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Cardiac rehabilitation: How a four-stage program can help those suffering from heart issues and prevent future problems
General Wellness

Cardiac rehabilitation: How a four-stage program can help those suffering from heart issues and prevent future problems

By Khushboo Kabra, Physical Therapist, Methodist South Rehabilitation
Posted: April 23, 2021

Cardiac rehabilitation is a four-stage, structured program of exercise and education, designed to help you return to optimal fitness and function following a cardiac event/injury.

It involves care from a multitude of healthcare professionals, including your doctor, nurses and rehabilitation specialists. A physical therapist (PT) is one of health care professionals that you will likely work with during cardiac rehab.

Who should take part in cardiac rehabilitation?

Many people with a range of heart problems can benefit from cardiac rehabilitation. It is often recommended for people who have/had:

  • A recent heart attack
  • Stable chest pain (also called angina)
  • Heart failure
  • A heart procedure, such as percutaneous coronary intervention (PCI), angioplasty or cardiac stenting
  • Heart surgery, such as coronary artery bypass surgery, heart valve repair or replacement

It can also be helpful for those who are pre and/or post heart or heart–lung transplant.

How does cardiac rehabilitation/cardiac physical therapy help patients?

Cardiac rehabilitation can have many health benefits in both the short and long term, including not limited to:

  • Strengthening your heart and body after a cardiac event
  • Relieving symptoms of heart problems, such as chest pain
  • Building healthier habits such as getting more physical activity
  • Reducing stress
  • Increasing your energy and strength to make daily activities like carrying groceries and climbing stairs easier
  • Preventing future illness and death from heart disease

What are the 4 phases of cardiac rehabilitation?

Phase 1 of cardiac rehabilitation starts in the hospital, where goal is to recover basic functional mobility. You will also learn techniques to monitor your activity level — and if you’ve had open heart surgery your PT can help you manage your sternal precautions.

Once you leave the hospital, you can engage in Phase 2 of cardiac rehabilitation. This happens at an outpatient clinic and focuses on monitored moderate intensity endurance exercises.

Phase 3 of cardiac rehabilitation involves more intensive exercise, focusing on cardiovascular endurance, muscle strength, flexibility, breathe retraining and activity modification, while we continue to monitor your body's response to increased workloads.

The last transition is to Phase 4 of cardiac rehabilitation, which is done independently by the patient at home.


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How will I know when to progress to Phase 3/outpatient cardiac therapy?

When your vital signs, such as heart rate and blood pressure, remain stable as you increase your activity and workloads prescribed in Phase 2, you are ready to transition to Phase 3. Your doctor and team at the Phase 2 rehab will work closely with you to ensure a safe transition to Phase 3.

What should I expect during my evaluation session for cardiac rehab/outpatient physical therapy?

During your initial evaluation, your physical therapist will likely perform various tests and measures to assess your current level of fitness. It may include, but are not limited to:

  • Range of motion (ROM), strength, endurance, heart rate, blood pressure, sternal precautions/scar mobility (if you have had surgery)
  • We may also perform specific outcome measure to get objective measure of your functional mobility, such as the six-minute walk test and the timed up and go test.

What will my cardiac physical therapy treatment include?

The focus of treatment during phase 3 cardiac rehabilitation is on “exercise and education.” Your physical therapist will prescribe individualized evidence-based exercises reflecting the findings from the evaluation.

Exercises — aim to improve your function and reach your goals

  • Endurance: Treadmill, Ergometer for upper and lower body
  • Strength: Upper and lower body strength training circuits
  • Flexibility exercises: stretches and yoga poses
  • Breathing exercises and relaxation techniques

Education — so you can “become your own therapist”

  • Energy conservation techniques, ergonomic considerations, lifestyle modification
  • Monitoring your own exercise and activity intensity.
  • Home Exercise plan: You will be given structured programs for independent exercises and activities. This is done to prepare you for phase 4 cardiac rehabilitation.

How long will the cardiac rehabilitation last and how long with be outpatient cardiac therapy (Phase 3)?

Cardiac rehabilitation programs usually last about three months but can range anywhere from two to eight months.

You will spend three to six weeks participating in Phase 3 cardiac rehabilitation with the ultimate goal of having you move on to Phase 4 cardiac rehabilitation.

Does my insurance cover cardiac rehabilitation/cardiac physical therapy?

Many insurance plans, including Medicaid and Medicare, cover it if you have a doctor’s referral.

What is the process of enrolling in cardiac rehabilitation or physical therapy program?

  1. Ask for a referral: Find out with your doctor if cardiac rehabilitation is recommended for you
  2. Enroll: With a prescription to participate in cardiac rehab, call us to make an appointment.
  3. After the evaluation: Set goals together with your therapist and start your physical therapy sessions.
  4. Keep at it: After completion, continue exercises on your own or with your peers.

A Word from Methodist South Rehabilitation team

Cardiac rehabilitation is an investment in your future health, so make it a priority. Keep in mind that the recovery after a cardiac event is variable; some people sail through each stage, while others may have a tough time getting back to normal. However, by participating in cardiac rehab and working closely with your PT and doctors, you can be sure to return to a healthy lifestyle!

Methodist South Outpatient rehabilitation offers physical therapy, occupational therapy and speech therapy services for adults and pediatric patient population. We are located at for at 1251 Wesley Drive, Suite 141, Memphis TN 38116 (opposite to Methodist south hospital). Reach us at 901-516-3726.

Want to Learn More About Our Rehabilitation Services?

Methodist outpatient rehabilitation centers feature specially trained physical and occupational therapists offering individual therapy, classes and support groups.

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