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Cardiac rehabilitation
By Mayo Clinic staffOriginal Article: http://www.mayoclinic.com/health/cardiac-rehabilitation/MY00771
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Definition
Cardiac rehabilitation — also called cardiac rehab — is a customized program of exercise and education. Cardiac rehabilitation is designed to help you recover from a heart attack, other forms of heart disease or surgery to treat heart disease.
Cardiac rehabilitation is often divided into phases that involve monitored exercise, nutritional counseling, emotional support, and support and education about lifestyle changes to reduce your risks of heart problems. The goals of cardiac rehabilitation are to help you regain strength, to prevent your condition from worsening and to reduce your risk of future heart problems.
Cardiac rehabilitation programs increase your chances of survival. Both the American Heart Association and American College of Cardiology recommend cardiac rehabilitation programs.
Why it's done
Cardiac rehabilitation is an option for people of all ages and with many forms of heart disease. In particular, you may benefit from cardiac rehabilitation if your medical history includes:
- Heart attack
- Coronary artery disease
- Heart failure
- Peripheral arterial disease
- Chest pain (angina)
- Cardiomyopathy
- Certain congenital heart diseases
- Coronary artery bypass surgery
- Angioplasty and stents
- Heart transplant
- Heart valve replacements
Don't let older age hold you back from joining a cardiac rehabilitation program. Even if you're older than 65, you're likely to benefit from cardiac rehabilitation.
Risks
Cardiac rehabilitation isn't appropriate for everyone who's had heart disease. Your health care team will evaluate your health to make sure you're ready to start a cardiac rehabilitation program.
Rarely, some people suffer injuries, such as strained muscles or sprains, while exercising as a part of cardiac rehabilitation. Your health care team will carefully monitor you while you exercise to lower this risk and will teach you how to avoid injuries when you exercise on your own.
How you prepare
If you've had a heart attack or heart surgery or if you have another heart condition, ask your doctor about joining a cardiac rehabilitation program. Insurance and Medicare often cover the costs of cardiac rehabilitation.
Cardiac rehabilitation often begins while you're still in the hospital and continues with monitored programs in an outpatient setting until home-based maintenance programs can be safely followed.
What you can expect
During cardiac rehabilitation
The first stages of most cardiac rehabilitation programs last about three to six months. During that time, you may work with cardiologists, nurse educators, dietitians, exercise rehabilitation specialists, occupational therapists, physical therapists, psychologists and psychiatrists.
Cardiac rehabilitation has four main parts:
- Medical evaluation. Initial and ongoing evaluation helps your health care team check your physical abilities, medical limitations and other conditions you may have, and keep track of your progress over time. Your health care team looks at your risk factors for heart disease, stroke or high blood pressure. This helps your team tailor a cardiac rehabilitation program to your individual situation, making sure it's safe and effective.
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Physical activity. Cardiac rehabilitation improves your cardiovascular fitness through walking, cycling, rowing, or even jogging and other endurance activities. You may also do strength training (lifting weights, for example) to increase your muscular fitness.
Don't worry if you've never exercised before. Your cardiac rehabilitation team will make sure the program moves at a comfortable pace and is safe for you, but in general you should exercise three to five times a week. You'll be taught proper exercise techniques, such as warming up and stretching.
- Lifestyle education. Guidance about nutrition helps you shed excess weight and learn to make healthier food choices aimed at reducing fat, sodium and cholesterol in your diet. You receive support and education on making lifestyle changes and breaking unhealthy habits, such as smoking. You also learn how to manage pain or fatigue. Cardiac rehabilitation also gives you ample opportunity to ask questions about such issues as sexual activity. Finally, it's critical you closely follow your doctor's advice on medications.
- Support. Adjusting to a serious health problem often takes time. You may feel depressed or anxious, lose touch with your social support system, or have to stop working for several weeks. If you get depressed, don't ignore it because depression can make your cardiac rehab program more difficult, as well as impact your relationships and other areas of your life and health. Counseling will help you learn healthy ways to cope with depression and other feelings, and your doctor may also suggest medications such as antidepressants. Vocational or occupational therapy will teach you new skills to help you return to work.
Although it may be difficult to start a cardiac rehabilitation program when you're not feeling well, you'll benefit in the long run. Cardiac rehabilitation can guide you through fear and anxiety as you return to an active lifestyle, with more motivation and energy to do the things you enjoy.
Cardiac rehabilitation helps you rebuild your life, both physically and emotionally. As you get stronger and learn how to manage your condition, you'll likely return to a normal routine, along with your new diet and exercise habits. It's important to know that your chances of having a successful cardiac rehab program rest largely with you; the more dedicated you are to following your program's recommendations, the better you'll do.
After cardiac rehabilitation
After your cardiac rehabilitation program ends, you'll need to continue the diet and exercise habits you learn for the rest of your life to maintain heart-health benefits.
Results
Cardiac rehabilitation is a long-term maintenance program — something to follow for the rest of your life. After about 12 weeks, you probably will have developed your own exercise routine at home or at a local gym. You may also continue to exercise at a cardiac rehab center. You may remain under medical supervision during this time, particularly if you have special health concerns. Education about nutrition, lifestyle and weight loss may continue, as well as counseling. For best success, make sure your exercise and lifestyle practices become lifelong habits.
Over the long term, you gain strength, learn heart-healthy behaviors, improve your diet, cut bad habits, such as smoking, and learn how to cope with heart disease. You'll also decrease your risk of coronary artery disease and other heart conditions.
One of the most valuable benefits of cardiac rehabilitation is often an improvement in your overall quality of life. If you stick with your cardiac rehab program, you're likely to come out of the program feeling better than before.
- Cardiac rehabilitation. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4490. Accessed April 29, 2011.
- Cardiac rehabilitation. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/rehab/rehab_all.html. Accessed April 29, 2011.
- Balady GJ, et al. Core components of cardiac rehabilitation/secondary prevention programs: 2007 update. Circulation. 2007;115:2675.
- Thomas RJ, et al. AACVPR/ACC/AHA 2007 performance measures on cardiac rehabilitation for referral to and delivery of cardiac rehabilitation/secondary prevention services. Circulation. 2007;116:1611.
- Williams MA, et al. Clinical evidence for a health benefit from cardiac rehabilitation: An update. American Heart Journal. 2006;152:835.
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