Cardiac Rehabilitation for Therapy Professionals

February is American Heart Month.

First celebrated in February 1964, American Heart Month aims to educate the public about the dangers of heart disease, illuminate risk factors, and encourage healthy lifestyles.

Cardiovascular disease remains the leading cause of death in the United States and across the world. Each year, more than 800,000 Americans suffer heart attacks — or one heart attack every 40 seconds. Roughly one in five patients will suffer a second heart attack within the next five years.

Related: Cardiac Conditions – Pathophysiology, Diagnostic Tests and Procedures, and Treatment

What is cardiac rehabilitation?

Cardiac rehabilitation is a multidisciplinary program of outpatient care designed to facilitate recovery from a cardiovascular event (e.g. heart attack, cardiac arrest, heart surgery, etc.). The core tenets of a cardiac rehabilitation program should include:

• Patient assessment nutritional counseling
• Weight management
• Blood pressure management
• Lipid management
• Diabetes management
• Tobacco cessation
• Psychosocial management
• Physical activity counseling
• Exercise training

Given the critical role of exercise in cardiac rehab, physical and occupational therapists play a key role in facilitating a successful program.

Who benefits from cardiac rehabilitation?

Patients who have suffered recent myocardial infarction or acute coronary artery syndrome are good candidates for a cardiac rehab program. Those with chronic stable angina or congestive heart failure may also benefit.

Additionally, the program can help strengthen patients who have just undergone coronary artery bypass surgery, percutaneous coronary intervention, valvular surgery, or a heart transplant.

Designing a cardiac rehabilitation program

A cardiac rehab program will often span several stages. The clinical phase begins soon after the patient’s procedure or cardiac event. Usually done in an inpatient setting, the purpose at this stage is to determine the patient’s physical limitations and capacity for exercise. What is their range of motion? Are there any contraindications present? Does the patient have any further risk factors?

Once the cardiologist clears the patient, phase two begins. This outpatient phase, which can last anywhere from three to twelve weeks, focuses on identifying the patient’s physical functional limitations. The therapist can then design a patient-centered plan incorporating exercise, education, and relaxation.

As the patient heals and becomes more independent, phase three begins. Self-monitoring is key at this stage, with a focus on building strength, flexibility, and aerobic conditioning.

Related: Heart Failure: Implications for Diagnosis, Medical Management, and Rehabilitation, 2nd Edition

Long- and short-term goals

The purpose of a cardiac rehabilitation program is twofold. In the short term, a patient-centered program can help control cardiac symptoms and increase functional capacity. Benefits extend beyond the physical, as well. Cardiac rehab can help limit the detrimental psychological and physiologic effects of cardiac illness.

Long-term, cardiac rehab can reduce the chances of another harmful cardiac event, stabilize or even reverse the progression of atherosclerosis, and equip the patient with the knowledge they need to live a heart-healthy life.