Cardiac Rehabilitation: Physical Therapy After a Heart Attack

What is cardiac physical therapy?

Heart attacks are the leading cause of death in the United States. According to the American Heart Association (AHA), the average age for a first heart attack in the United States is 65.6 years for men and 72.0 years for women.

Cardiac rehabilitation is a program to help you recover from a heart attack and improve your quality of life. This program is critical for minimizing your chances of having another heart attack. It often starts while you’re in the hospital or shortly after you leave.

According to the Centers for Disease Control and Prevention (CDC), anybody who has had a heart problem, like a heart attack, can benefit from cardiac rehabilitation. Most programs last about 3 months, but they can last anywhere from 2 to 8 months.

A cardiac rehabilitation program consists of:

• exercise counseling and training
• education for managing risk factors
• counseling to reduce stress

A physical therapist usually leads the physical activity portion of a cardiac rehabilitation program. A 2014 review suggests the aim of the program is to improve your exercise capacity and quality of life in the short term and long term.

Staying physically active after a heart attack is important for keeping your heart strong. Research from 2018 has found that increased physical activity in the first year after a heart attack is related to a reduced chance of death.

A physical therapist can help assess your current fitness levels and create a detailed exercise program for you to improve your fitness.

What are the benefits of cardiac physical therapy?

Attending a cardiac rehabilitation program gives you the best chance to avoid a future heart attack and improve your quality of life.

Research has found that cardiac rehabilitation can:

• improve your health-related quality of life and functional capacity
• lower your risk of future heart attack
• improve your lung capacity
• improve your heart health
• strengthen your heart and body
• help you maintain a moderate body weight
• improve your blood pressure
• improve your mental health
• improve your ability to work
• reduce your body pain
• help you reduce stress
• improve your energy and endurance
• improve your exercise, dietary, and lifestyle habits

What can you expect during cardiac physical therapy?

Cardiac rehabilitation often starts while you’re in the hospital or just after leaving. Each program is tailored to your individual needs.

A 2016 review indicates that the physical activity program generally consists of 36 sessions over 12 weeks, but some programs can be longer.

At the start of your rehab, a physical therapist will assess your ability with a physical exam and possibly fitness tests or imaging of your heart. They’ll then design a custom program that increases in intensity over time.

According to 2020 guidelines, your physical therapy may include:

• aerobic exercise to strengthen your heart
• counseling to improve exercise and lifestyle habits
• resistance training to strengthen your bones and muscles
• exercises to retrain your breathing mechanics
• balance and flexibility training

While you’re still in the hospital, your physical therapist may guide you through exercises in bed that are not strenuous. These exercises aim to improve your range of motion and prevent deconditioning and stiffness from extended bed rest.

Once you leave the hospital, a typical exercise session might involve riding an exercise bike, jogging, or using other cardiovascular fitness. Your physical therapist will monitor your heart rate, blood pressure, respiration rate, and oxygen level while you exercise to assess how your body responds.

What are the risks of cardiac physical therapy?

Some people may not make good candidates for the exercise portion of cardiac rehabilitation, such as people with unstable angina. Your doctor can help you figure out if you have a condition that may preclude you from exercise.

Programs that include intensive aerobic exercise and resistance training are considered safe by many leading health authorities.

Serious risks are very rare. A 2006 study from France found that the rate of cardiac arrest was 1.3 per million hours of exercise.

A small 2017 study of people who received heart rhythm management devices found that those who underwent cardiac rehabilitation had fewer complications than those who didn’t.

What do I need to know before I start cardiac rehabilitation?

Cardiac rehabilitation requires a referral from your doctor. Your doctor can let you know what your program will include.

If you have insurance, it’s a good idea to make sure your policy will cover treatment before you start. Some people may not be covered, such as those who have received a heart rhythm management device.

The AHA says that Medicare and most other insurance providers offer reimbursement for cardiac rehabilitation for treating heart attacks. According to the National Heart, Lung, and Blood Institute, Medicare covers 36 supervised sessions over 12 weeks.

What is the outlook after cardiac rehabilitation?

Attending cardiac rehabilitation gives you the best chance to maintain a high quality of life and prevent another heart attack.

• A 2021 review indicates that participants may have a 13 percent lower chance of having another heart attack.
• A 2016 study found that in a group of 4,929 people who experienced heart attacks, people who underwent cardiac rehabilitation lived significantly longer.
• Studies have found that cardiac rehabilitation decreases your chances of dying in the 5 years after a cardiac event from any cause by about 32 percent.

Talk with your doctor about how cardiac rehabilitation can improve your recovery after a heart attack.