Cardiac Rehab

Physical therapy after a Cardiac event is key to treatment and long term health and wellness.  Cardiac rehabilitation refers to a structured program of exercise and education designed to help you recover from a heart attack or other cardiac event. Working with a team of specialists in various settings, you can return to optimal fitness and function by following a multiphase cardiac rehabilitation plan.

What Are The Benefits Of Cardiac Physical Therapy?

Attending a cardiac rehabilitation program gives you the best chance to avoid a future heart attack and improve your quality of life.

Research has found that cardiac rehabilitation can:

  • improve your quality of life and functional capacities
  • lower your risk of future heart issues
  • improve your lung capacity
  • improve your heart health
  • strengthen your heart and body
  • help you maintain a moderate body weight
  • improve your blood pressure
  • improve your mental health and attitude
  • improve your ability to work
  • reduce your body pain
  • help you reduce stress
  • improve your energy and endurance
  • improve your exercise, dietary, and lifestyle habits

Who Needs Cardiac Rehab?

Cardiac rehabilitation isn’t just for heart attacks

Physical therapy and cardiac rehabilitation are an important part of the recovery for many types of heart surgery or cardiac events. Rehabilitation can help you bounce back from:

What Can You Expect During Cardiac Physical Therapy?

Cardiac rehabilitation often starts while you’re in the hospital or just after leaving. Each program is tailored to your individual needs.

At the start of your rehab, a physical therapist will assess your ability with a physical exam and possibly fitness tests or imaging of your heart. They’ll then design a custom program that increases in intensity over time.

According to 2020 guidelines, your physical therapy may include:

  • aerobic exercise to strengthen your heart
  • counseling to improve exercise and lifestyle habits
  • resistance training to strengthen your bones and muscles
  • exercises to retrain your breathing mechanics
  • balance and flexibility training

While you’re still in the hospital, your physical therapist may guide you through exercises in bed that are not strenuous. These exercises aim to improve your range of motion and prevent deconditioning and stiffness from extended bed rest.

Once you leave the hospital, a typical exercise session might involve riding an exercise bike, jogging, or using other cardiovascular fitness. Your physical therapist will monitor your heart rate, blood pressure, respiration rate, and oxygen level while you exercise to assess how your body responds.

There is also some evidence that exercise-based rehab can help people diagnosed with stable angina.

Through cardiac rehab, healthcare professionals work together to help you improve your functional mobility, decrease risk factors related to your cardiac injury, and help you and your family manage the psychosocial effects that may influence your recovery after a heart attack.

Your cardiac rehabilitation team will include physical therapists who help evaluate cardiac function, assess impairments that may limit your mobility, and prescribe progressive exercise and physical activity to help you return to your normal lifestyle after a cardiac event.

There are four phases of cardiac rehabilitation. The first phase occurs in the hospital after your cardiac event, and the other three phases occur in a cardiac rehab center or at home once you’ve left the hospital. Keep in mind that the recovery after a cardiac event is variable; some people sail through each stage, while others may have a tough time getting back to normal. Work closely with your healthcare provider to understand your progress and prognosis after a cardiac event.

The Acute Phase

The initial phase of cardiac rehabilitation occurs soon after your cardiac event.  A Cobblestone therapist will work closely with your other healthcare providers, nurses, and other rehabilitation professionals to help you start to regain your mobility.

The initial goals of phase one cardiac rehabilitation include:

  • Assess your mobility and the effects that basic functional mobility has on your cardiovascular system
  • Work with healthcare providers, nurses, and other therapists to ensure that appropriate discharge planning occurs
  • Prescribe safe exercises to help you improve your mobility, and to improve cardiac fitness
  • Help you maintain your sternal precautions if you have had open-heart surgery
  • Address any risk factors that may lead to cardiac events
  • Prescribe an appropriate assistive device, like a cane or a walker, to ensure that you are able to move around safely
  • Work with you and your family to provide education about your condition and the expected benefits and risks associated with a cardiac rehabilitation program

Once significant healing has taken place, you may be discharged home to begin phase two cardiac rehab.

The Subacute Phase

Once you leave the hospital, your cardiac rehabilitation program will continue at an outpatient facility. Phase two of cardiac rehabilitation usually lasts from three to six weeks and involves continued monitoring of your cardiac responses to exercise and activity.

Another important aspect of phase two cardiac rehabilitation is education about proper exercise procedures, and about how to self-monitor heart rate and exertion levels during exercise. This phase centers around your safe return to functional mobility while monitoring your heart rate.

Towards the end of phase two, you should be ready to begin more independent exercise and activity.

Intensive Outpatient Therapy

Phase three of cardiac rehabilitation involves more independent and group exercise.1 You should be able to monitor your own heart rate, your symptomatic response to exercise, and your rating of perceived exertion (RPE). Your physical therapist will be present during this phase to help you increase your exercise tolerance and to monitor any negative changes that may occur during this phase of cardiac rehab.

As you become more and more independent during phase three of cardiac rehabilitation, your physical therapist can help tailor a program of exercises, including flexibility, strengthening, and aerobic exercise.

Measuring Cardio Health

To determine whether cardiac rehab is helping your heart recover from injuries, healthcare professionals use a system to measure cardiorespiratory fitness known as metabolic equivalent of tasks (METs). This is a ratio of the rate of oxygen you consume when working to the rate of oxygen you consume when resting.

As you progress through the cardiac rehab phases, METs capacity may be increased, which, according to research, should lower your risk of future heart problems.5

Independent Ongoing Conditioning

The final phase of cardiac rehabilitation is your own independent and ongoing conditioning.4 If you have participated fully in the previous three phases, then you should have excellent knowledge about your specific condition, risk factors, and strategies to maintain optimal health.

Independent exercise and conditioning are essential to maintaining optimal health and preventing possible future cardiac problems. While phase four is an independent maintenance phase,  your Cobblestone therapist is available to help make changes to your current exercise routine to help you achieve physical fitness and wellness.

An unexpected cardiac event, like a heart attack or open-heart surgery, can be a scary and life-altering experience. By working closely with your healthcare provider and rehab team, and by participating fully in the four phases of cardiac rehabilitation, you can increase your chances of returning to optimal health quickly and safely.

Source: Healthline.com

(2023)

 

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