Topic Overview

Cardiac rehabilitation (rehab) may start while you are in the
hospital. The hospital program is one part, or phase, of your cardiac rehab. This phase emphasizes exercise and education.

The parts of a hospital program include:

  • A customized exercise program, based on your
    medical history, clinical condition, and symptoms.
  • Discharge instructions about recovery activities.
  • Education on lifestyle changes and how to lower your risk of future heart problems.
  • Ways to help your body recover and:
    • Increase appetite
      and strength.
    • Increase aerobic capacity.
    • Increase lung capacity.
    • If you had a heart transplant, avoid rejection of your new

Your rate of recovery depends on age, gender, and other health
conditions. Depending upon your condition and how you respond to rehab, you may
stay in a particular phase or move back and forth among the various phases.
There is no set length of time that you must stay in a specific phase.

Your hospital rehab staff should be able to provide you with
information and resources for making the transition from hospital to
home. This includes
how to find a cardiac rehab program in your community.

Exercise program

The following exercises are examples. Your exercise program depends on your medical history, clinical status, and symptoms.
Discuss with your doctor any additional physical limitations or medical issues before you begin any exercise program.

An exercise program in the hospital progresses from
initial supportive and self-care activities to regular daily walking.

  • You will start with easy activities, such as
    sitting up in a chair and walking, as soon as you are able. Early activity is
    important, because you lose muscle strength very quickly when you stay in
  • As you become stronger, you might be active 2 or 3 times a day for 5 to 20
    minutes each time, depending on your condition. A member of the rehab staff
    will monitor your heart rate to be sure it doesn’t get too high while you walk
    or slowly climb stairs.
  • How long you stay in the hospital depends on what problem, procedure, or surgery you had. Your cardiac rehab program might be 3 to
    5 days in the hospital, including transition to home-based
    activities. If you had an open-heart surgery, you will likely be in the hospital longer.
Examples of initial activity

Step 1

  • Rest in bed until stable.
  • Sit
    up in bed with assistance.
  • Stand at bedside with
  • Perform self-care activities while seated.

Step 2

  • Sit up in bed
  • Walk in room and to bathroom.
  • Perform
    self-care activities in bathroom.

Step 3

  • Sit and stand
  • Walk in hall with assistance: 5 to 10 minutes, 2 or
    3 times a day.

Step 4

  • Walk in hall: 5 to 10 minutes, 3 or 4
    times a day.
  • Walk down stairs with assistance.
Examples of increases in activity


Walking in hospital hall


Early mobile (days 1 to 3)

  • 1 or 2 times a day (always warm up and
    cool down)

Later mobile (days 2 to 4)

  • 3 or 4 times a day


  • Heart rate 30 beats above your resting heart rate
  • Rating of perceived exertion (RPE) of 11 (light exertion)
  • Stop when you
    get tired.


  • Intermittent bouts, 3 to 5
  • Rest periods at your discretion, 1 to 2 min. shorter than
    exercise bout
  • To progress, initially increase to 10 to 15 min.,
    then increase intensity.
  • Include stair climbing when your doctor
    says it’s okay.


Other Works Consulted

  • American College of Sports Medicine (2010). Exercise prescription for patients with cardiac disease. In WR Thompson et al., eds., ACSM’s Guidelines for Exercise Testing and Prescription, 8th ed., pp. 207-224. Philadelphia: Lippincott Williams and Wilkins.
  • Graham IM, et al. (2011). Rehabilitation of the patient with coronary heart disease. In V Fuster et al., eds., Hurst’s the Heart, 13th ed., vol. 2, pp. 1513-1530. New York: McGraw-Hill.


ByHealthwise Staff
Primary Medical Reviewer Rakesh K. Pai, MD, FACC – Cardiology, Electrophysiology
E. Gregory Thompson, MD – Internal Medicine
Specialist Medical Reviewer Richard D. Zorowitz, MD – Physical Medicine and Rehabilitation

Current as ofOctober 5, 2017