Cardiac rehabilitation helps patients following discharge from the hospital, but more than half of heart disease patients eligible for such rehabilitation are not referred for it.
Heart disease is the number one killer in India. It is also a major cause of disability. A recent study published in the British journal Lancet states that India will bear 60% of the world’s heart disease burden in the coming years. Further, the research points out that the average age of patients with heart disease is getting lower among Indians compared to people in other developed countries. A report by the Earth Institute at Columbia University warned that without sustained effort on individual and national levels, the coming heart-disease epidemic will exact a devastating price on the physical and economic health of any nation.
Indeed, a cause for concern, particularly with 60 per cent of the country’s current population aged below 25, and the present working-age population is aged 15-59. While the problem is grim, there is hope for heart patients in the form of cardiac rehabilitation programs. Although there has been credible evidence that cardiac rehabilitation helps patients following discharge from the hospital, more than half of heart disease patients eligible for such rehabilitation are not referred for it.
Cardiac rehabilitation programs are designed for patients who are recovering from a heart attack, recovering from a coronary bypass surgery or valve replacement surgery or those patients who have had angioplasty or stent placement. Cardiac rehabilitation involves exercise and counseling on diet and other risk factors. It has been shown to decrease the likelihood of future heart problems. Cardiac rehab programs are often designed to fit the individual, so the length of the program can vary from weeks to months, depending on the specific needs of the heart patient.
Rehab in three phases
Cardiac rehabilitation is often divided into phases that involve monitored exercise, nutritional counseling, emotional support, and support and education about lifestyle changes to reduce your risks of heart problems.
Phase 1 cardiac rehab program, a one-on-one in patient program, is meant for those who are hospitalized and is aimed at regaining basic skills, such as getting out of bed and going to the bathroom without any help.
The second phase which is post-hospitalization involves a supervised exercise program designed to build strength and endurance, usually lasting for three months thrice a week. Apart from the conventional treadmill, the phase II cardiac rehab program also involves non-traditional activities such as dance or other exercise classes.
The third phase is a continuation of supervised exercise aimed at maintaining consistent, healthy lifestyle habits. Long-term follow up may include home health visits and telephone calls from healthcare team.
Counseling & stress management
Although a supervised exercise training program is the foundation of heart failure rehabilitation, education and counseling programs are important as well. The counseling sessions may include talk therapy, stress management, relaxation exercises, coping techniques, and, in some cases, the use of antidepressant medications. Some studies show that heart patients who underwent counseling as part of cardiac rehabilitation programs have greater reductions in psychological distress, blood pressure, heart rate, and cholesterol levels than people who underwent cardiac rehabilitation without a counseling component.
During the course of the program, the heart patient will be given instructions on different strategies to quit smoking and dietary tips to reduce fat, salt and cholesterol. A rehabilitation program may offer classes or lectures including an introduction to your disease, energy conservation, breathing techniques, and learning to live with your diagnosis.
The counseling programs also focus on managing stress, depression and how to cope up with heart problems such as getting back to work. Studies reveal that about one in five people suffer from major depression after a heart attack, bypass surgery, or angioplasty. Some degree of depression occurs in up to a third of all heart attack survivors. Women generally experience more depressive symptoms than men after a heart attack or bypass surgery. Sometimes people who survive a heart attack or undergo bypass surgery suffer from post-traumatic stress disorder (PTSD). PTSD is a condition that develops after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened.
The goals of cardiac rehabilitation are to help you regain strength, to prevent your condition from worsening and to reduce your risk of future heart problems. Cardiac rehabilitation programs increase your chances of survival. Therefore it is essential for all heart patients to go for a cardiac rehab program to increase their chances of survival and lead a normal life.