Exercise Is at the Heart of Patients' Recovery

Clinical exercise physiologist Kristin Jacobs (left) is part of a team that includes physicians, nurses, a psychologist and a nutritionist. They help patients manage exercise as well as diet and stress levels.

At 2 p.m. on a Friday, people from all walks of life gather in the waiting room of the Preventive and Rehabilitative Cardiac Center at the Cedars-Sinai Heart Institute.

A bespectacled gentleman with a walker and a delicate woman in a headscarf, accompanied by her daughter, are the latest to arrive, as another patient laughs and gripes about having to swap her heels for sneakers.

Some of the patients gathered here are in recovery from serious cardiac conditions or heart surgery, while others are at high risk for heart disease. None of them, however, are here to see a doctor. They have come to exercise.

"Cardiac rehabilitation is exercise intended to get patients back to the activities of daily life after a cardiac event," said Rich Gordon, EP, the center's program coordinator.

Gordon has overseen the center for 27 years. His domain includes dozens of pieces of equipment designed to pump up the cardiovascular system: stationary bicycles, treadmills, seated elliptical trainers, even a seated stair-climber.

Chrisandra Shufelt, MD, the center's associate director said, "Our goal is to keep these patients healthy for the long term."

Research has shown that heart patients who participate in the recommended number of cardiac rehabilitation sessions lower their risk of future heart attacks and mortality.

The center, led by C. Noel Bairey Merz, MD, has an impeccable safety record. Each exercising patient is connected to a heart monitor that displays their heart rate and rhythm at a central nursing station. Nurses continuously assess the data in real time, advising patients on whether to exercise harder or back off a bit.

"Our priority is patient safety," Shufelt said. "We have an expert team of professionals on the floor at all times. Through careful observation, we catch issues early, and I am there to handle any medical problems that may arise."

Many patients are afraid to exercise after a heart event and need encouragement.

Clinical exercise physiologist, Rich Gordon (right), has overseen the Preventive and Rehabilitative Cardiac Center for nearly thirty years. He teaches heart patients how to become active while remaining safe.

"We are teaching patients that it is safe to work out and what a safe level of exertion feels like," said Gordon.

Shufelt, Gordon and the center's team of exercise physiologists and nurses collaborate to ensure that when patients move on from the center's program they can exercise and live confidently.

"I tell everyone to take a three-pronged approach to wellness," said Gordon. "Exercise is crucial, but patients need to manage their diet and stress levels as well."

To that end, patients are offered a visit with a registered dietitian who can provide individualized food plans, and a psychologist is on hand for patients dealing with stress.

"Our psychologist teaches patients a type of biofeedback that enables them to control their heart rate response when stressed," said Gordon.

"What sets the Preventive Rehabilitative Cardiac Center apart is how engaged our team is," said Shufelt. "Every week the staff has care conferences, and the first thing we talk about is patients who are missing sessions. As a service, a staff member will call to check on them."

On the other hand, some patients become committed to the center's program. Even after they have completed their insurance-covered sessions they pay a small fee to keep coming.

"We have people in their 90s who have come here for 20 years," Gordon said. "It feels great to see heart patients graduate from rehabilitation to a health and wellness program that they can maintain for life."