Exercise

Do you have days when you feel on top of the world?  Are there times when you feel well enough to do lots of things? 

Are there other days when you feel so tired that you struggle to do ordinary, everyday things? 

Why should you feel like that? 

Good days and bad days – the over/under activity cycle

“On a good day I wake up feeling really well. I make sure that I get as much done as possible on days like that. I catch up on jobs that I have left. I feel a sense of achievement at the end of it.”

“My bad days often follow my good days. I seem to swing between the two. On a bad day I wake up feeling tired, my body seems to be telling me to rest, so I do. I put my feet up and take things easy until I feel well again.”

This person is in the ‘over/under activity cycle’. This isn’t as complicated as it sounds. It means that on good days we may do far too much. The next day or so we feel very tired, and we must rest to recover. It’s this swinging from doing so much on a good day followed by needing to rest to recover that’s called the over/under activity cycle.

Why does it matter?

It matters because we lose fitness more quickly than we gain it. So, working hard on one day would help to improve your fitness. Unfortunately, resting the next day would mean that you would lose the fitness you have gained, plus a little bit more. Over time you’ll end up less fit. 

In the early stages of recovery, it’s normal to have good days and bad days. So, if you’re having a bad day, it’s important not to push yourself to do things.  

As you recover try to pace yourself by keeping the amount of activity to an ‘easy level’ which you’re able to maintain every day. This can be done by breaking down jobs into smaller, easier chunks which may take longer but will mean better fitness and fewer bad days.

Formal classes are an important part of our structured cardiac rehabilitation exercise programme.

Following an initial assessment, should you wish to engage in the exercise classes, you will be offered a series of exercise sessions that you’ll attend once a week, with classes lasting approximately one hour and you’ll be encouraged to continue exercising at home. 

Format

1. The class begins with a warm-up to slowly raise the heart rate and mobilise all the points. This is important to prevent injury and reduce the risk of further cardiac problems.
2. We then move on to the conditioning phase. This includes cardiovascular exercise to work the heart a little harder, interspersed with active rests which allow the heart to have a break without dropping your heart rate too low. As you progress through the classes the number of cardiovascular exercises increase, while active rests are reduced until the whole conditioning phase is all cardiovascular work.
3. After the conditioning phase it’s important to have an active cool down to get your heart rate to slowly return to your near pre-exercise heart rate. This is best achieved by slow walking to make sure the calf pump continues to work. 
4. Once your heart rate has slowed down, it is important to stretch to prevent muscle soreness and joint tightness. During this period of time, a series of strengthening exercises designed to strengthen specific muscle groups, will be demonstrated.
5. On completion fo the cool down, before leaving the department, we will ensure your heart rate has returned to its resting state. Links to the audio can be found on the relaxation page.

Towards the end of the programme, you’ll have a re-evaluation assessment which may include a physical capacity test to check your progression and get you ready for the next stage of your rehabilitation process

We always recommend that you join one of our exercise classes if you can.

Attending the exercise classes offers the physical benefits of taking part and being in a class offers you the benefits of being part of a group and seeing staff face to face.

However, if you’re not able to come to a formal class, we can help you exercise at home. This is through either a self-directed programme or programme supported with written or online material. This will be supported by telephone contact calls from our cardiac exercise specialists to provide guidance in ensuring you meet your exercise goals.

If you’d like this type of support, you’ll need an initial assessment so we can accurately prescribe the correct exercise intensity level for you and make sure you understand how to exercise safely and how to self-monitor.

At the assessment, we’ll tell you how to follow the exercise programme and complete the exercise diary.

As you follow the programme, you’ll need to report back your exercise levels and exertion so we can help you progress.

Once you’ve completed the programme, we expect you to come to re-assessment evaluation to measure your progress and talk about ongoing exercise.

The cardiac rehabilitation service offers a structured programme of exercise and education for people continuing to recover from a cardiac event.

It helps increase fitness levels and lessen cardiac symptoms. It also will improve your health and lower the risk of future heart problems. Qualified, knowledgeable cardiac rehabilitation instructors run these sessions.

The cardiac rehabilitation team or your GP will refer you and then an instructor will be in touch to arrange a meeting to talk about the right programme for you.

Activity specific exercise leaflets

Advice leaflets from the Association of Chartered Physiotherapists in Cardiac Rehab

• Bowls 
• Class Exercise
• Cycling 
• Gardening
• Golf
• Gym equipment
• Home Exercise
• Racquet Sports
• Running
• Strength Training
• Swimming and other water-based activities 
• Tai Chi, Yoga and Pilates 
• Walking
• Winter Sports