If you or your loved one has gone through a cardiac event, such as a heart attack or a procedure like open heart surgery, you most probably require thorough treatment for you to return to your former level of function. Additionally, your doctor would most likely suggest that take part in a cardiac rehab program, which is the physical therapist’s job to work with you particularly in the acute phase of the program.
There are four stages in the cardiac rehabilitation plan, but the first and acute phase is done within the hospital, while the last two steps begin when you leave the hospital. It is usually done at home or in an outpatient rehab facility. The fourth and final stage of the program is the maintenance stage where you are required to perform a fitness program formulated by a physical therapist regularly and to practice a healthy lifestyle.
Cardiac Rehab Phase 1
The program is done while the cardiac patient is still in the hospital just a few days after the cardiac incident. The patient can start his therapy in the intensive care unit or in the unit that he’s placed in. The physical therapist works with other health professionals at this phase to make sure that the patient quickly and safely goes back to his previous function. The family will probably feel anxious and worried that the patient is engaged while he is still in the ICU, but they shouldn’t be. The physical therapist is qualified and skilled in doing the needed assessment, evaluation, and treatment without disrupting the tubes and bottles that be attached to the patient.
When the patient is given the doctor’s confirmation that he is stable, then physical therapy will be ordered to help him regain movement and function. The acute physical therapist is the expert on this area of the rehab and will be doing the initial assessment and evaluation in the hospital. While this is being done, the therapist interviews the patient and then takes several tests and measurements to help formulate a suitable treatment plan for him. Some examples of these tests include blood pressure, heart rate, upper and lower extremity range of motion and strength, oxygen saturation, and self-care and mobility tasks. The therapist then collaborates with you as well as with your family to make sure that you will have a better knowledge of how your cardiac rehab program will benefit you and your health.
This is also a vital part of the rehabilitation process, and it involves your physical therapist walking the patient through the hospital guidelines about his particular cardiac condition. Important instructions that are typically included are:
- The risk factors for the patient’s specific cardiac condition
- Sternal precautionary measures
- Exercises that are required to be done on the bedside to prevent contractures
- Self-monitoring strategies for heart rate
Aside from clear verbal instructions, the physical therapist is encouraged to write these down so that the patient will not be confused.
Phase 1 Treatment
An important goal of physical therapy in the initial phase of the program is to safely and progressively increase the patient’s level of activity. Again, it is crucial that the therapist regularly monitors the patient’s blood pressure, heart rate, and oxygen sat level during the exercise and as the exercises are increased. An electrocardiogram can also be done on the patient to ensure that the heart is responding normally.
In all activities especially on mobility, such as walking and moving from the bed to the chair and back, the physical therapist stands behind or in front of the patient at all times (depending on the position of the patient). He works with the patient as the patient advances in phase 1 of the cardiac rehab program, for instance, stair climbing. He also meets with the other members of the medical team to guarantee that everything so far is appropriately performed and the health professionals know what medications and other precautions are set for the patient’s safety.
Finally, when the patient leaves the hospital, the primary physician refers approves for him to progress to phase 2 to continue the development that he has made while he was in the hospital. The patient is reminded to strictly follow his doctor’s orders when he is out of the hospital to prevent untoward incidents from happening.
If you’ve been a cardiac patient, you may have felt that you will never be able to regain most of the basic tasks. But if you try your best and work with your physical therapist in the acute phase of cardiac rehabilitation, you will surely be able to return to your former activity level in no time gradually.