Exercise for Your Heart and Health

The heart is like any other muscle - it needs to work out to stay strong and healthy. Regular exercise is good for your overall well-being. A minimum of 150 minutes per week of moderate exercise is recommended.

Exercise can improve your health by:

• Reducing the risk of dying from heart disease
• Helping your heart and cardiovascular system work more efficiently
• Decreasing symptoms of angina (chest discomfort) and heart failure

Exercise can improve your heart disease risk factors by:

• Reducing the risk of developing diabetes and high blood pressure
• Improving blood sugar tolerance (if with diabetes)
• Helping to control high blood pressure
• Improving blood lipid levels (cholesterol, LDL, HDL and triglycerides) along with other strategies (diet and medications)
• Supporting efforts to quit smoking
• Reducing your body fat and managing your weight

Exercise can improve your strength and general health by:

• Helping to keep muscles, bones and joints healthy
• Increasing your ability to do daily activities without getting tired
• Improving your flexibility and balance
• Improving posture and maintaining muscle tone
• Reduce feelings of anxiety or depression
• Improving your sense of well-being and helping you feel good about yourself

Phases of exercises

Warm-up

This phase helps you move from resting to activity. A warm-up reduces the stress placed on your heart and muscles. This helps to slowly increase breathing, heart rate and body temperature. It also aids to improve flexibility and reduce muscle soreness. This includes:

• Exercise at a low intensity (e.g. walking at a slow pace)
• Range of Motion activities
• Stretching exercises

For the best effects on your muscles and cardiovascular system, your warm-up should last approximately 15 minutes in duration.

Conditioning

This phase follows the warm-up. For the best results, remember these four important points in your conditioning phase:

• Frequency

How often you need to exercise. You should exercise on most days of the week.

• Intensity

How vigorous you need to exercise. You should exercise at a moderate intensity - enough to increase your heart rate and breathing.

Monitor your heart rate closely and modify the activity appropriately to a level in which you can carry on a conversation or speak clearly while exercising (Talk Test). This is a general rule of thumb to help you determine if an activity is too strenuous or too easy for you. You can use your Rate of Perceived Exertion Scale provided by your Physical Therapist when exercising.

• Time

How long you need to exercise. You should exercise 30 to 40 minutes continuously, or 10 minute increments to equal 30 to 40 minutes throughout the day.

If you haven't exercised in a while, your heart, lungs and muscles will need to work up to your exercise duration. Begin with shorter bouts of exercise, about 15 minutes or so, every other day. Progress by three to five minute increments per week, until you reach your goal of 30 to 40 minutes on most days.

• Type
• Aerobic: Activities that increase the depth and rate of your breathing raise your heart rate and use the large muscle groups repetitively for a sustained amount of time. Some examples are walking and cycling.
• Strength Training: This type of exercise can be completed every other day but important to include in your exercise program. This type of exercise can help improve muscle fitness by exercising a muscle group.
• Stretching: Helps maintain or improve your flexibility and helps the body prepare for exercise and also important following the exercise to prevent delayed onset of muscle soreness.

Cool-down

This last phase allows your body to recover from the conditioning phase. Heart rate and blood pressure will return to near resting values. Cool down does not mean sit down. You should also not stand still or lie down directly after exercise. This may cause you to feel dizzy, light-headed or have palpitations.

During cool-down:

• Slowly decrease the intensity of your activity and remember to keep your feet moving.
• Perform gentle stretching and range of movement exercises to avoid delayed onset of muscle soreness.

Similar to the warm-up phase, the cool-down should last approximately 10 minutes for best results.

Please follow these guidelines for your safety

• It can be dangerous for you to exercise if you have not taken your medication, especially your cardiac medications, as instructed by your physician.
• If you have diabetes, it can be dangerous to exercise if your blood glucose levels are either too high or too low. Therefore, all diabetic patients (except those taking metformin only) should check blood glucose levels before and after exercising.
• Type 1 Diabetes: If you have Type 1 Diabetes, your blood glucose level needs to be between 100 mg/dL (5.5 mmol/L) and 250mg/dL (13.8 mmol/L) in order for you to safely exercise.
• Type 2 Diabetes: If you have Type 2 Diabetes, your blood glucose level needs to be between 100mg/dL (5.5 mmol/L) and 300mg/dL (16.6 mmol/L) in order for you to safely exercise.

