Rehabilitation phases

Phase I Rehabilitation (Inpatient care)

Educational topics covered while in the hospital include reducing risk factors, energy conservation, work simplification, stress reduction, activity precautions after surgery, signs of overexertion, sexuality and returning to daily living activities. Exercise components include exercise progression and guidelines, self-assessment skills and an individualized home exercise program. Patients’ heart rate and blood pressure in response to activity are measured.  At discharge, therapists may recommend home-care therapy or Phase II cardiac rehabilitation if appropriate.

Phase II Rehabilitation (Outpatient services)

A doctor’s referral is needed to take part in Phase II rehabilitation, which concentrates on functional outcomes and prevention through education and individualized exercise instruction. Physical therapists and cardiac nurses evaluate and chart progress in monitored group exercise sessions two times to three times per week, for four weeks to six weeks. Modified programs are available for patients who, due to age, physical endurance or a diagnosis, may not require the complete program. Referrals also are accepted for a one-time exercise evaluation and home exercise instruction.

During the exercise program, the therapy team evaluates heart rate, blood pressure and the electrical activity of the heart at rest and with exertion. Patients participate in progressive conditioning that includes calisthenics (exercises for muscle tone), aerobic training and instruction in foot, ankle, knee and hip stretching. Equipment and exercises used for the program includes treadmills, elliptical machines, stationary bikes, recumbent bikes, recumbent stair steppers, upper body ergometers (which measure the amount of work being done by the muscles) and chair aerobics. The educational component includes instruction in risk factor modification, cardiac symptoms, heart anatomy and physiology, diet, medications, activity selection, self-assessment skills and stress reduction techniques. Patients also are provided with information about the heart and vascular lecture series.    

Phase III Rehabilitation

Phase III is a monitored fitness program that includes regular supervision by physical therapists and registered nurses, plus education on topics such as diet and stress reduction. These health care professionals also can recommend fitness products and supplies to be used at home and teach patients how to use them. By adding fitness to their regular activities, and learning more about healthy lifestyles, participants can lower their heart disease risk.

Phase III is designed for people who have completed outpatient cardiac rehabilitation or pulmonary rehabilitation or for people who have a history of heart disease or significant cardiac risk factors. Patients with past pulmonary issues are encouraged to consider this program for improving endurance and breathing.

A doctor’s referral is required for all participants. People who have not participated in cardiac rehabilitation or pulmonary rehabilitation in the past three months must undergo a complete electrocardiogram session (which records the electrical activity of the heart) at the initial visit for an additional cost. Insurance typically does not cover this service.