Quick answer
What Is Cardiac Rehabilitation Phase III?
Phase III cardiac rehabilitation is the maintenance stage after a Phase II rehabilitation program is completed. Its goal is to maintain fitness and healthy habits for the long term. You exercise more independently following a personal exercise program while still controlling blood pressure, cholesterol, blood sugar, and weight, with regular reviews by the rehabilitation team.
Sources01 / Understanding the procedure
About Cardiac Rehabilitation Phase III
What Is Phase III Cardiac Rehabilitation
Cardiac rehabilitation is divided into several phases. Phase I begins while you are still in the hospital, Phase II consists of supervised exercise for several weeks after you go home, and Phase III is the long-term maintenance stage. In Phase III, you carry out exercise and healthy habits more independently, with support and regular reviews from the rehabilitation team. This is covered on the Structured Cardiac Rehabilitation Program, Cardiac Rehabilitation Phase I, and Cardiac Rehabilitation Phase II pages.
How It Works in Brief
The benefits of exercise for the heart only last as long as you keep exercising. The fitness gained in Phase II can decline within a few months if exercise stops. For this reason, Phase III helps you turn supervised exercise into a long-term habit: the exercise program is adjusted to your abilities and daily activities, its intensity is monitored using your pulse or how tired you feel, and the results are reviewed regularly.
Components of Phase III
- Aerobic exercise: brisk walking, cycling, or swimming at moderate intensity almost every day, for a total of at least 150 minutes per week.
- Strength and flexibility training: light to moderate weight training twice a week, plus stretching.
- Risk factor control: blood pressure, cholesterol, blood sugar, weight, and quitting smoking continue to be monitored. This is covered on the Cardiovascular Risk Management Program page.
- Diet and healthy habits: a heart-healthy diet, enough sleep, and stress management. This is covered on the Lifestyle Counseling and Risk Management page.
- Support and mental health: exercising with a group or with fellow survivors helps keep you motivated; persistent anxiety or sadness should be discussed with your doctor.
At a Rehabilitation Facility or at Home
Phase III can be carried out at a rehabilitation facility, at a fitness center, or at home. Research shows that home-based rehabilitation gives results comparable to center-based rehabilitation for patients at low to moderate risk. In some patients, the exercise stress test is repeated to adjust the program. This is covered on the Treadmill Stress Test page.
02 / Understanding the procedure
When Is This Procedure Considered?
A doctor may consider this procedure in the situations below. The decision is always made after a thorough assessment.
- Completed Phase II RehabilitationTo maintain the results of exercise and healthy habits.
- After a Heart Attack or Stent PlacementAs part of preventing repeat events.
- After Heart SurgerySuch as bypass or valve surgery, once the early recovery period is over.
- Stable Heart FailureRegular exercise helps maintain your ability to carry out daily activities.
- Stable AnginaWith an exercise program adjusted to the level at which symptoms appear.
- Risk Factors That Still Need to Be ControlledSuch as hypertension, diabetes, or excess weight.
Situations to Consider First
- New or Worsening Chest PainStop exercising and get checked before continuing.
- Unstable Heart FailureFor example, increasing shortness of breath or swelling; exercise is postponed.
- Rhythm Problems or Fainting During ExerciseThese need to be evaluated, and you may need to return to supervised exercise.
- Very High Blood Pressure at RestExercise is postponed until blood pressure is under control.
- Fever or Acute IllnessPause exercise until you have recovered.
03 / Before the procedure
How Should You Prepare?
Preparation is done before starting Phase III and before each exercise session.
Phase II summary. Bring your exercise stress test results and records of your previous exercise program, if available.
Medication list. Bring all the medications you are currently taking, including nitrates if prescribed.
Clothing and shoes. Wear comfortable clothing and well-fitting athletic shoes.
Eating and drinking. Have a light meal 1 to 2 hours before exercise and bring drinking water.
Monitoring device. If you have one, bring a heart rate monitor or smartwatch to learn how to monitor exercise intensity.
Unsure about the preparation instructions? Ask our team before the procedure.
04 / During the procedure
How Is the Procedure Done?
Each exercise session usually lasts about 1 hour. Phase III is long term, with regular reviews every few months.
Initial Assessment
The doctor reviews your Phase II results, symptoms, medications, and risk factors, then designs a personal exercise program, including safe limits for your pulse or level of tiredness.
Exercise Sessions
Each session starts with a warm-up of about 10 minutes, followed by 30 to 40 minutes of aerobic exercise and strength training, and ends with a cool-down and stretching.
Independent Exercise
You exercise on your own at home or outdoors according to your program, keep a record of your exercise and symptoms, and measure your blood pressure if advised.
Regular Reviews
Your progress and risk factors are reviewed regularly. The program is increased gradually or adjusted if your condition changes.
05 / Benefits and risks
Benefits and Risks Should Be Discussed Together.
Every medical procedure has benefits and risks. Your doctor will explain both for your situation before the procedure.
Benefits You Can Expect
- Phase II Results Are MaintainedThe fitness you have gained does not decline.
- Lower Risk of Repeat EventsExercise and risk factor control help prevent heart attacks and repeat hospital stays.
