Physical activity and Heart failure

So, you have experienced a heart attack, heart failure or have been diagnosed with another cardiovascular disease, what now? After receiving treatment, what can you do to improve cardiovascular health and physical fitness? The answer to both questions is cardiac rehabilitation. Cardiac rehabilitation is a medical program, designed by physicians, that helps a patient recover after major heart problems. These programs are specialized to meet the specific needs of the patient. An entire panel of professionals including doctors, nurses, dietitians, exercise therapists and physical therapists work to provide a safe recovery. Typically, a cardiac rehab program occurs in a series of phases and includes exercise, nutritional counseling, emotional support and education to reduce future risk. While members of a cardiac rehab team will provide the information required for a patient to successfully complete a program, many patients still have questions and concerns regarding the exercise portion of the program.

There are three common questions regarding the exercise portion of cardiac rehab. When can I start to exercise? What kind of exercise is safe? How long will rehab last?

The exercise program often begins while the patient is still in the hospital, shortly after a heart attack or another complication. It is important for a program to start at this time. In the past, medical professionals believed that rest was most effective for cardiovascular health. However, a recent study found that for every week that a patient delayed an exercise program, he would have to train an extra month to obtain equal benefits. Thus, the best time to start is right when your physician clears you for physical activity.

The kind of exercise that is safe depends on the stage of rehab and the individual’s circumstances. Early in rehab, the exercise will be very simplistic. For example, following surgery rehab might include sitting up in bed, standing up and walking (assisted or unassisted) down the hall. This may seem too easy, but major surgery and other heart conditions can be very draining. Early in recovery, everyday tasks become very difficult. That is why cardiac rehab begins with activities that help return normal mobility.

After a patient leaves the hospital, the exercise routine changes. At first the exercise sessions will take place at an outpatient rehab facility. The starting exercise routines will include aerobic exercise for 3-5 days a week and weight training for 2 to 3 days a week. Specifically, a patient will start out with walking, cycling or climbing stairs to improve cardiovascular health. They will also use free weights or weight machines to work on muscle strength. As an add on to the exercise routine, patients will be encouraged to add physical activity to daily activities. This can be done with simple changes. Both parking farther from a building and taking the stairs are examples that can work into an average day. Eventually, the patient will be able to workout at home. For most this will be a major milestone of personal independence.

It is important to note that safety is not a huge focus for patients early in rehab. While exercising in the hospital or rehab facility, patients are closely monitored for blood pressure and heart activity. When patients shift to home exercise, it is because the doctor believes the patient can exercise safely at home.

The length of time to expect for rehab is not easy to define. It varies greatly based on the cardiovascular problem the patient is having and individual cases. Rehab could take six weeks, six months or longer. However, some physicians recommend at least six months of exercise for the best recovery.

Here is an example of a beginner at home routine:

Perform all exercises standing. Remember to breath. Forgetting to breath steadily during exercise can raise your blood pressure. After the third day, add small weights (1-2 pounds). Keep feet at shoulder width for all exercises. Consult a physician before implementing this routine.

Elbow Bends - Stand with elbows against your stomach and hands under your chin. Straighten your arms out forward. Return to starting position and repeat.

Bent Arm Raises - Use the same starting position as elbow bends. Raise arms over your head. Return to staring position and repeat.

Elbow Extensions - Use the same starting position as elbow bends. Extend your arms to the side, while keeping your elbow in place. Return to starting position and repeat.

Straight Arm Raises - Place arms at your sides, straight down. Keeping arms straight, raise them in front as high as you can. Move slowly into starting position and repeat.

Arm Circles - Put your arms straight to your sides, in line with shoulders. Move your arms steadily in small circles. Switch between forward and backward circles after 10 circles.

After 5 days working on the home routine, add the following exercises:

Marching In Place - Hold your arms slightly bent, as if in running position. Lift your legs by bending at the knee. Move your arms while you march.

Waist Bends - Rest your hands on your hips, with elbows bent. Keep your legs straight and bend at the waist to the right. Do the same for the left and repeat.

Waist Twist - Use same positioning as waist bends. Turn your upper body to the left and return to center. Do the same for the right and repeat.

After 7 days of home exercise add the following exercise:

Knee Touches - Start with your arms raised above your head. Bend over and touch your knees. Repeat the exercise.

After 3 weeks of home exercise add the following exercise:

Knee Bends - Hold your hands on your hips with elbows bent. Bend your knees to a comfortable position and return to standing.

There are some risks involved in exercise for cardiovascular health. Exercise may not be safe for patients with high blood pressure or severe heart disease. If either of these are true, it may be best to address these issues through lifestyle changes or medication before exercising. In addition, exercise can cause injury to muscles or bones. In order to insure personal safety, it is best to contact a physician before proceeding with a workout plan.

Some symptoms may indicate health problems during exercise. These symptoms include chest pain, nausea, heavy breathing, severe fatigue, extreme sweating, abnormal heart rate change (either low or high), abnormal blood pressure and abnormal blood sugar. If any of these symptoms occur, immediately stop exercising and contact your physician.

You have been sticking to your cardiac rehab exercise routine, what results can you expect? Exercise will help build up your muscles and improve the health of your heart. This will lead to a more normal routine. You may find your life returning to the same pace as before your cardiovascular problems. Cardiac rehab can be a slow process, but the more you stick to the exercise routine, the better your results will be.