Cardiac rehabilitation in the United States: from evidence to application.

Cardiac rehabilitation (CR) programs first appeared in the United States in the late 1960s. Over the past 40 years, CR has evolved into a comprehensive rehabilitation and secondary prevention service, delivered by a multidisciplinary staff, and based on scientific and clinical evidence. CR is now recognized as an important element in the continuum of care for patients with cardiovascular disease. The contemporary definition of cardiac rehabilitation is: ‘...services are comprehensive, long-term programs involving medical evaluation, prescribed exercise, cardiac risk factor modification, education, and counseling. These programs are designed to limit the physiologic and psychological effects of cardiac illness, reduce the risk of sudden death or reinfarction, control cardiac symptoms, stabilize or reverse the atherosclerotic process, and enhance the psychosocial and vocational status of selected patients’ [1].