What is Cardiac Rehab?
The US Public Health Service defines outpatient cardiac rehabilitation as "...comprehensive, long-term programs involving medical evaluation, prescribed exercise, cardiac risk factor modification, education and counseling. These programs are designed to limit the physiologic and psychological effects of cardiac illness, reduce the risk for sudden death or re-infarction, control cardiac symptoms, stabilize or reverse the atherosclerotic process, and enhance the psychosocial and vocational status of selected patients." In other words, cardiac rehab is a comprehensive, disease-management program designed to improve one's physical function and overall health and quality of life, increase self-confidence in managing chronic heart and vascular disease, and lessen the chances of recurrent hospital admissions for heart problems.
Cardiac rehab professionals work with the patient to achieve the best possible physical, emotional, and medical outcomes after an heart event such as a heart attack, angioplasty procedure, coronary bypass surgery, heart transplant, heart valve repair or replacement, or in those patients on medical management of chronic stable angina.
Cardiac rehabilitation staff may include nurses, exercise physiologists, physical therapists, dieticians, social workers, psychologists, pharmacists, and physicians.
There are typically three phases to cardiac rehabilitation:
- Inpatient (Phase 1) rehabilitation: Performed during the hospital stay and focused on "survival training" until entry into an outpatient program.
- Outpatient (Phase 2): Usually three to four months of exercise training, monitoring and education designed to improve strength and endurance, manage heart and vascular disease risk factors, and support healthy behavior changes. This phase is usually covered by a person's health insurance plan, but it is wise to check first before enrolling. Most programs will assist patients in determining their coverage for cardiac rehabilitation.
- Maintenance: Upon completion of outpatient cardiac rehab, patients continue their exercise programs at home, in community fitness centers, or in maintenance groups in the cardiac rehab center.
You may be eligible to participate in cardiac rehabilitation if you have had one of the following diagnoses or procedures within the past year:
- Myocardial Infarction (Heart attack)
- Coronary Artery Bypass Surgery
- Percutaneous Coronary Angioplasty (PTCA), with or with Coronary Stents
- Heart Valve Repair or Replacement Surgery
- Heart Transplant
- Recent hospitalization for Heart Failure or Angina
- Peripheral Vascular Disease
- Heart Failure
You should check with your specific health care plan for coverage of services and applicable co-pays before enrolling in cardiac rehabilitation. If you do not have health care insurance, check with your hospital's financial office or the cardiac rehabilitation program for alternative payment options.
What is Pulmonary Rehab?
The American Thoracic Society and the European Respiratory Society define pulmonary rehabilitation as "an evidence-based, multidisciplinary, and comprehensive intervention for patients with chronic respiratory diseases who are symptomatic and often have decreased daily life activities. Integrated into the individualized treatment of the patient, pulmonary rehabilitation is designed to reduce symptoms, optimize functional status, increase participation, and reduce health care costs through stabilizing or reversing systemic manifestations of the disease." Pulmonary rehabilitation programs involve patient assessment, exercise training, education, nutritional intervention, and psychosocial support. In a broader sense, pulmonary rehabilitation includes a spectrum of intervention strategies integrated into the lifelong management of patients with chronic respiratory disease and involves a dynamic, active collaboration among the patient, family, and health care providers.*
Staff in pulmonary rehab may include nurses, physical therapists, exercise physiologists, respiratory therapists, dieticians, pharmacists and psychologists.
There are typically two phases to pulmonary rehabilitation:
- Outpatient phase: Usually three to four months of exercise training, monitoring and education designed to improve strength and endurance, manage pulmonary disease risk factors and medications, and lessen exacerbations of pulmonary disease. This phase is usually covered by a person's health insurance plan, but it is wise to check first before enrolling. Also, there may be certain medical criteria that must be met before insurance will cover rehab costs. Most programs will assist patients in determining their coverage for pulmonary rehabilitation.
- Maintenance: Upon completion of outpatient pulmonary rehab, patients continue their exercise programs at home, in community fitness centers, or in maintenance groups in the pulmonary rehab center.
* American Thoracic Society/European Respiratory Society statement on pulmonary rehabilitation. Am J Respir Crit Care Med. 2006.