Cardiac Rehabilitation is a continuous process commencing in hospital following an acute event and continuing on discharge into the community (AHA 1994). Cardiac Rehabilitation is predominately offered to individuals following acute Myocardial Infarction, Percutaneous Coronary Intervention, Coronary Artery Bypass Surgery and Heart Valve Surgery. Cardiac Rehabilitation can be divided into four distinct phases.
Phase 1:This phase relates to the period of hospitalisation following an acute cardiac event. The duration of this phase may vary depending on the initial diagnosis, the severity of the event and individual institutions. During this phase, individuals typically undergo a risk assessment and risk stratification as well as receiving information regarding their diagnosis, risk factors, medications and work/social issues. Involvement of the partner and family is facilitated and encouraged. This phase also includes early mobilisation and adequate discharge planning.
Phase 2:This phase encompasses the immediate post discharge period, which is typically a period of four to six weeks. It focuses on health education and resumption of physical activity. The structure of this phase may vary dramatically from centre to centre. It may take the format of telephone follow up, home visits or individual or group education sessions. Either way, some form of contact is maintained with the patient, facilitating ongoing education and exchange of information.
Phase 3:This phase is sometimes incorrectly referred to as the 'exercise phase'. However it incorporates exercise training in combination with ongoing education and psychosocial and vocational interventions. The duration of phase 3 may vary from six to twelve weeks, with patients required to attend a CR unit two to three times weekly for structured exercise and other lifestyle interventions.
Phase 4: This phase constitutes the components of long-term maintenance of lifestyle changes. It is when patients leave the structured Phase 3 programme and continue exercise and other lifestyle modifications indefinitely. This may be facilitated in the CR units itself or in a local leisure centre. Alternatively individuals may prefer to exercise independently and Phase 4 may involve helping them set a safe and realistic maintenance programme.