Cardiac Rehabilitation (For Physicians)
Together, we improve your patients’ lives
Cardiac rehabilitation is an essential step in improving the health and quality of life of nearly all individuals living with cardiovascular disease. Through a personalized program of exercise, counseling, and support, we help your patients enhance their physical and psychosocial condition, reduce cardiovascular risk, and gain better control over their health.
Cardiac rehabilitation is a Class I Level A indication for the majority of patients with cardiovascular disease, according to American1, European2, and British3 guidelines, as it reduces mortality by 23% and hospital readmissions by 42%4.
Cardiac rehabilitation consists of the following:
- Patient assessment
- Exercise training
- Management of diabetes, dyslipidemia, and hypertension
- Counseling to increase physical activity
- Counseling on healthy nutrition and weight management
- Smoking cessation counseling
- Psychosocial support and counseling
Cardiac rehabilitation is indicated for the following diagnoses/procedures:
- Stable angina
- Stable heart failure
- Acute coronary syndrome within the previous 12 months
- Coronary angioplasty or stent placement
- Coronary artery bypass graft surgery
- Heart valve repair or replacement
- Heart or heart–lung transplantation
Cardiac rehabilitation may be delivered in person or remotely, with comparable safety and effectiveness1. At PHYSIORAMA, we provide comprehensive and personalized remote cardiac rehabilitation (tele-rehabilitation).
Specifically, we provide the following services:
Exercise
The patient is required to undergo a symptom-limited exercise stress test (either at your practice or with our collaborating Cardiologist). We require the test report along with ECG segments at rest, peak exercise, recovery, and any relevant findings (e.g., horizontal ST depression).
Based on this information, we will develop a personalized, safe, and effective aerobic exercise program, including detailed parameters (Frequency, Intensity, Time, Type – FITT). If we are collaborating, we will send the program to you for approval of exercise intensity (or modification requests); otherwise, it will be sent to our collaborating Cardiologist. The approved program will be delivered to the patient in their preferred format (e.g., printed, digital, or via a mobile app).
The patient will receive at home (or may visit us to collect) a European Commission–certified medical device that records their electrocardiogram (ECG) during exercise. The patient will install the associated mobile application and record their ECG throughout each exercise session, sending it to us at the end of the session (these procedures take only a few seconds). The device is small, easy to use (simply worn as a chest strap), and requires no wires or patches.
We will review the patient’s ECG after each exercise session to identify any findings not present during the stress test. If we are collaborating, these findings will be sent to you for your consultation; otherwise, they will be reviewed by our collaborating Cardiologist.
Before each exercise session, the patient will measure heart rate and blood pressure (and blood glucose if diabetic or on antidiabetic medication) and will contact us if values are exercise-limiting (heart rate > 100 bpm, blood pressure > 160/100 mmHg, glucose < 90 mg/dL and/or > 250 mg/dL). The patient will repeat these measurements after completing the session and report all measurements weekly.
The exercise program will be reassessed weekly, and any modifications to exercise intensity will be sent to you for approval if we are collaborating; otherwise, they will be sent to our collaborating Cardiologist. The updated program will then be delivered to the patient in their preferred format.
Cardiovascular Disease Management (diabetes, dyslipidemia, and hypertension)
If any of the above risk factors are not optimally controlled and we are collaborating, we will send the relevant measurements for your evaluation and potential action; otherwise, they will be sent to our collaborating Cardiologist.
Counseling to Increase Physical Activity
A specialized Physiotherapist will conduct at least one high-definition video consultation session.
Counseling on Healthy Nutrition and Weight Management
A specialized collaborating Dietitian will conduct at least one high-definition video consultation session.
Smoking Cessation Counseling (if the patient smokes)
A specialized Physiotherapist will conduct at least one high-definition video consultation session.
Psychosocial Management (optional)
A specialized collaborating Psychologist will conduct at least one high-definition video consultation session.
Video consultations are conducted through a platform specifically designed for telemedicine. It is secure, compliant with the General Data Protection Regulation (GDPR), and does not require software installation or patient registration. The patient simply connects with one click via a link sent by email or SMS.
Together, we will empower your patients to live longer and better
References
- Brown TM et al. Core Components of Cardiac Rehabilitation Programs: 2024 Update: A Scientific Statement From the American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation. 2024 Oct 29;150(18):e328-e347.
- Ambrosetti M et al. Secondary prevention through comprehensive cardiovascular rehabilitation: From knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology. Eur J Prev Cardiol. 2021 May 14;28(5):460-495.
- British Association for Cardiovascular Prevention and Rehabilitation. The BACPR Standards and Core Components for Cardiovascular Disease Prevention and Rehabilitation 2023, 4th. Available at https://www.bacpr.org/s/BACPR-Standards-and-Core-Components-2023.pdf.
- Dibben G et al. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev. 2021 Nov 6;11(11):CD001800.
