehab Program with a doctor’s prescription. It’s possible to also enter the program directly following a new cardiac diagnosis.
Working with a patient’s cardiologist, Burke physicians and clinical exercise physiologists develop an extensive plan of care to address a patient’s unique needs. It includes:
- physician-supervised sessions of individualized, ECG telemetry-monitored aerobic exercises three times a week
- education on exercise self-monitoring skills where patients learn to check their heart rate and level of activity
- seminars on all aspects of cardiac well-being
- nutritional guidance in adopting a heart-healthy diet.
Phase III of cardiac rehab at Burke is a non-ECG-monitored program offered through Burke’s fitness center. It includes an exercise regimen under the expert supervision of exercise physiologists and certified fitness instructors. State of the art cardio and strength equipment, personalized services, and educational lectures are provided for both phase II and III programs. Outpatient cardiac rehab patients also have access to an additional array of services such as yoga, tai chi, strength training classes and educational opportunities that address specific physical or psychological challenges of the cardiac patient.
It’s important to keep in mind that the success of any cardiac rehab program rests largely with the patient. The more dedicated a patient is to following the program’s recommendations the quicker they’ll return to a normal routine and successfully manage their condition in the long run.
What should I consider when choosing a Cardiac Rehab program?
Your doctor may recommend a cardiac rehabilitation program or a patient can ask for a recommendation. Because cardiac rehab requires a time commitment it’s important to choose a program in a location that’s easy to get to and at a time that’s convenient. Also, look for a program where the staff is specially-trained or certified in cardiac rehabilitation and a doctor is either nearby or has direct contact with the staff during the exercise sessions. Another consideration is whether the program’s education and counseling services are available to the whole family, since it can be a great source of support for everyone involved. Most insurance plans and Medicare cover the cost of cardiac rehab.
--Richard S. Novitch, M.D., Director of Burke's Cardiopulmonary Rehabilitation Program
This post first appeared on Burke's Rehab Insights blog, which is updated every week with the latest information on rehabilitation, events at Burke and more.