Cardiac Rehabilitation: Phases & Exercises To Help Your Heart

Cardiac Rehab Phases

It is a multidimensional service that aims to help the heart patients, who have recently been through myocardial infarction, heart surgery, or any other related issues. The implementation phase comprise of four sub phases as outlined below.

Phase I: Inpatient Phase (Hospital Phase)

• When: During hospital stay after a cardiac event (e.g., heart attack, surgery).

Goals:

• Stabilize the patient medically.
• The possible complications of bed rest include formation of blood clots.
• Resume walking, sit up, and take short strolls.
• Teach patient and his/her relatives about heart disease, causes, and the changes that should be made in the patient’s lifestyle.
• Duration: It tremendously depends on the condition and recovery of the patient whereby it can take anything from a few days to a week.

Phase II: Early Outpatient Phase 

• When: Begins shortly after hospital discharge.

Goals:

• Strengthen one’s cardiovascular health by performing exercising regime that is supervised and structured.
• Extensions of teaching include diet, medication, stress, and smoking and its relation to the heart.
• Physical activity limitations include dyspnea during a specified duration and chest pain while using the product.
• Duration: It most often takes 6-14 weeks, with two-three sessions per week.

Phase III: Maintenance Phase 

• When: After completing Phase II.

Goals:

• Subsequently, children ought to continue with the exercises independently with little supervision.
• Maintain healthy lifestyle habits.
• Ongoing support through periodic check-ins or group sessions.
• Duration: Long-term, often several months to years.

Phase IV: Long-Term Maintenance (Self-Directed)

• When: Lifelong continuation.

Goals:

• Prescribe exercising, nutrition plan maintenance, and lifestyle risk factors.
• However, such patients are not put under any form of supervision but just self-monitoring and follow-up by the physician.
• Prevent recurrence of cardiac events.

Heart Rehabilitation Exercises

Heart (cardiac) rehabilitation exercises are tailored to enhance cardiovascular health, endurance, strength, and flexibility safely. These are introduced gradually depending on the patient's condition and rehab stage. The following is a list of typical exercises employed in cardiac rehab:

Aerobic (Cardio) Exercises

• Purpose: Enhance heart and lung efficiency.

Examples:

• Walking (treadmill or outdoors)
• Stationary cycling
• Elliptical training
• Low-impact aerobics
• Swimming or water walking (if cleared)
• Intensity: Moderate (you should be able to speak but not sing)
• Frequency: 3–5 times/week, 20–60 minutes/session

Resistance (Strength) Training

• Purpose: Increase muscle strength, boost metabolism

Examples:

• Light weights or resistance bands
• Leg presses, wall push-ups
• Seated weight machines (low weight, high repetitions)

Guidelines:

• Begin only after doctor approval (typically Phase II)
• 2–3 times/week on non-consecutive days

Flexibility and Stretching

• Purpose: Enhance range of motion, decrease injury risk

Examples:

• Gentle yoga
• Static stretching (after exercise)
• Neck rolls, shoulder circles, hamstring stretches
• Frequency: Daily or post-warm-up/post-cool-down

Balance and Functional Exercises

• Purpose: Prevent falls and enhance daily activity

Examples:

• Heel-to-toe walking
• Sit-to-stand exercises
• Step-ups
• Integrated at: Advanced stages (Phase III/IV) particularly for elderly individuals

Cardiac Rehab Program

Elements of a Cardiac Rehab Program:

Medical Evaluation

• Heart health, physical constraints, and risk factor assessment at baseline.
• Personalized treatment plan according to your condition and objectives.

Supervised Exercise Training

• Aerobic and resistance training suited to your level.
• Tracked for heart rate, blood pressure, and ECG (in initial stages).
• Progress according to tolerance and recovery.

Education for Heart-Healthy Living

• Diet and nutrition guidance (e.g., low-fat, low-sodium, heart-healthy diet).
• Knowledge about medications and compliance.
• Risk factor management (diabetes, hypertension, cholesterol).

Lifestyle Modification Assistance

• Quit smoking
• Weight control
• Alcohol reduction
• Improve sleep

Psychosocial Support and Guidance

• Manage stress, anxiety, or depression associated with heart disease.
• Support groups or one-on-one therapy.
• Family engagement to enhance home support.

Best Exercises for Heart Patients

Top Exercises for Heart Patients:

• Walking (Treadmill or Outdoor)
• Stationary Cycling
• Swimming or Water Aerobics
• Low-Impact Aerobics or Dancing
• Strength Training (Light Weights or Resistance Bands)
• Yoga or Tai Chi
• Stretching and Flexibility Exercises

Cardiac Rehab Phase 1

Cardiac Rehab Phase 1 takes place when a patient is in the hospital after a cardiac event like heart attack, angioplasty, or cardiac surgery. Safe recovery, avoiding complications, and pre-discharge planning are the center of attention here.

Objectives of Phase 1

• Stabilize heart function.
• Institute light activity to prevent deconditioning.
• Educate family and patient about heart condition and risk factors.
• Encourage self-care and mobility independence.
• Develop plan for transitioning to outpatient (Phase 2) rehab.

