Structure and stages of the cardiac rehabilitation program

Cardiac rehabilitation programs are usually divided into 3 or 4 stages in accordance with the clinical status of patients. Stage 1 includes programs conducted in the hospital shortly after an acute coronary event or intervention. Stage 1 cardiac rehabilitation programs are currently not very common due to the short hospital stay, however, in some European countries, they still have inpatient cardiac rehabilitation programs that can last several weeks.

Even with the short duration of hospitalization of cardiac patients, the stage 1 cardiac rehabilitation program remains useful for activating elderly patients after complicated cardiac events and in many patients after cardiac surgery. Stage 1 cardiac rehabilitation programs in the United States are often performed by the physiotherapy departments of hospitals or by special personnel trained in the principles of cardiac rehabilitation.

Stage 1 is also an excellent period to familiarize the patient with the concept of cardiac rehabilitation and to facilitate his involvement in this program.

Stage 2 includes outpatient cardio-rehabilitation programs in the presence of a doctor. Control by the doctor and ECG control in these programs are mandatory conditions imposed by the majority of insurance companies when issuing compensation. Historically, patients in the programs of stage 2 train 3 times a week for 3 months.

Other approaches to cardiac rehabilitation include simple, self-controlled home programs, home programs with a nurse visit, and home programs with telephone ECG monitoring. A comparison was made of these approaches in the framework of scientific research and standard medical practice. It turned out that the physical performance of patients improves more with physical training (TF) at home, although this improvement may be due to a tendency to reveal positive results.

Another duration of rehabilitation programs was also studied, for example, 1 lesson per week for 1 year. Such a program can improve the physical performance of patients and contribute to adaptation to ongoing physical rehabilitation, however, standard 12-week programs are most common, because insurance companies only cover these programs.

The programs of stage 3 cardiac rehabilitation are carried out without a doctor and an ECG cat. These programs are supportive; they are provided by the same institutions as the programs of stage 2. Some insurance companies partially reimburse the costs of the programs of stage 3.

Phase 4 programs for cardiac rehabilitation are carried out without medical supervision (usually in health clubs and fitness centers). In the United States, insurance companies do not reimburse Stage 4 programs.

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