Cardiac Rehab: Is It Just Cardiovascular Exercise?

Cardiac rehabilitation (CR) is a series of activities and interventions designed to help people who’ve had heart disease or a heart attack recover as much as possible. To achieve this, CR programs often incorporate cardiovascular exercise and other activities that stress the body’s capacity for exertion.

But is this enough? Or do we need more from CR? CR programs are usually structured around four key phases: diagnostic, education, exercise and follow-up care. Cardiac rehab programs can last anywhere from 12 weeks to several months depending on the severity of the illness or injury and the needs of the participant.

However, recent research points to another option: Home Cardiac Rehab. The question is — in what ways could this be even more beneficial than standard in-hospital cardiac rehab?

What is Cardiac Rehab?

Cardiac rehabilitation (also referred to as cardiopulmonary rehab or CR) is a program of exercise and other interventions designed to help people who’ve had heart disease or a heart attack recover as much as possible.

The goal is to improve overall health and quality of life and prevent further heart disease by helping people make healthy lifestyle changes and follow a prescribed program of supervised exercise.

Cardiac rehabilitation programs are usually structured around four key phases: a diagnostic phase, an education phase, an exercise phase and a follow-up care phase. Programs can last anywhere from 12 weeks to several months depending on the severity of the illness or injury and the needs of the participant.

How Does Cardiac Rehab Help Recovery?

While many people associate cardiopulmonary rehabilitation with cardiovascular exercise, there are many other aspects to these programs. These include individualized education about heart disease and its risk factors, nutritional guidance, stress management techniques, lifestyle risk factor modification (smoking cessation, diet and nutrition, etc.), self-monitoring of lifestyle risk factors, and communication with other individuals in the program. The overall goal is to help participants learn how to modify their lifestyles to minimize heart disease risk while increasing their quality of life.

What is Home Cardiac Rehab?

Home cardiac rehabilitation (HCR) is an alternative to a traditional in-hospital cardiac rehabilitation program. It’s an outpatient program for people who’ve had heart disease or a heart attack.

These people are generally too ill to do an in-hospital cardiac rehabilitation program, but could benefit from an outpatient program that can be tailored to their needs.

HCR programs are supervised by a cardiopulmonary therapist (someone who specializes in heart and lung disease). In an HCR program, participants do exercises to improve their heart and lung function and learn strategies to reduce their risk of future heart disease.

Is Prolonged Cardio Exercise Enough for Recovery?

While cardiovascular exercise is essential to a successful cardiac rehab program, there are some who argue that we may be doing a disservice to patients – especially those with more severe illness.

The concern is that, while a person’s heart disease is still in the acute phase, they may be doing a lot of cardiovascular work – work that their hearts are not yet able to handle. What are the indicators that exercise can begin? Cardiac Function Altered (CFA) and Cardiac Risk Equation (CRE) scores are the two commonly used tools for determining when a person is ready for exercise. A CFA score of 50 or above indicates that a person’s heart is ready for exercise; a CRE score of 5 or above indicates that it’s also ready.

So Why Might We Need More Than Cardiovascular Exercise?

Although cardiovascular exercise is essential, it has its limits. This is especially so when we are dealing with people who have more severe illness. If we do not expand the exercise regimen to include other elements, we may be doing a disservice to those who need it most.

There are some who argue that cardiac rehabilitation may be missing an important opportunity. This is because one of the best ways of helping the heart recover is through the nervous system. The autonomic nervous system (ANS) is responsible for regulating the internal organs – including the heart.

The ANS is also responsible for regulating the “fight-or-flight” response, which is what happens when we are stressed. The autonomic system is also where most of the “hidden injuries” occur. This is because the ANS is responsible for regulating all of the body’s internal organs – including the heart.

Summary
While cardiovascular exercise is essential to a successful cardiopulmonary rehab program, there are some who argue that we may be doing a disservice to patients – especially those with more severe illness.

The concern is that, while a person’s heart disease is still in the acute phase, they may be doing a lot of cardiovascular work – work that their hearts aren’t yet able to handle. This is why it may be important to expand the exercise regimen to include other elements, like breathwork and meditation, which can help the heart recover through the nervous system.

Also Read: The 5 Best Breathing Exercises for COPD