The Benefits of Cardiac Rehab

Most people understand the value of physical therapy after a bone or muscle injury. Specific exercises are prescribed to strengthen the affected body part(s), reduce pain, hasten recovery and help restore function. When the injured muscle is the heart, the same principles apply. Cardiac rehabilitation is designed strengthen the heart muscle, improve function and lower the risk of another potentially life-threatening cardiac event.

“My patients often ask me if they really need cardiac rehab,” says Chad Raymond, DO, Director of Cardiovascular Rehabilitation for University Hospitals Harrington Heart & Vascular Institute. “I respond with yes, if you want to live longer and feel better. The benefits of cardiac rehab are substantial. In combination with lifestyle modifications and counseling, it can reduce the risk of another heart attack and mortality as well as or better than many of the medications that are often prescribed after a cardiac event or heart surgery,” he adds.

How Medical Protocols Have Evolved

Historically, physical activity after a heart attack or other cardiovascular event was not recommended. Patients were confined to bed for up to six weeks based on the belief that the heart needed complete rest to heal. This practice, in fact, led to significant weakening of the entire body, including the heart.

In the 1940s and 1950s, recommendations were slowly modified to include some activity, beginning with simply getting out of bed to sit in a chair and later, short daily walks were permitted. Since then, ongoing research has repeatedly linked a sedentary lifestyle with cardiovascular disease. Today, the benefits of exercise are widely accepted for overall health and heart health in particular.

What to Expect With Cardiac Rehab

Ideally, a cardiac rehab program will begin while you are still in the hospital after heart surgery or treatment for a heart attack or other heart-related problem. Your care team will encourage you to get up and move, and may have you use equipment such as a stationary bike or treadmill if it is available. The goal is to prepare you for discharge and a safe return to your normal activities of daily living.

In addition, your team will discuss the specifics of your health condition and provide education about recovery and your unique risk factors. Lifestyle modifications will often be suggested to reduce your risk, improve your heart health and enhance day-to-day functioning. Outpatient rehab sessions will be scheduled to ensure your continued progress and recovery after leaving the hospital.

Therapy Continues after Discharge

Outpatient cardiac rehab typically consists of three sessions a week for up to 36 sessions. This is the most important phase of cardiac rehab. If a patient has not progressed as expected after 36 sessions, some may be approved to continue for up to 72 sessions. Regardless of duration, patients remain under close physician supervision and their cardiac function is closely monitored.

At the initial visit, a personalized therapy plan will be developed to meet each patient’s unique abilities and goals. In addition to the prescribed exercises, there are several educational sessions provided along with counseling related to lifestyle modifications for risk reduction, including:

• Smoking cessation
• Diet and weight loss
• Management of chronic conditions like hypertension and diabetes
• Management of stress, anxiety and depression
• Alcohol use
• Sexual activity counseling

For those patients who have time constraints or work-related hardships, a home-based program may be offered. Although there is growing evidence that home-based programs can be as effective as a facility-based program, they do require full patient participation in the prescribed exercise regimen for a successful outcome.

Lifetime Maintenance

After completing outpatient rehab, patients will have the tools and knowledge they need to continue their program at home. Some may choose to use their own fitness equipment or join a local gym.

The exercises and the lifestyle modifications should be maintained for the rest of a patient’s life. Follow-up visits with their doctor or cardiologist will vary depending on their individual medical profile, age and any co-existing conditions they may have.

Is Cardiac Rehabilitation Safe?

“Yes, absolutely,” says Dr. Raymond. “Medically supervised cardiac rehab has been proven to be very safe with an extremely low risk of cardiovascular complications.” The many benefits include:

• Reduced mortality rates and fewer hospital re-admissions
• Improved ability to perform the activities of daily living
• Enhanced quality of life
• Support from their care team and other participants, often leading to lasting friendships and the motivation needed to make the recommended lifestyle changes

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University Hospitals offers a dedicated, multidisciplinary cardiac rehabilitation program to help patients improve their heart health and overall physical fitness after a heart attack, heart surgery or other heart-related event.