[Benefits of cardiac rehabilitation--a controversy]

Cardiac rehabilitation is a comprehensive process of continuing care which takes place at different levels. Individual office-based care, out-patient group activities and in-patient programmes in specialized centres may be complementary or alternatively used according to the needs of individual patients. In Switzerland organized cardiac rehabilitation is available for 6000 patients per year. Formal rehabilitation programmes exert their beneficial effects mainly through exercise training, instruction in relaxation techniques as well as dietary and occupational counseling. These benefits are documented as an overall reduction of cardiovascular mortality by 20%, a slowing of disease progression, an improvement of physical work capacity, the modification of serum lipid fractions, and possibly improved psychosocial adjustment. Patients should be helped to accept coronary disease as a chronic disease, to maintain lifestyle changes in order to halt progression and to avoid complications while enjoying a meaningful life. Future improvements in Switzerland will include the careful selection of patients for the different forms and phases of rehabilitation, more extensive psychosocial counseling, continuity of care and the involvement of family members.