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Fitness

2002-02-01 16:18:00

What is the typical regimen for cardiac rehab?

Question:   What is a typical regimen for cardiac rehab following heart surgery?

Answer:  Some people choose to participate in a Cardiac Rehabilitation Program offered by a hospital that is insurance funded while others choose to follow a program at home.  Whichever one you choose, it is important to check with your cardiologist and heart surgeon for any restrictions you may have.  If you choose to follow a program at home, it is best to start out in small increments and gradually build up your activity.  There are two main purposes to an exercise program.  First, to gradually increase your cardiovascular endurance safely and progressively. Second, to help you establish an exercise habit which will help reduce your cardiovascular risk of recurrent events.  Low intensity walking or biking is the best activity you could do.  If you have a treadmill or stationary bike, it is recommended to use that in the winter or walk indoors, since it is best not to be outdoors exercising if the temperature is 32 degrees or below.  Start out walking about five to ten minutes at a time, three to four times a day.  It is important to keep in mind that you will have days you feel better than others.  Do not push yourself too hard, or you will pay for it later.  As you feel comfortable, or about every other day, increase your walking time by a minute or two.  As you reach ten minutes, decrease the amount of times you walk a day down to two or three.  As you progress to twenty minutes at a time, decrease to walking once a day.  Keep increasing the time until you reach thirty minutes at one time.  Once you reach thirty minutes, you may walk three to five times per week.  It is important to check your pulse before your exercise and then again while you are exercising.  You can check your pulse at your wrist or your neck.  An easy way to take your pulse, if you don't know how, is to count how many times it beats in ten seconds.  The first beat should be counted as zero.  Your exercising heart rate should be three to five beats (twenty to thirty if you take your pulse for a minute) above your resting heart rate.  An example would be if you get twelve beats in ten seconds at rest, your exercising rate should be fifteen to seventeen beats in ten seconds.    An important addition to your exercise program that is usually overlooked is a warm-up and cool-down.  It is very important to incorporate this into your exercise program so as not to do any harm to yourself or your heart.  Warm-up and cool-down can be as easy as slow walking for five to ten minutes before and after your exercise.  You may also do gentle stretching or range of motion exercise before and after.  Do be careful of what you do with your upper body to make sure your incision and breastbone heal properly.  Four to six weeks after your surgery, you may add upper body exercises to help strengthen those muscles.  One to five-pound weights or Vitabands work well.  Vitabands are resistance bands used in place of weights.  Some important signs to watch for while exercising are angina or chest pain, light-headedness, dizziness, loss of balance, excessive shortness of breath, nausea, leg problems, fatigue that is beyond ordinary tiredness and irregular heartbeat or palpitations.  If you experience any of these while exercising, stop immediately and rest.  If they do not go away with rest, call your doctor.  Do make sure to wait an hour or so after eating to exercise.  Your heart is working harder to digest your food, so it is a good idea to wait.  Do not exercise outside if it is colder than 32 degrees or warmer than 90 degrees.Remember that the most important thing is to gradually increase your exercise.  Do what is fun to you.  If you don't enjoy it, you will not continue.  Good luck, good health and keep walking!