Cardiac Rehabilitation / The Japanese Journal of Rehabilitation Medicine

ABSTRACT

Cardiac rehabilitation (CR) offers a highly effective causative treatment of atherosclerotic coronary and peripheral disease. The life style and risk factor modifications achieved by CR have been shown to halt disease progression, and to reduce cardiovascular mortality and the rate of non-fatal myocardial infarction in patients with coronary artery disease. CR programs consist of exercise training, medical counseling, cardiovascular disease education, and psychosocial support. This comprehensive approach has significant benefits on exercise capacity, coronary risk factors, and health-related quality of life. In addition, CR reduces all-cause mortality as well as cardiovascular events. In general, CR programs consist of 3 stages acute stage (phase I), convalescent stage (phase II), and chronic stage (phase III). In addition to this preventive approach, exercise-based intervention programs are also effectively used for chronic heart failure (CHF). Since exercise intolerance in CHF is primarily related to the degree of peripheral changes (such as muscle atrophy, reduced peripheral perfusion due to endothelial dysfunction, abnormalities in ventilation), regular aerobic training in CHF has been shown to improve peak oxygen uptake, to reduce peripheral vascular resistance, to retard or reverse muscle wasting, and to reduce morbidity. Despite its documented clinical effectiveness, rehabilitation and a preventive approach are still widely underutilized in Japan. However, it becomes increasingly clear that the use of interventional and surgical procedures is suboptimal therapy in the absence of simultaneous lifestyle modifications, including regular physical exercise and controlling cardiovascular risk factors.