• Don't exercise when you feel too tired. It is better to wait until you feel more rested.
• Don't exercise during an acute illness, infection or fever. Wait after a few days until all symptoms disappear before restarting your activity program, unless your doctor gives you other instructions.
• Don't exercise in extreme weather conditions, such as:
• Hot weather
• Arrange to walk in the cooler morning or evening hours to avoid added stress on your heart.
• Change your schedule if the temperature and humidity exceed 27 degrees Celsius and 80% humidity.
• Cold weather
• Walk in the warmest parts of the day
• It is best not to exercise outside if it is slippery or if the temperature is below -7 degrees Celsius
• Extremely bad weather
• You can use local malls and shopping centers for walking.
• Don't take extremely hot or cold showers or sauna baths after exercise.
• Don't drink alcohol before exercise.
• Dress appropriately for certain weather conditions and always wear proper footwear.
• Wait at least 60 minutes after eating before exercising. Avoid eating a large meal before exercise. Drink moderate amounts (150-250 ml) of liquids (such as water) before and during exercise, unless your doctor has told you to restrict fluids.
• Inform the Cardiac Rehabilitation team if there are any changes in your medications before continuing your exercise program. Medications can greatly affect your body's response to activity.
• Decrease your activity level if your exercise program is interrupted for several days (due to illness, vacation, bad weather, period of Ramadan, or other circumstances). Gradually advance your activity level as tolerated once you begin your exercise program again.
• Ensure you follow the guidance provided by your Physical Therapist for your target heart range for your exercise. Your target heart rate range is one way of monitoring your physical activity intensity.
• Stop your exercise session and rest if you feel any of the symptoms listed below.
• Call your doctor if the following symptoms last longer than 20 minutes or return on a regular basis:
• Extreme shortness of breath
• Chest discomfort (tightness, fullness, heaviness and or burning)
• Discomfort down either arm, neck or jaw and or radiating pain between shoulder blades
• Dizziness or feeling faint during exercise
• Palpitations (sudden pounding, fluttering or racing sensation in your chest)
• Extreme exhaustion
• Joint or bone pain during or after exercise

Some tips to help you make exercise a lifelong routine

Make short-term goals. Big change does not come overnight. With time, you will see you have improved and made strides toward your target exercise goal.

Find an activity that fits into your schedule

• Pick a time of day that you feel the best to exercise. Write it down as you would other appointments.
• Do not depend on exercise classes to meet your exercise needs. If you miss the class one day, use that time to take a walk outside or in the mall.

Plan ahead

• If you choose an outside activity, plan for exercise you can do inside on bad weather days.

Keep an exercise record

• Write down the type of activity you did how long you did it, your RPE Scale self- rating or target heart rate and any comments you would like to write down. After a few weeks, you'll be able to see where you started and the progress you have made.
• Begin slowly and progress gradually with your activity program. Set goals and work towards them in a gradual manner. Do not expect an overnight success.

Exercise should be fun

• Choose an exercise which you enjoy.
• You may want to switch up your activities (walk one day, bike the next).
• Listen to music or watch TV during exercise if your activity is indoors.
• Find an exercise buddy or group to walk or cycle with. It is a good way to meet new friends.

Make exercise a habit

• It is a must that you follow your exercise program for several months to make it part of your daily routine.
• At first, if you do not exercise regularly for a week, start again the following week. Soon, you will find you want to exercise or you miss it!

Make exercise time a family fun time

• Instead of doing something that requires sitting (watching TV), you and your family can take a walk or bike-riding. It is a great way to see nature, explore new places and have healthy fun.