The benefits of Physiotherapy in the fight against heart disease

Coronary heart disease is chronic heart disease that is usually progressive and not curable. It occurs when the coronary arteries become narrowed, causing less blood going to the heart muscle than is needed. This is most commonly caused by atherosclerosis of the coronary arteries, which is a progressive build-up of fatty material (plaque) in the arteries.

Lack of blood supply to the heart can cause chest pain and discomfort (angina), and this sometimes occurs during exercise or when the heart rate is evaluated. However, if the coronary artery is completely blocked this can cause a heart attack and is a medical emergency.

Physiotherapy is important in the management of coronary heart disease. The cornerstone of physiotherapy management is cardiac rehabilitation. In patients undergoing heart surgery, physiotherapy can also help with recovery after surgery. Your physiotherapist may see you before and after your surgery to help prevent a chest infection and regain your mobility and walking as soon as possible.

One way sufferers can benefit is from a cardiac rehabilitation program. Cardiac rehabilitation is a program for people with a variety of cardiovascular diseases. The cornerstone of cardiac rehabilitation is exercise training. The program also involves education and support about managing the disease, including reducing risk factors, getting back to your usual life, managing your medications, psychological issues, maintaining a good diet and stopping smoking. Joining a cardiac rehabilitation program is the easiest way to learn about how to exercise with your disease.

At the clinic, a physiotherapist will measure your exercise capacity, your symptoms and your safety for exercise. They will teach you how to do the exercises and monitor you closely throughout. Speak to one of our physiotherapists for more information.

There are three types of cardiac rehabilitation.

• Phase I occurs in the hospital straight after surgery. A physiotherapist will teach you some gentle exercises and provide education on the things to do and not to do to help your recovery. They may also provide you with a home-exercise program to start once you get home. Phase I usually runs multiple times per week on the hospital ward from the first day after your surgery.
• Phase II cardiac rehabilitation occurs in the outpatient setting after discharge from hospital following surgery and stenting. As well, people with coronary heart disease not requiring surgery are suitable for cardiac rehabilitation once cleared by a medical doctor. This phase usually runs once or twice a week for 6-8 weeks.
• Phase III is a long-term maintenance program running in the community for people who have already completed the other phases.

How effective is physiotherapy for coronary heart disease?

There is a large body of research to confirm the effectiveness of physiotherapy improving many aspects of life for people with coronary heart disease. Research has supported the development of a number of clinical practice guidelines for clinicians about how to best manage their patients.

There is strong evidence that cardiac rehabilitation reduces hospital re-admissions and death within the first year of a cardiac event. It also speeds up recovery, reduces risk factors (such as high blood pressure and cholesterol), improves fitness levels, reduces smoking, reduces further hospitalisations or cardiac events, and improves quality of life. There is also growing evidence that shows breathing exercises (muscle training) before and after cardiac surgery results in faster recovery after surgery, including fitness, anxiety and of life.