Exercise Guidelines During Cardiac Rehabilitation

What are the Exercise Guidelines During Cardiac Rehabilitation

When you are recovering from a heart condition, such as from heart surgery, heart attack, or heart failure, it is important to have heart-healthy habits, including exercise routines. Discuss an appropriate exercise program with your heart specialist (cardiologist) and rehabilitation therapist.

It is important to design a program that is safe and effective for you. The program should meet your specific abilities and needs. Walking, biking, jogging, and swimming are all good aerobic activities. These take light to moderate effort. Adding some light resistance training is also important. Even simple lifestyle changes can help. These lifestyle changes may include parking farther from the store or taking the stairs instead of the elevator.

At first, you may begin exercising under supervision, such as at a hospital or clinic. Over time, you may begin exercising at home, with your health care provider’s approval.

Types of exercise

Aerobic exercise

During cardiac rehabilitation, it is important to do aerobic activities. Aerobic exercise keeps joints and muscles moving. It involves large muscle groups. It is also rhythmic and must be done for a longer period of time. Doing these exercises improves circulation and endurance. Examples of aerobic exercise include:

  • Swimming.
  • Walking.
  • Hiking.
  • Jogging.
  • Cross-country skiing.
  • Biking.
  • Dancing.

Static exercise

Static exercise (isometric exercise) uses muscles at high intensities without moving the joints. Some examples of static exercise include pushing against a heavy couch that does not move, doing a wall sit, or holding a plank position. Static exercise improves strength but also quickly increases blood pressure. Follow these guidelines:

  • If you have circulation problems or high blood pressure, talk with your health care provider before starting any static exercise routines. Do notdo static exercises if your health care provider tells you not to.
  • Do nothold your breath while doing static exercises. Holding your breath during static exercises can raise your blood pressure to a dangerously high level.

Weight-resistance exercise

Weight-resistance exercises are another important part of rehabilitation. These exercises strengthen your muscles by making them work against resistance. Resistance exercises may help you return to activities of daily living sooner and improve your quality of life. They also help reduce cardiac risk factors. Examples of weight-resistance exercise include using:

  • Free weights.
  • Weight-lifting machines.
  • Large, specially designed rubber bands.

You will usually do weight-resistance exercises 2 times a week with a 2-day rest period between workouts.

Stretching

Stretching before you exercise warms up your muscles and prevents injury. Stretching also improves your flexibility, balance, coordination, and range of motion. Follow these guidelines:

  • Stretch both before and after exercising.
  • Do notforce a muscle or joint into a painful angle. Stretching should be a relaxing part of your exercise routine.
  • Once you feel resistance in your muscle, hold the stretch for a few seconds. Make sure you keep breathing while you hold the stretch.
  • Go slowly when doing all stretches.

Setting a pace

  • Choose a pace that is comfortable for you.
    • You should be able to talk while exercising. If you are short of breath or unable to speak while you exercise, slow down.
    • If you are able to sing while exercising, you are not exercising hard enough.
  • Keep track of how hard you are working as you exercise (exertion level). Your rehabilitation therapist can teach you to use a mental scale to measure your level of exertion (perceived exertion). Using a mental scale, you will think about your exertion level and rate it in a range from 6 to 20.
    • A rating of 6 to 9. This means that you are doing “very light” exercise and are not exerting yourself enough. For a healthy person, this may be walking at a slow pace.
    • A rating of 11 to 15. This is exercise that is “somewhat hard.” For a healthy exercise session, you should aim for an exertion rate that is within this range.
    • A rating of 16 to 17. This is considered “very hard” or strenuous. For a healthy person, exercise at this rating may start to feel heavy and difficult.
    • A rating of 19 to 20. This means that you are working “extremely hard.” For most people, these numbers represent the hardest you’ve ever worked to exercise.
  • Your health care provider or cardiac rehabilitation specialist may also recommend that you wear a heart rate monitor while you exercise. This will help you keep track of your heart rate zones and how hard your heart is working.

Frequency

As you are recovering, it is important to start exercising slowly and to gradually work up to your goal. Work with your health care provider to set up an exercise routine that works for you. Generally, cardiac rehabilitation exercise should include:

  • 40 minutes of aerobic activity 3 – 4 days a week.
  • Stretching and strength exercises 2 – 3 days a week.

Contact a doctor if:

  • You have any of the following symptoms while exercising:
    • Pain, pressure, or burning in your chest, jaw, shoulder, or back (angina).
    • Lightheadedness.
    • Dizziness.
    • Irregular or fast heartbeat.
    • Shortness of breath.
  • You are extremely tired after exercising.

Get help right away if:

  • You have angina that does not get better with medicine and lasts for more than 5 minutes.
  • You have nausea or you vomit.
  • You have excessive sweating that is not caused by exercise.

Summary

  • When you are recovering from a heart condition, it is important to have heart-healthy habits, including exercise routines.
  • At first, you may begin exercising under supervision, such as at a hospital or clinic. Over time, you may begin exercising at home, with your health care provider’s approval.
  • Aim for 40 minutes of aerobic exercises 3 – 4 days a week.
  • Aim to do stretching and strength exercises 2 – 3 days a week.
  • Choose a pace that is comfortable for you. You should be able to talk while exercising.
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