We offer structured exercise programmes supported by cardiac exercise specialists. For some people a home programme supported by our exercise specialists may be better suited.
These exercise programmes will help you gain confidence, become fitter, and learn how to exercise safely.
Now you have returned home, you may be feeling tired and perhaps a little worried about the future. One way to help is by gradually increasing your activity. This needs to be done slowly and at your own pace, as talked about with your cardiac nurse specialist.
If you have managed to increase your level of activity as advised, it’s important to remember to start slowly for the first 10 minutes before increasing any intensity, slowing down again for the final five minutes. This gives your heart and muscles a chance to prepare before exercise and then to have a cool down period at the end.
If you are unwell such as if you have a cold, or you’re experiencing discomfort then you should not exercise. Leave it for another day.
Please remember that extreme weather conditions may also affect your ability to exercise outdoors. So in very hot or humid weather, try to exercise in the early morning or the evening, when the temperature is cooler. In very cold or windy conditions, avoid exercising outside and do more activity indoors. If you do go out, avoid walking into the wind and put a light scarf across your mouth and nose to warm the air.
- Wear loose comfortable clothing (preferably not jeans) and supportive footwear – well worn shoes may be comfortable but sometimes they do not offer a deal of support.
- Make sure you feel well and rested before starting any exercise. If you have a GTN spray, have it with you when you exercise.
- Warm up at the start . Your heart and body need time to work up to a pace gradually. Joints and muscles need time to warm up and loosen to avoid stresses and strains, and your pulse needs to increase slowly.
- Hydrate before, during and after exercising unless you’re on a restricted fluid programme. Drinking water is best.
- Cool down. Make sure you slow down gradually over a period of about 5 minutes. Do not just stop as this can make you feel faint and dizzy.
- Do not exercise for at least two hours after a meal or drinking alcohol.
- It’s not recommended to exercise if the temperature is above 24 degrees inside or outside. In warm weather it’s better to exercise early in the morning or later in the day. In cold or windy weather keep your chest, neck and jaw covered.
- Do not exercise if your heart feels irregular and this is not normal for you, you have a temperature or feel unwell, you have chest pain at rest or you feel unusually breathless. Seek advice if you are experiencing any of these things.
The over/under activity cycle
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, you’ll attend once a week for eight weeks, with classes lasting approximately one and a half hours and you’ll be encouraged to continue exercising at home.
- The class begins with a warm up to slowly raise the heart rate and mobilise all the joints. This is important to prevent injury and reduce the risk of further cardiac problems.
- 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.
- 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.
- Once your heart rate has slowed down, it is important to stretch to prevent muscle soreness and joint tightness.
- Classes finish with a 10 minute relaxation session to further help your heart rate to recover before you go home. Links to the audio can be found on the relaxation page.
Towards the end of the programme you’ll have a discharge evaluation which may include a physical capacity test to check your progression and get you ready for the next stage.
We always recommend that you join one of our exercise classes if you can. As well as the physical benefits of taking part, coming to a class gives 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 an outreach programme supervised by our cardiac exercise specialists.
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. These are available on Youtube, Facebook or DVD.
As you then 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 a discharge evaluation to measure your progress and talk about ongoing exercise.
As you’ll be exercising unsupervised, we’ll need you to sign a disclaimer and we’ll inform your GP that you have chosen this form of cardiac rehab.
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. Highly-qualified and knowledgeable cardiac rehabilitation instructors run the 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.
Ongoing exercise is available at:
- Westgate Leisure Centre, Chichester
- The Bourne School, Southbourne
- The Grange Centre, Midhurst
- The Wave, Littlehampton
- Bersted Park Community Centre
- Arun Leisure Centre, Bognor Regis.
Benefits of continuing to exercise in a group setting are:
- encouragement of qualified, specialist instructors
- support of exercising with people who may have experienced similar health issues
- ongoing improvement to enhance wellbeing and confidence
- continuation of the benefits of exercising that you experienced through the hospital programme, for your heart and the rest of your body
- social and fun sessions.
Activity specific exercise leaflets
Advice leaflets from the Association of Chartered Physiotherapists in Cardiac Rehab (ACPICR):