- Greater IndependenceYou learn to monitor your own exercise intensity and symptoms.
- Better Quality of LifeDaily activities feel easier.
- Regular SupportThe program is adjusted if your condition changes.
The benefits of a procedure are not a promise of a cure. Ask how the results will affect your care plan.
Risks You Should Know
- Muscle or Joint InjuryIf exercise is increased too quickly; build up gradually.
- Heart Symptoms During ExerciseRare when the intensity follows the program; learn to recognize the warning signs.
- Low Blood SugarIn people using insulin or certain diabetes medications; keep a snack on hand and monitor your blood sugar.
- Declining MotivationMany people stop after a few months; exercising with others and setting small goals help.
Risks can differ from person to person. A full explanation and consent are given after an individual assessment.
06 / After the procedure
What Is Recovery Like?
There is no special recovery period. Mild soreness after a new exercise is normal and eases within one to two days.
Regular exercise. Try to exercise almost every day, ideally at the same time, so it becomes a habit.
Talk test. Moderate intensity means you can still talk but cannot sing while exercising.
Watch the weather. Reduce the intensity when the weather is very hot or humid, and drink enough water.
Keep taking your medications. Exercise does not replace the medications prescribed by your doctor.
Warning signs. Stop exercising and go to the emergency room right away if you experience:
- Chest pain or pressure that does not go away with rest
- Shortness of breath that is out of proportion to the exercise
- Severe dizziness, nearly fainting, or fainting
- A very fast or irregular heartbeat
Know the Signs That Need Prompt Care.
Follow the team's guidance on warning signs. If severe or sudden symptoms appear after the procedure, go to the nearest emergency department right away or call Heart Attack Center 1500 258.
07 / Team and support
Doctors and Procedure Support
The doctors below are listed for this procedure. Listed by name, not by ranking.
dr. Ayu Amalia U. Putri, Sp.KFR
Physical Medicine & Rehabilitation
Clinical focusCardiac Rehabilitation · Postoperative Rehabilitation
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Dr. med. dr. Denio A. Ridjab, Sp.JP(K)
Interventional Cardiology
Coronary Intervention Procedures +2 centers
Clinical focusInterventional Cardiology · Coronary Artery Disease
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dr. Juweni Joe, Sp.GK
Clinical Nutrition
Clinical focusMedical Nutrition Intervention · Nutrition for Cardiovascular Patients
View Profile08 / Common questions
Before You Plan the Procedure.
Frequently asked questions about Phase III cardiac rehabilitation. Your exercise program is designed together with the rehabilitation team.
What is the difference between Phase III and Phase II?
Phase II consists of scheduled exercise supervised directly by the team, usually with ECG monitoring, for several weeks after you leave the hospital. Phase III is the long-term maintenance stage: you exercise more independently according to a personal program, with less frequent supervision and regular reviews to adjust the program.
How long does Phase III last?
Phase III essentially continues indefinitely, because the benefits of exercise for the heart only last as long as you keep exercising. Reviews by the rehabilitation team are usually done every few months during the initial year, then less often once your condition is stable and you can exercise independently and safely.
Can I exercise at home or at a fitness center?
Yes, if your doctor considers your risk to be low to moderate. Research shows that home-based rehabilitation gives results comparable to center-based rehabilitation in suitable patients. Follow the intensity limits in your program, and tell the trainer at the fitness center about your heart condition and the medications you take.
How do I know my exercise intensity is right?
A simple method is the talk test: at moderate intensity, you can still talk but cannot sing. You can also use the pulse limits or tiredness scale provided by the rehabilitation team. If you take a beta blocker, your pulse may not rise much, so how tired you feel becomes a more reliable guide.
Can I lift weights?
Yes. Strength training with light to moderate weights is recommended twice a week to maintain muscle strength. Avoid holding your breath while lifting, start with a weight you can lift 10 to 15 times without it feeling too heavy, then increase gradually. After open heart surgery, wait for your doctor's approval because the breastbone needs time to heal.
What if I stop exercising for a while?
This happens often, for example because of illness or a busy schedule. Restart at a lower intensity and duration, then increase gradually over one to two weeks. If you stopped for quite a long time or have new symptoms, contact the rehabilitation team for an evaluation before returning to your original program.
Sources and Medical Review
Translated from the Indonesian edition medically reviewed by dr. Juweni Joe, Sp.GK.
Sources as cited in the Indonesian edition.
- Ambrosetti M, Abreu A, Corrà U, et al. Secondary prevention through comprehensive cardiovascular rehabilitation: From knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology. Eur J Prev Cardiol. 2021;28(5):460-495.
- Pelliccia A, Sharma S, Gati S, et al. 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease. Eur Heart J. 2021;42(1):17-96.
- Dibben G, Faulkner J, Oldridge N, et al. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev. 2021;11:CD001800.
- Anderson L, Sharp GA, Norton RJ, et al. Home-based versus centre-based cardiac rehabilitation. Cochrane Database Syst Rev. 2017;CD007130.
- Thomas RJ, Beatty AL, Beckie TM, et al. Home-Based Cardiac Rehabilitation: A Scientific Statement From the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology. Circulation. 2019;140(1):e69-e89.