Cardiac Rehab Phase 2

Phase 2 Cardiac Rehab starts shortly after discharge from the hospital—typically within 1 to 3 weeks following a cardiac episode such as a heart attack, angioplasty, or surgery. Phase 2 is medically supervised and concentrates on developing cardiovascular fitness in a safe manner, lowering risk factors, and educating for long-term heart health.

Objectives of Phase 2

• Enhance cardiovascular endurance by structured exercise.
• Observe the body's adaptation to exercise.
• Initiate safe strength training.
• Educate on heart-healthy lifestyle: diet, stress control, medications, etc.
• Decrease risk of future cardiac events.

Cardiac Rehab Phase 3

Phase 3 cardiac rehabilitation is a maintenance phase lasting for the long term following the formal outpatient rehab of Phase 2. It is for patients who have already done early rehab and are now prepared to exercise more on their own, usually in a community or clinic setting with intermittent supervision.

Phase 3 Goals

• Sustain and enhance cardiovascular fitness.
• Sustain lifestyle modification (diet, stress, weight control, no smoking).
• Prevent recurrent cardiac events.
• Form a lifelong physical activity habit.
• Increase self-esteem and quality of life.

Cardiac Rehabilitation Benefits

• Reduces Risk of Future Heart Problems
• Improves Cardiovascular Fitness
• Manages Risk Factors
• Helps control:
• High blood pressure
• Cholesterol levels
• Diabetes and blood sugar
• Obesity
• Promotes Heart-Healthy Lifestyle Changes
• Improves Mental Health
• Enhances Quality of Life
• Educates Patients and Families
• Long-Term Support and Monitoring

Exercises after Heart Surgery

Weeks 1–4 (Home or Hospital Phase)

Activities:

• Deep breathing exercises (e.g., incentive spirometer).
• Gentle stretching.
• Short indoor walks (begin with 2–5 minutes, several times a day).
• Ankle pumps, seated leg lifts.

Weeks 4–8 (Beginning of Cardiac Rehab Phase 2)

Activities:

• Treadmill walking or outdoor walking (15–30 minutes, 3–5 times/week).
• Stationary bike (light resistance).    
• Light strength training (e.g., sit-to-stand, wall push-ups) without lifting >5–10 lbs.
• Gentle stretching and balance exercises.

Weeks 8+ (Phase 2–3 Cardiac Rehab)

Activities:

• Increase aerobic intensity and duration.
• Initiate moderate resistance training if cleared.
• Include flexibility, core stabilization, and minimal yoga.

Heart Attack Recovery Exercises

Week 1–2: Early Recovery Phase

Objective: Light, gradual movement to acclimatize the body to activity.

Exercises:

• Breathing exercises: Deep breathing (pursed-lip and diaphragmatic breathing).
• Ankle pumps: To facilitate circulation.
• Gentle stretching: Neck, shoulders, arms, and legs.
• Short, slow walks: 5–10 minutes, 1–2 times a day.

Week 3–6: Early Rehabilitation (Phase 1/2)

Objective: Reintroduce low-impact aerobic exercise and light strength training.

Exercises:

• Walking: Begin with 10–15 minutes at a slow pace; gradually increase to 30 minutes a day.
• Stationary bike (if doctor clears): Start with mild resistance for 10–15 minutes.
• Strength exercises (light weights or resistance bands): Begin with light weights (e.g., 1–3 lbs), doing simple exercises such as wall push-ups, sit-to-stand, and leg lift.
• Gentle yoga or stretching: For flexibility improvement.

Week 6–12: Strengthening and Building Endurance (Phase 2)

Objective: Enhance cardiovascular health and strengthen the muscles.

Exercise:

• Walking: Gradually increase duration to 30–40 minutes, including moderate intensity (you can talk but not sing).
• Cycling: Stationary or outdoor cycling for 15–30 minutes.
• Resistance training: Gradually increase weight slightly (e.g., 5–8 lbs), targeting arms, legs, and core muscles.
• Stretching and flexibility: Concentrate on expanding range of motion.

At 3 Months: Maintenance and Lifestyle Incorporation (Phase 3)

• Objective: Retain fitness and adopt exercise as a lifestyle.

Exercises:

• Aerobic activity: Brisk walking, cycling, swimming—try for 5–7 days per week, 30–60 minutes.
• Strength training: Add resistance exercises 2–3 times a week, weights or resistance bands.
• Balance exercises: Tai Chi or other movement that emphasizes balance may be beneficial.

Cardiac Rehab Guidelines

General Guidelines for Cardiac Rehab:

Medical Evaluation

Prior to initiating cardiac rehab, a comprehensive evaluation is required to:

• Evaluate overall cardiovascular status.
• Establish exercise tolerance and limitations.
• Create an individualized plan.
• Screen for any underlying medical conditions (e.g., diabetes, hypertension).

