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Cardiac rehabilitation programme

Chrissie Bannister, heart surgery nurse, explains what the cardiac rehabilitation programme is, and what you can expect if you participate in one.

About the cardiac rehabilitation programme

Details

  • What is a cardiac rehabilitation programme? What is a cardiac rehabilitation programme?

    A cardiac rehabilitation programme is a series of sessions that are designed to help your recovery. Not everyone will need to take part in a programme like this – it will depend on the type of surgery you’ve had, where you’re receiving care and your general health.

    If you’re advised to access a cardiac rehabilitation programme and you’ve had private treatment, it’s important to be aware that it may not be provided by your private healthcare provider. If this applies to you, please ask for details of any local courses, and how you might access them when you leave hospital (at discharge). You may need to make arrangements through your GP practice via the NHS, but in some areas, there may be a self-referral scheme where you can contact them directly.

    If you do attend a programme, it’s an opportunity to share experiences with other patients as well as get instructions and support from a range of healthcare professionals. These include nurses, physiotherapists and dietitians. They’ll give you advice about a healthy lifestyle, diet and exercise, which will help you recover from your surgery.

    The main goals of cardiac rehabilitation programmes are to prevent you having further heart problems and to help you get back into your normal, everyday way of life in your community.

    The benefits of exercise-based cardiac rehabilitation are that it:

    • reduces later heart-related hospital admissions 
    • improves your quality of life 
    • enables you to take part in physical activity that you may struggle to do if you weren’t on the programme
  • What happens when I join a cardiac rehabilitation programme? What happens when I join a cardiac rehabilitation programme?

    If you join a cardiac rehabilitation programme, a nurse will draw up what’s called a patient care plan. This is specifically designed for you. The aim is to understand your needs, goals and medical risk factors, and to gain an understanding of what activities you may be able to do. Your nurse will then talk to you about the programme and what’s available to you. He or she may cover things such as:

    • your health beliefs and how you view your illness 
    • the benefits of attending a cardiac rehabilitation programme 
    • the role you as a patient play – your motivation is a key part of your recovery and progress 
    • your feedback on the programme so that it can be improved

    Your care may be delivered in a variety of settings such as the hospital, your home, and community-based settings. Where possible, there will be a choice of times available so that you can choose sessions that fit in easily with your life. For example, if you’re working, you may be able to choose sessions that are run after work. You may also have the opportunity to discuss any potential problems that might stop you attending sessions, such as transport difficulties.

    Your carers or family members may be invited to take part in the programme too if you decide it would be helpful for you.

  • What is covered in a cardiac rehabilitation programme? What is covered in a cardiac rehabilitation programme?

    Physical activity

    Your nurse will provide you with a range of different types of exercise to do. These will be designed to cater for your age, any other illnesses, and the surgery you’ve had. You may be able to do these at home or in a group.

    The idea is to build up your level of physical activity over the weeks. Start slowly and build up. This can improve your fitness, mobility and confidence.

    At a physical activity session, you’ll start by doing some warm-up exercises. These will get your body ready to do some aerobic exercise. This is a type of exercise that improves your heart and circulation fitness. There may be a variety of exercises such as using stationary bikes or doing exercises sitting on a chair. Or you might not use any equipment at all. At the end of the session, you’ll do some gentle exercise to cool down so that you end the session safely.

    Mental wellbeing

    Your nurse will offer support and activities to help you manage any stress you may be feeling. This may be in the form of relaxation exercises.

    If you’re feeling anxious or are depressed, your nurse and medical team will be able to give you the treatment you need.

    Healthy lifestyle

    You’ll also learn about how to eat well and to stop smoking (if you smoke). A healthy, balanced diet is made up of the following.

    • Starchy foods: these are bread, rice, pasta and potatoes. They should be your main energy source. 
    • Fruit and vegetables: you should eat five portions a day. Steam rather than boil vegetables. 
    • Fibre: this means high-fibre breakfast cereals, beans, pulses, wholemeal bread, potatoes (leave the skin on), pasta, rice, oats, fruit and vegetables. 
    • Fish: it’s a good idea to eat two portions a week. One portion should be oily fish like mackerel, herring, pilchards or salmon. 
    • Lean meat: remove any excess fat, pour away fat after cooking, and don’t eat fatty products like sausages and meat pies. Boil, steam or bake rather than fry meat. 
    • Olive oil or sunflower oil: use these oils rather than butter when you do cook with fat. Thicken sauces with cornflour rather than butter and flour. 
    • Dairy foods: choose low-fat yoghurts, spreads and cheeses. Edam and cottage cheese are lower-fat varieties.  
    • Salt: reduce how much salt you add to foods. Don’t eat processed foods or crisps and salted nuts because their salt content is very high. 
    • Sugar: cut down on sugar and sweet things like cakes and biscuits. 
    • Water: unless you have been advised on fluid restrictions, you should aim to drink a large glass of water with each meal, and aim for at least four to six pints of fluid a day. If you’ve been advised to have fluid restrictions, please only follow the advice given to you by the health professional who is overseeing your management and care.
    • Don’t drink too much alcohol: new guidance is no more than 14 units a week for both men and women, in those who have not previously been advised to restrict or avoid alcohol.

    How to stop smoking

    If you smoke, stopping is the single most important thing you can do for your health. And you don’t have to go it alone. Medicines and one-to-one or group counselling can help you stop smoking for good.

    Some medicines can help reduce your cravings, others can help reduce your withdrawal symptoms, making it easier to quit. Medicines do have side-effects but the long-term benefits of giving up smoking outweigh temporary side-effects. Your GP or nurse can help you decide which medicine is right for you.

    The NHS stopping smoking service provides courses for people who smoke and want to stop. Courses last for several weeks and involve one-to-one counselling or you may have group counselling. The course helps you plan for stopping smoking and gives you the support and motivation you need to quit for good.

  • Support throughout your cardiac rehabilitation programme Support throughout your cardiac rehabilitation programme

    Your nurse will monitor you all the way through the programme to make sure you’re recovering and progressing well. This also helps put services in place that can help you continue your rehabilitation in the long term. Throughout you may have:

    • tests and advice about how to lower your blood pressure and cholesterol, and how to manage your blood sugar level 
    • access to community-based programmes and leisure centre memberships 
    • invitations to community exercises such as group walks 
    • healthy eating and weight management support 
    • access to support groups for people recovering from heart surgery 
    • support to stop smoking (if you smoke)

    Once you’ve completed the programme, your nurse will carry out a further assessment. This is to review your progress and identify areas where you may need ongoing support.

    It is important to keep in regular contact with your GP about your medication. He or she will also keep an eye on your heart to prevent or slow down further problems.

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