The Rehab Programmes

Cardiac rehab is a programme designed specifically for the individual patient.  It includes exercise, lifestyle changes, education, and emotional support. It can help improve your health and enable you to live a more active life after you have had a heart attack or heart surgery or if you have a long-term heart problem such as heart failure. Cardiac rehab can also help you return to work safely and in a timely manner.

You may start a cardiac rehab program while you are still in the hospital after having treatment for a heart attack or other heart problem, soon after leaving the hospital, or at any other time to help prevent future heart problems, improve the quality of your life, and make you healthier. Your doctor will give you an exercise prescription that gives you and your cardiac rehab team guidelines for the frequency, duration, and intensity of exercise. The prescription will be based on your medical condition and your fitness level.

How fast you recover depends on your age, your health, and whether you have other health conditions that may slow your recovery. A younger person without other health problems may improve more quickly than an older person who is in poor health. Depending on your condition and how you respond to rehab, you may stay in a particular phase or move back and forth among the various phases. There is no set length of time that you must stay in a specific phase.

Cardiac rehab has four phases. The cardiologist or doctor determines which phase is best for a patient to enter the programme.

Phase I: Inpatient programme
Phase I takes place in the hospital after you have experienced a heart attack or other major heart problem. Phase I of cardiac rehab usually includes:

  • Determining how well you can care for yourself (bathing, dressing, and grooming) after your heart attack or surgery.
  • Measuring your ability to exercise. Your cardiologist will probably want you to have an exercise test before you begin your cardiac rehab exercise program. This test will show what types of exercise are safe for you and how soon you can begin to exercise.
  • Identifying which daily activities, such as lifting, you can safely do.
  • Providing patient and family education about the lifestyle changes you need to make, such as eating healthy foods and stopping cigarette smoking. Changes in your diet may be difficult to make. But even small changes can help improve cholesterol levels and improve your health. For ideas that can help you get started, see:
  • Doing light exercise, such as walking short distances several times a day.

The remaining three phases of your cardiac rehab take place outside the hospital. At first, your rehab team will keep a close watch on how exercise affects your heart and how you are progressing, before gradually releasing you from supervision to continue cardiac rehab on your own. The healthier lifestyle you've learned-including eating a balanced diet, exercising regularly, and not smoking-can then become a way of life for you.

Phase 4 Cardiac Rehab prepares you for exercising unsupervised, providing the rehab team with the  reassurances that your cardio vascular fitness and confidence are now ready for you to play an active part in normal life. Phase 4 is still exercise based, but more challenging than earlier phases.

Many patients continue to attend Phase 4 supervised classes, even when they are fit enough to exercise unsupervised, and have built such activity into their lifestyle.  This ensures that friendships built up during attendance throughout the programme are maintained, and social contact often continues for many years.

What does the Cardiac Rehabilitation program involve?

The Cardiac Rehabilitation programme involves exercise, relaxation, goal setting and education classes.  This process is divided into Phase 3 and Phase 4 Classes, progressing from the latter to the former. All are carried out in a supportive fun environment with people who are in similar circumstances. Some of the details of what the programme involves are listed below:

Exercise
Exercise is good for us! Our hearts are muscles, which will become stronger if we do moderate exercise for 30 minutes at least five times per week.

Phase 3 offers an Individual exercise programme, which is agreed between the patient and cardiac nurse. The intensity of the exercise is gradually increased according to how the patient feels during the exercise, but is not set at a level which is a deterrent.  As Cardio vascular fitness increases, the patient is moved on to Phase 4 classes, where the process is similar, but more challenging.  All exercise is supervised by a qualified fitness instructor.

Education
A variety of educational talks are included in the Cardiac Rehab programme. These include:

  • Healthy Eating.
  • Stress and Stress Management.
  • Risk Factors.
  • Sleep/concentration and Memory.
  • Return to work issues.
  • Dr’s Question Time
  • Exercise.
  • Psychological contribution – for things such as anxiety/ relationship issues/depression etc.
  • Relaxation.
  • Medication.

Goal Setting
This is an opportunity for patients to meet with a member of the cardiac rehabilitation team for some individual time, to identify areas which require further support, e.g.:- increasing walking distance, returning to work, making lifestyle changes such as diet etc.

Relaxation
A short session is provided following each exercise session in the gym. Relaxation has many benefits for health as well as:

  • reducing stress
  • coping with problems
  • lowering blood pressure
  • reducing heart rate