Structured Exercise Program

• Intensity: Must be moderate, targeting 50-85% of target heart rate (as directed by your healthcare provider).
• Type: Combination of aerobic exercises (e.g., walking, cycling) and strength training (e.g., resistance bands, light weights).
• Duration: Initial sessions may be 15–20 minutes, progressing to 30–60 minutes per session.
• Frequency: 3-5 days a week (depending on your condition and progress).

Monitoring During Exercise

• Continuous monitoring of vital signs (heart rate, blood pressure, oxygen levels).
• ECG monitoring in early stages for high-risk patients (especially after heart surgery or major heart events).
• Application of the Borg Rating of Perceived Exertion (RPE) scale to rate exercise intensity.
• Warm-up and cool-down: A warm-up and cool-down of 5-10 minutes with stretching must always be included.

Individualized Approach

Each participant's rehabilitation program must be individualized according to their particular medical condition, fitness level, and personal objectives. This guarantee:

• Progress in intensity and length based on recuperation.
• Safe integration of activities to avoid overexertion.

Lifestyle Education

Cardiac rehabilitation involves education on:

• Heart-healthy nutrition (e.g., low-fat, low-sodium, high-fiber diet).
• Medication management: Being informed about medications and following up on treatment.
• Smoking cessation: Smoking-cessation programs.
• Stress management: Skills such as deep breathing, relaxation, and counseling.
• Weight and exercise guidelines for maintaining long-term health.

Psychosocial Support

• Deal with emotional well-being: A lot of individuals have anxiety, depression, or stress following a cardiac event. Counselling, support groups, or cognitive-behavioural therapy (CBT) can be beneficial.
• Family support: Engage family members for improved support at home and in sustaining lifestyle modifications.

Warning Signs and Safety

Participants must stop exercise and seek the advice of a healthcare professional if they have:

• Chest pain or discomfort.
• Shortness of breath that exceeds mild effort.
• Dizziness, lightheadedness, or fainting.
• Palpitations, irregular heartbeat.
• Severe fatigue or unexplained swelling in limbs.

Gradual Progress

Cardiac rehab is a progressive program. With time:

• Intensity and duration of aerobic exercises should increase gradually.
• Strength training must increase in intensity, with greater resistance and additional exercises for the different muscle groups.
• Patients should be encouraged to move to Phase 3 (independent exercise) when ready.

Post-Rehab Maintenance (Phase 4)

After completing formal rehab:

• Patients should resume exercising on a regular basis (3-5 times/week).
• Continued self-assessment of vitals and physical activity is essential.
• Promote continued participation in community-based exercise programs (e.g., walking clubs, fitness classes).

Home Cardiac Rehab Exercises

• Duration: Begin with 10–20 minutes daily, progress to 30–45 minutes
• Frequency: 3–5 times a week

Warm-Up (5 Minutes)

• March in place – 2 minutes
• Arm circles – 1 minute
• Neck rotations – 1 minute
• Ankle pumps – 1 minute

Aerobic Exercises (10–30 Minutes)

Select one or mix two:

• Brisk walking (in place or outdoors)
• Seated marching (if balance is a problem)
• Stationary cycling (if equipped)
• Step-ups on a low stair
• Intensity Tip: You can speak but not sing during the exercise.

Strength Training (2–3 Days/Week)

• Use light dumbbells (1–3 lbs) or resistance bands:
• Wall push-ups – 2 sets of 10
• Sit-to-stand from chair – 2 sets of 10
• Arm curls – 2 sets of 10
• Leg raises (seated or lying) – 2 sets of 10
• Rest for 30–60 seconds between sets.

Flexibility and Breathing (Daily)

• Shoulder rolls & chest stretches
• Hamstring stretch (seated or standing)
• Diaphragmatic breathing: Breathe slowly, deeply through the nose, fill belly, exhale with pursed lips. Repeat for 5 minutes to decrease stress and increase lung function.

Top Doctors

• Dr. Akshi Joshi Kukreti
• Dr. Naresh Trehan
• Dr. (Col) Manjinder Sandhu
• Dr. Mohan Bhargava
• Dr. Amit Mittal

Best Hospitals

• Artemis Hospital, Gurgaon
• Medanta-The Medicity, Gurgaon
• Fortis Memorial Research Institute, Gurgaon
• Max Hospital, Saket
• Apollo Hospital, Delhi

Why Choose GetWellGo for Cardiac Rehabilitation?

GetWellGo is regarded as a leading supplier of healthcare services. We help our foreign clients choose the best treatment locations that suit their needs both financially and medically.

We offer:

• Complete transparency
• Fair costs.
• 24 hour availability.
• Medical E-visas
• Online consultation from recognized Indian experts.
• Assistance in selecting India's top hospitals for cardiac rehabilitation.
• Expert cardiologist with a strong track record of success
• Assistance during and after the course of treatment.
• Language Support
• Travel and Accommodation Services
• Case manager assigned to every patient to provide seamless support in and out of the hospital like appointment booking
• Local SIM Cards
• Currency Exchange
• Arranging Patient’s local food