What makes a good cardiac rehab programme?

Unfortunately, over 7.4 million people in the UK currently suffer from cardiovascular disease1 and a high proportion of these will suffer from a significant cardiovascular event or have to undergo surgery to prevent such an event.

Following these events individuals in the UK should be offered cardiac rehabilitation to help recuperation and prevent further cardiovascular issues. However currently service provision of these programmes is affected by several factors which will impact the quality of delivery. If you or a family member are recommended or referred to cardiovascular rehabilitation what should you be looking out for to ensure a good quality programme that will lead to positive health changes?

  1. Assessment – on entry to the programme an individual should receive a comprehensive assessment to establish baseline health and lifestyle parameters which will be vital in forming a safe and effective programme. These assessments should be completed periodically through the programme to ensure goals are being met and the programme is being adapted accordingly.
  2. Bespoke prescription – every individual in the programme will have a different background and clinical status, therefore rehabilitation will be much more effective if bespoke to the individual. The programme should be made bespoke by using specific exercises, using heart rate to monitor intensity and personal activity monitoring to track health behavior changes over time.
  3. Exercise modality – both cardiovascular and resistance exercise should form part of the rehabilitation programme. Cardiovascular exercise is designed to improve energy metabolism, fatigue tolerance and heart health whereas resistance training will improve muscular and functional health which will reduce the workload on the heart.
  4. Education – unfortunately most individuals who undergo cardiovascular rehabilitation previously had lifestyle factors that increased their risk of the subsequent event. Therefore, it is important that in order to instill behaviour changes education should be provided on nutrition, physical activity, stress, sleep and other important topics which are known to impact cardiovascular health.
  5. Feedback – the programme should provide feedback on physiological changes and behavior change, this can be provided through tracking of health metrics (for example resting heart rate and body mass) and subjective discussion. Feedback is important to ensure the participants expectations of the necessary work needed and outcomes available are appropriate.
  6. Multi-disciplinary team (MDT) support – cardiac rehabilitation is a complex process and therefore involves the expertise of many health professionals. The programme should involve different health care professionals to ensure the participants are provided with the full support on exercise, nutrition, medications, lifestyle and clinical issues.
  7. Length of programme – there is currently a vast difference in programme lengths across the UK. A longer programme gives a higher chance of success as it allows for more opportunity for change. However, it is important to remember health is an ongoing variable and something that requires perpetual input to ensure that quality of life and longevity is maximized.

At CP+R we pride ourselves on creating bespoke, safe and effective programmes that work for all individuals. We utilise a comprehensive assessment system to create a bespoke 1-2-1 programme delivered by our MDT in a 4 Pillar method that ensures long-term success.

1BHF UK Factsheet January 2020 – click here

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