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cardiac rehabilitation Physical activity and


HOW DOES PHYSICAL ACTIVITY HELP IF YOU HAVE HAD A HEART ATTACK? n Regular physical activity can improve the blood supply to the heart muscle. This helps reduce your risk of suffering from another heart attack or from experiencing irregular patterns of heart beats (arrhythmias).


n As the heart muscle gets fitter through physical activity the heart rate and blood pressure decrease which means the heart doesn’t have to work as hard as before, for a given amount of work. This means it is less likely to become short of oxygen and if you suffer from angina you are less likely to experience symptoms or you will be able to do more activity before experiencing the symptoms.


n Physical activity also helps to reduce a number of other risk factors in heart disease including high blood pressure, high blood cholesterol, being overweight and the risk of developing diabetes.


n Other benefits include reductions in the risk of several types of cancers, osteoporosis and the risk of falling.


n It also helps reduce anxiety, depression and stress, and improves your overall feeling of well-being as well as helping you sleep better.


STAYING SAFE n To prevent blood pooling when exercising, keep your legs and toes moving particularly when you are standing during activities.


WHAT TYPE OF ACTIVITY IS BEST?


Activities at Phase IV may include both supervised and independent exercise. It is important that these activities become a regular part of your life so try and pick ones that you enjoy and that are affordable. A mix of exercises are good, with stamina-type activities being most important. Stamina-type activities: Walking, swimming, cycling, dancing, tennis and housework (washing floors or windows) Strength-type activities: Walking uphill, carrying shopping, climbing stairs, gardening (digging or mowing) and housework Flexibility-type activities: Dancing, yoga, T’ai Chi, Pilates and gardening.


Tips on increasing your activity level n Walking is an ideal activity as it’s free and easy to do anywhere. Perhaps take a dog for a walk to make it more interesting.


n Look for opportunities to be active during your whole day. For example park at the far end of the car park, or walk one stop further to catch the bus, and take 10 minutes out of your lunch break to go for a walk.


n Try using the stairs instead of the escalator. If you do use the escalator start by walking part of the way up and gradually progress to walking up the whole way.


n Choose activities that you enjoy doing. Involve your friends and family to make your activities fun, sociable and enjoyable.


n Exercise that involves lying down should be done after the cool down.


n Avoid long sustained actions with your hands held above your head as this requires an unnecessary increase in the function of your heart.


n Avoid holding your breath during exercise as this increases the heart’s workload.


n Try not to do any heavy manual jobs outdoors when it is cold, and avoid exercising after a heavy meal. Both of these increase the work your heart is required to do.


n Do not exercise if you are unwell, or if you have a temperature or chest infection.


n Using a GTN spray or tablet before an activity can help.


If you get any of the following problems stop exercising and ask for medical advice n Discomfort in your chest or upper body brought on by physical activity.


n Uncomfortable or severe breathlessness, dizziness or nausea. n Fainting or palpitations (a very fast or irregular heart beat) during activity.


HOW DO I USE MY GTN SPRAY OR TABLETS? If you regularly get angina when walking or doing any activity, try either reducing your level of exertion or taking your GTN before you start. This should mean that you can walk further before the chest pain comes on.


HOW MUCH AND HOW OFTEN?


Frequency Your main aim is to build up to 30 minutes of moderate intensity activity on 5 or more days of the week. If this seems too much to start with, try starting with 3 x 10 minute walks spread throughout the day and work towards 2 x 15 minute walks and then 30 continuous minutes. One goal is to try and increase your activity by 2 minutes each day.


Intensity Moderate intensity means breathing harder and getting warmer than normal. It does not need to be hard. You should be able to talk and be active at the same time.


Advice Whatever your chosen activity, it should be performed at a gentle intensity which gradually increases until after about 10 minutes you have reached the level you can maintain for your chosen period of activity. This gets the blood flowing to your muscles and allows your heart rate to increase gradually. When you are nearing the end of your activity you should also slowly decrease the level of activity over 5-10 minutes to allow your heart rate to slow down gradually.


Remember Set yourself realistic goals and don’t worry if you miss one day. Just make sure that the next day you pick up where you left off.


The information contained in this article is intended as general guidance and information only and should not be relied upon as a basis for planning individual medical care or as a substitute for specialist medical advice in each individual case. To the extent permissible by law, the publisher, editors and contributors accept no liability for any loss, injury or damage howsoever incurred (including negligence) as a consequence, whether directly or indirectly, of the use by any person of the contents of this article.


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