Phase 4 Cardiac Rehabilitation

The Role of Physical Therapy in Cardiac Rehab

Senior couple holding hands and walking in park
Phase 4 cardiac rehab involves engaging in independent exercise.. Paul Bradbury/Caiaimage/Getty Images

After your cardiac event like a heart attack, heart surgery, or a stroke, you may benefit from the skilled services of a physical therapist during cardiac rehabilitation.  Your PT will work with other healthcare professionals to help you learn how to monitor your exercise and activity to safely return to your previous level of function.

There are four phases of cardiac rehabilitation which span from the onset of your cardiac event to more advanced exercise and activity.

The fourth phase of cardiac rehabilitation is the final stage of the rehab process after a cardiac event.  The hallmark of this phase is independent exercise and activity.  The main goal of phase 4 cardiac rehab is to get you back to your normal activities.

The Role of Physical Therapy in Phase 4 Cardiac Rehabilitation

Your physical therapist will remain an important member of your healthcare team during the independent exercise phase of cardiac rehab.  He or she can continue to monitor your progress, provide motivation, and can make changes and modifications to your home exercise program and fitness routine.  This can help keep your exercise program safe, challenging, and fun.

Your physical therapist can also help keep you on track with exercise and activity level monitoring. He or she can ensure you are taking your heart rate properly and can make sure you are keeping an eye on your activity to ensure it is not too strenuous or too simple to provide therapeutic benefit.

Your physical therapist can also act as a resource to keep you on track with lifestyle changes that you may have made since starting on your journey through cardiac rehab.

What About Sternal Precautions?

If you have had open heart surgery, your doctor may have ordered you to keep sternal precautions.

 The precautions are to be used to help protect your incision as it heals.  Depending on how quickly you progress through cardiac rehab will determine if you should continue monitoring your sternal precautions during phase 4 of the rehab program.  

Most likely, you will not need to worry about sternal precautions once you start phase 4 cardiac rehab.  Speak with your doctor and physical therapist to understand when it is safe for you to start moving more liberally without worrying about sternal precautions.

Are You Ready for Independent Exercise?

Since your heart attack or cardiac event, you have been on a long road.  From the acute stages of rehab in the hospital to the outpatient PT clinic, you have been slowly and steadily progressing through the rehabilitation process.  Still, making the transition to being a fully independent exerciser can feel a little daunting.

Remember, your physical therapist is someone who can act as a resource for you to turn to if you have questions or are feeling unsure about your independent fitness program.

 You may want to have a plan in place when transitioning from phase 3 outpatient rehab to independent exercise. This will allow you to gradually start exercise on your own while still visiting the PT clinic from time to time for check ups.  Your physical therapist can help you set up an appropriate schedule to transition to phase 4 cardiac rehab.

If you have had a cardiac event that limits your functional mobility, you may benefit from cardiac rehabilitation to help get you moving again.  Phase 4 cardiac rehab, the final phase, is your introduction to normal, independent exercise and activity.  Your physical therapist can help you get there.

Source: Hillegas, E. and Sadowskyi, H.S. "Essentials of Cardiopulmonary Physical Therapy." 1994. W.B Saunders Co. Philadelphia.

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