Center for Consumer Health Information, Cleveland Clinic

 

Heart Failure Exercise/Activity 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
  • Help increase your energy levels so you can do more activities without becoming tired or short of breath
  • 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 doctor or nurse first before starting an exercise program. Your doctor or nurse 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)
What type of exercise is best?

Exercise can be divided into three basic types:

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.

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.

Strengthening: repeated muscle contractions (tightening) until the muscle becomes tired.

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 five times a week.

What should I include in my program?

Every exercise session should include a warm-up, 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. It helps you to slowly increase 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 the beginning of the activity at a low intensity level (intensity is how hard you are exercising).

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. 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 sitting down! In fact, do not sit, stand still, or lie down right after exercise. This may cause you to feel dizzy, lightheaded, or 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
  • Wait at least 90 minutes after eating a meal before aerobic exercise.
  • 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)
  • Warm up. Take time to include a five- minute warm-up, including stretching exercises, before any aerobic activity.
  • Cool down. Include a five-to ten-minute cool down after the activity. Stretching can be done while standing or sitting.
  • When drinking liquids during exercise, remember to follow your fluid restriction guidelines.
  • Dress for the weather conditions and wear protective footwear.
  • 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 that is effective.
  • Exercise does not have to put a strain on your wallet. Think twice before buying expensive equipment or health club memberships unless you are certain you will use them regularly. There are plenty of other activities that can be done with no extra cost to you (e.g., walking).
  • 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. This will allow you to see your progress.
Sources

http://www.americanheart.org/downloadable/heart/5360_HFGuidelineFinal.pdf

http://www.hfsa.org/hf_guidelines.asp

© Copyright 1995-2013 The Cleveland Clinic Foundation. All rights reserved.

This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional written health information, please contact the Health Information Center at the Cleveland Clinic (216) 444-3771 or toll-free (800) 223-2273 extension 43771 or visit www.clevelandclinic.org/health/.

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