Heart Failure Exercise Guidelines
Why should I exercise?
Regular exercise has many benefits. Exercise, especially aerobic
exercise, can:
- Strengthen your heart and cardiovascular system
- Reduce your heart disease risk factors, such as high blood pressure and
being overweight
- Improve your circulation and help the body use oxygen better
- Improve your heart failure symptoms
- Build energy levels so that you can do more activities without becoming tired
or short of breath
- Increase endurance
- Lower blood pressure
- Improve muscle tone and strength
- Improve balance and joint flexibility
- Strengthen bones
- Help reduce body fat and help you reach a healthy weight
- Help reduce stress, tension, anxiety, and depression
- Boost self-image and self-esteem
- Improve sleep
- Make you feel more relaxed and rested
- Make you look fit and feel healthy
Talk to your health care provider first
Always
check with your health care provider before starting an exercise program.
Your health care provider can help you find a program that matches your level of
fitness and physical condition. Here are some questions to ask:
- How much exercise can I do each day?
- How often can I exercise each week?
- What type of exercise should I do?
- What type of activities should I avoid?
- Should I take my medication(s) at a certain time around my exercise
schedule?
- Do I have to take my pulse while exercising?
Cardiac rehabilitation
Your doctor may
encourage you to participate in the hospital's cardiac rehabilitation (rehab)
program. A cardiac rehab program is designed to help you exercise safely and
maintain a heart-healthy lifestyle. The program generally includes:
- A tailored exercise program
- Education
- Changing risk factors (such as quitting smoking and changing your diet)
Exercises that may be included in your cardiac rehab program include cycling on a stationary bike, using a treadmill, low-impact aerobics, and swimming.
During exercise sessions at the cardiac rehab center, your heart rate and blood
pressure will be monitored.
The cardiac rehab program will allow you to meet others like you who can
help you stay on track to maintain a healthier heart. Your doctor will work
closely with the cardiac rehab trainers to chart your progress.
What type of exercise is best?
Exercise
can be divided into three basic types:
1. Stretching: slow lengthening of the muscles. Stretching the arms and legs
before and after exercising helps prepare the muscles for activity and helps
prevent injury and muscle strain. Regular stretching also increases your range
of motion and flexibility.
2. Cardiovascular or aerobic: steady physical activity using large muscle
groups. This type of exercise strengthens the heart and lungs and improves the
body's ability to use oxygen.
Aerobic exercise has the most benefits for your heart. Over time, aerobic
exercise can help decrease your heart rate and blood pressure and improve your
breathing (since your heart won't have to work as hard during exercise).
Aerobic exercises include: walking, jogging, jumping rope, bicycling
(stationary or outdoor), cross-country skiing, skating, rowing, and low-impact
aerobics or water aerobics.
3. Strengthening: repeated muscle contractions (tightening) until the muscle
becomes tired. For people with heart failure, many strengthening exercises are
not recommended.
How often should I exercise?
The
frequency of an exercise program is how often you exercise. In general, to
achieve maximum benefits, you should gradually work up to an aerobic session
lasting 20 to 30 minutes, at least three to four times a week. Exercising every
other day will help you keep a regular aerobic exercise schedule.
What should I include in my program?
Every
exercise session should include a warm-up, a conditioning phase, and a cool down.
The warm-up helps your body adjust slowly from rest to exercise. A
warm-up reduces the stress on your heart and muscles, slowly increases your
breathing, circulation (heart rate), and body temperature. It also helps improve
flexibility and reduce muscle soreness.
The best warm-up includes stretching, range of motion activities, and beginning the activity at a low intensity level.
The conditioning phase follows the warm-up. During this phase, the
benefits of exercise are gained and calories are burned. During the conditioning
phase, you should monitor the intensity of the activity.
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Rated Perceived Exertion (RPE) Scale
The RPE scale is used to measure the intensity of your
exercise. The RPE scale runs from 0-10. The numbers below relate to
phrases used to rate how easy or difficult you find an activity. For
example, 0 (nothing at all) would be how you feel when sitting in a
chair; 10 (very, very heavy) is how you feel at the end of an exercise
stress test or after a very difficult activity. Use this scale when
completing your exercise log.
0.......... Nothing at all
0.5....... Just noticeable
1.......... Very light
2.......... Light
3.......... Moderate
4.......... Somewhat heavy
5.......... Heavy
6
7.......... Very heavy
8
9
10.......... Very, very heavy
In most cases, you should exercise at a level that
feels 3 (moderate) to 4 (somewhat heavy). When using this rating scale,
remember to include feelings of shortness of breath, as well as how tired
you feel in your legs and overall. |
The intensity is how hard you are exercising, which can be measured by
checking your heart rate. Your health care provider can give you more
information on monitoring your heart rate.
Over time, you can work on increasing the duration of the activity.
(The duration is how long you exercise during one session.)
The cool-down phase is the last phase of your exercise session.
It allows your body to gradually recover from the conditioning phase. Your heart
rate and blood pressure will return to near resting values. Cool-down does not
mean to sit down! In fact, do not sit, stand still, or lie down right after
exercise. This may cause you to feel dizzy or lightheaded or to have heart
palpitations (fluttering in your chest).
The best cool-down is to slowly decrease the intensity of your activity. You
may also do some of the same stretching activities you did in the warm-up phase.
General exercise guidelines
-
Gradually increase your activity level, especially if you have not been
exercising regularly.
-
Remember to have fun! Choose an activity that you enjoy -- exercising
should be fun and not a chore. You'll be more likely to stick with an
exercise program if you enjoy the activity. Here are some questions you can
think about before choosing a routine:
--What physical activities do I enjoy?
-- Do I prefer group or individual activities?
-- What programs best fit my schedule?
-- Do I have physical conditions that limit my choice of exercise?
-- What goals do I have in mind? (losing weight, strengthening muscles, or
improving flexibility, for example)
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Wait at least 1 1/2 hours after eating a meal before exercising.
-
When drinking liquids during exercise, remember to follow your fluid
restriction guidelines.
-
Dress for the weather conditions and wear protective footwear.
-
Take time to include a five-minute warm-up, including stretching
exercises, before any aerobic activity. Include a five- to ten-minute
cool-down after the activity. Stretching can be done while standing or
sitting.
-
Schedule exercise into your daily routine. Plan to exercise at the same
time every day (such as in the mornings when you have more energy). Add a
variety of exercises so that you do not get bored.
-
Exercise at a steady pace. Keep a pace that allows you to still talk
during the activity.
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Exercise does not have to put a strain on your wallet. Avoid buying
expensive equipment or health club memberships unless you are certain you
will use them regularly.
-
Stick with it. If you exercise regularly, it will soon become part of your
lifestyle. Make exercise a lifetime commitment. Finding an exercise
"buddy" will also help you stay motivated.
-
Keep an exercise record.
© Copyright 1995-2005 The Cleveland Clinic
Foundation. All rights reserved.
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