Cardiac Rehabilitation Phase I: In the Hospital
Topic Overview
Cardiac rehabilitation phase I starts while you are in the
hospital and emphasizes exercise and education.
The parts of phase I include:
- A customized exercise program, based on your
medical history, clinical condition, and symptoms.
- Discharge instructions about recovery activities.
- Education on lifestyle changes and how to lower your risk of future heart problems.
- Ways to help your body recover and:
- Increase appetite
and strength.
- Increase aerobic capacity.
- Increase lung capacity.
- If you had a heart transplant, avoid rejection of your new
heart.
Your rate of recovery depends on age, gender, and other health
conditions. Depending upon your condition and how you respond to rehab, you may
stay in a particular phase or move back and forth among the various phases.
There is no set length of time that you must stay in a specific phase.
Your hospital rehab staff should be able to provide you with
information and resources for making the transition from hospital to
home. This includes
how to find a cardiac rehab phase II program in your community.
Exercise program
The following exercises are examples. Your exercise program depends on your medical history, clinical status, and symptoms.
Discuss with your doctor any additional physical limitations or medical issues before beginning any exercise program.
A phase I cardiac rehab exercise program should progress from
initial supportive and self-care activities to regular daily walking.
- You will start with easy activities, such as
sitting up in a chair and walking, as soon as you are able. Early activity is
important, because you lose muscle strength very quickly when you stay in
bed.
- As you become stronger, you might be active 2 or 3 times a day for 5 to 20
minutes each time, depending on your condition. A member of the rehab staff
will monitor your heart rate to be sure it doesn't get too high while you walk
or slowly climb stairs.
- How long you stay in the hospital depends on what problem, procedure, or surgery you had. Your cardiac rehab program might be 3 to
5 days in the hospital, including transition to home-based
activities. If you had an open-heart surgery, you will likely be in the hospital longer.
Examples of initial activity
|
Step 1
|
- Rest in bed until stable.
- Sit
up in bed with assistance.
- Stand at bedside with
assistance.
- Perform self-care activities while seated.
|
|
Step 2
|
- Sit up in bed
independently.
- Walk in room and to bathroom.
- Perform
self-care activities in bathroom.
|
|
Step 3
|
- Sit and stand
independently.
- Walk in hall with assistance: 5 to 10 minutes, 2 or
3 times a day.
|
|
Step 4
|
- Walk in hall: 5 to 10 minutes, 3 or 4
times a day.
- Walk down stairs with assistance.
|
Examples of increases in activity
|
Mode
|
Walking in hospital hall |
|
Frequency
|
Early mobile (days 1 to 3)
- 1 or 2 times a day (always warm up and
cool down)
Later mobile (days 2 to 4) |
|
Intensity
|
|
|
Time
|
- Intermittent bouts, 3 to 5
minutes
- Rest periods at your discretion, 1 to 2 min. shorter than
exercise bout
- To progress, initially increase to 10 to 15 min.,
then increase intensity.
- Include stair climbing when your doctor
says it's okay.
|
References
Other Works Consulted
- American College of Sports Medicine (2010). Exercise prescription for patients with cardiac disease. In WR Thompson et al., eds., ACSM's Guidelines for Exercise Testing and Prescription, 8th ed., pp. 207–224. Philadelphia: Lippincott Williams and Wilkins.
- Graham I (2008). Rehabilitation of the patient with
coronary heart disease. In V Fuster et al., eds., Hurst's The Heart, 12th ed., pp. 1529–1548. New York: McGraw-Hill
Medical.
Credits
|
By
|
Healthwise Staff |
|
Primary Medical Reviewer
|
E. Gregory Thompson, MD - Internal Medicine |
|
Specialist Medical Reviewer
|
Richard D. Zorowitz, MD - Physical Medicine and Rehabilitation |
|
Last Revised
|
August 10, 2011 |
Last Revised:
August 10, 2011
