Physical therapist role in Cardiac RehabilitationFebruary 6, 2021
The definition of cardiac rehabilitation to the physical therapist established by the World Health Organization was: “the set of activities necessary to assure heart patients an optimal physical, mental and social condition that allows them to occupy by their own means such a normal place as possible ”.
To this day, this definition is still valid. That is why the therapeutic approach to cardiac patients must be carried out in a multidisciplinary way in a team that integrates actions on physical, psychological, work, and social aspects of the person. The ideal team should include professionals from medicine, nursing, physical therapist, psychology, occupational therapy, and social assistance.
These programs act at different levels, promoting the physical and psychological training of patients and in addition to monitoring and controlling their risk factors.
Within cardiac rehabilitation programs, the physiotherapist plays an outstanding role in developing his work in three areas of intervention:
- Prescription, adaptation, and supervision of physical training.
- Health education.
- Emotional and motivational support.
Prescription, adaptation, and supervision of physical training
Physical exercise is one of the fundamental parts of rehabilitation and we are fortunate to take care of this part. One of the main tasks is to teach patients how to exercise without hurting themselves and trying to enjoy as much as possible.
To do this, we must know what exercises they can and cannot do in the warm-up, main part and calm down, how to adapt them to each patient according to their cardiovascular pathology and other associated pathologies, how to make them progress in appropriate neuromuscular stimuli and challenges.
Many of the patients come with other health conditions such as back pain, arthritis, osteoarthritis, hip or knee replacement, previous stroke, respiratory problems, diabetes. However, the physiotherapist has the experience and practical skills in dealing with disorders of the musculoskeletal, neurological, and respiratory systems. Consequently, we must know and minimize the risks to maximize the benefits of physical exercise.
Likewise, another important task of the cardiac rehabilitation physiotherapist is to keep track of the aerobic and strength exercise, record the training heart rates, calculate the maximum repetition, record the series and repetitions that are done. And as the program progresses, the workload and effort increase as the patient generates physiological adaptations and improves his functional capacity.
In its day, the Society of Family and Community Medicine made this description of health education that I like:
“It is a very important tool that seeks to provide a combination of knowledge, attitudes, and skills so that the patient can define and achieve their own health goals”. This is another of the beautiful and grateful tasks of the physiotherapist within his functions in cardiac rehabilitation. It consists of providing information through individual or group talks that motivate and help change previous beliefs, adopt and maintain healthy lifestyles.
The second aspect that we work on in health education is the relaxation part. We share with patients strategies to combat stress with guided body listening and mindfulness meditations. This part of education with patients offers us, physical therapist, the opportunity to establish trusting relationships with them. Cardiac rehab patients really appreciate it.
Emotional and motivational support
Psychological disorders frequently associated with cardiovascular diseases are specifically treated by psychologists and psychiatrists.
But in a transversal way and inherent to our clinical practice, the role of the physical therapist and the rest of the professionals is to transmit positive messages that favor the change towards behaviors beneficial to health and provide psychological and emotional support to patients. Similarly, we must implement the necessary mechanisms to assess the success of these interventions through questionnaires and other measurements. The physical therapist thus becomes ‘a guide/travel companion’, providing feedback and encouraging compliance with all indications, prescriptions, rules, and advice given during the training period.
Cardiac rehabilitation programs are low-cost treatments that help save lives. Our job as physical therapists is to help patients recover physically and emotionally through physical exercise, education, and psychological support.
Our clinical experience allows us to adapt physical exercise, send public health messages and provide individual support that helps people change their lifestyles and avoid or reduce higher costs to public health. Physical therapists play a very important role in cardiac rehabilitation programs. For me, it is a very grateful and wonderful job.