my pers nal trainer · my pers nal trainer your step-by-step guide active heart, healthy heart....

MY peRS nal tRaineRYour step-by-step guide

active heart, healthy heart

let’s get started

Active heart, healthy heart 02

Monitor yourself 03

Getting ready 03

How should I feel before I exercise? 03

Cem’s story

Cem Hilmi 04

My workout

The exercise programme 06

The stages explained 07

Music 07

My safety tips

How hard should I be exercising? 08

Monitoring exertion using the Borg RPE Scale® 09

How you might feel when you are exercising 10

What to do if you have chest pain, 11 discomfort or tightness

My thoughts

Worries and concerns... 12 answering your questions

Is it safe for me to become more active? 13

Are there any activities I should avoid? 14

My family don’t want 14 me to do anything active

Where can I find more information? 15

My records

To record how you feel while exercising 16

Contents

name

Date of Birth

address

01

Welcome to your home exercise DVD, part of your cardiac rehabilitation programme. it has been designed by cardiac rehabilitation teams and is suitable for most levels of fitness. Before you start your exercise, it is important that you’ve had an assessment with your cardiac rehabilitation team to work out how much exercise you can safely do at home. this assessment will also help decide which level of exercise you should follow on your DVD.

active heart, healthy heart

let’S Get Sta teD

02

How should i feel before i exercise?

Getting ready

Someone from your cardiac rehabilitation team should have explained how to monitor and pace yourself while you are exercising. They will also have spoken about the importance of the warm up and cool down.

It is really important that you have read and understand the information in this booklet, and that you know on which level of exercise you should start. If you’re unsure about anything, please contact your cardiac rehabilitation team who will be able to help you.

• Wearloose,comfortableclothingthat helps you to move freely

• Clearenoughspaceintheroomsoyou can take three steps in any direction

• Keepthetemperaturecomfortable

– perhaps open a window so you don’t get too hot

• Don’texerciseforatleasttwohours after eating food, or drinking alcohol

• Haveaglassofwatertohandduringtheexercise, and at the end to replace the fluid you lose during the session.

• Beforeyoustartanyexercise,makesure you are rested and feel well.

• Youshouldnotstarttheexerciseand should contact your GP or cardiac rehabilitation team if

–Yourheartbeatfeelsirregular,andthis is not normal for you

–Youhaveatemperatureorfeel generally unwell

–Youhavechestpainwhenresting.

Monitor yourself

03

CeM’S St RYCem Hilmi was 37 when he suffered a heart attack. He was incredibly fit and active. Cardiac rehab helped to pull him back.

“One Sunday morning I woke up not feeling 100%. I was in the middle of training for a triathlon but I didn’t feel well enough to go for a run. It was unusual for me.

Later that day, I collapsed while doing the washing up. I was having a heart attack. In hospital I was rushed in for an emergency stent.

It was a shock because I exercised and ate healthily. The hospital gave me tablets and let me go. I felt alone and I became very emotional. I might have slipped through the net but my wife found a BHF cardiology nurse. If it weren’t for her, it would have been a different story. She enrolled me in a cardiac rehab programme.

At each class they checked my pulse and my blood pressure. I had to walk on a treadmill. My exercise tolerance improved and after six weeks I was backto running by myself.

Other people in the programme would ask why I was there. They didn’t believe I’d had a heart attack because of my age. When I told them I was in the same boat it spurred them on too.

Six months to the day of my heart attack I completed a half marathon and then a triathlon the following year. I put that down to the support I got.”

04

Cem Hilmi

05

MYW RKoUtthe exercise programme

You will have a safer, more effective exercise session, and less chance of injury, if you warm up properly first and cool down fully afterwards. all three stages of the exercise programme are equally important and it is essential that you work through them in the order they have been filmed. Don’t be tempted to miss out any parts, even if you are short of time.

06

Music

the stages explained

Warm up (15 minutes)

This prepares your body for exercise. The gradual build up of activity improves the blood flow to the heart and working muscles. This helps the oxygen get to where it is needed. The stretches at the end of the warm up improve your range of movement.

Conditioning phase (referred to as dynamic endurance in the seated programme) (10 minutes in the seated programme and 20 minutes in the other programmes)

This is the main part of the exercise session and will help tone and strengthen your muscles andimproveyourheart’sefficiency.Youwill be able to progress through the different levels of exercise with the advice of your cardiac rehabilitation team.

Cool down (5 minutes in the seated programme and 10 minutes in the other programmes)

This part of the exercise is about gradually slowing down your exercise so that your heart rate and blood pressure return to normal. They will both have risen during the exercise. Yourepeatthestretchestotryandhelpprevent any stiffness which you might feel later, and to improve your flexibility.

We have provided music to go with the exercises as you do them. To turn on the music please use theplaybackaudiocontrolsonyourDVDplayer.

07

MY SafetY t pSHow hard should i be exercising?

During your assessment with the cardiac rehabilitation team, they’ll have shown you the Borg rating of perceived exertion (Rpe) scale and how you should use it. it helps you to check that you are exercising at a level that is both safe and effective for you. the exercise instructor will refer to it twice during the conditioning phase of your exercise programme, and it will be shown on screen at the same time. You will be then given time to record your Rpe, so make sure you have the booklet and a pen nearby. You should have been introduced to this scale during your assessment with your cardiac rehabilitation team.

08

Monitoring exertionDuringtheworkwewantyoutousethisscaleto rate your perception of exertion, ie, how heavy and strenuous the exercise feels to you and how tired you are. The perception of exertion is mainly felt as strain and fatigue in your muscles, as breathlessness, or some aches.

6 “no exertion at all”, means that you don’t feel any exertion what so ever, for example, no aches or muscle fatigue, no breathlessness or difficulties breathing.

9 “Very light” exertion, as taking a shorter walk at your own pace.

13 a “somewhat hard” work, but it still feels oK to continue.

15 it is “hard” and tiring, but continuing isn’t terribly difficult. this is often hard enough.

17 “Very hard”. this is very strenuous work. You can still go on, but you really have to push yourself and you are very tired.

19 an “extremely” strenuous level. for most people this is the most strenuous work they have ever experienced.

Try to appraise your feeling of exertion and fatigue as spontaneously and as honestly as possible, without thinking about what the actual physical load is. Try not to underestimate and not to overestimate your exertion. It’s your own feeling of effort and exertion that is important, not how this compares with other people’s. Often you should only concern yourself about your “overall perceived exertion” and not focus on any special factor. However, sometimes it’s of interest to try to rate your breathlessness and your muscle fatigue separately. As a patient you may also experience and try to rate other symptoms, such as chest pain or some pain from your joints. When exercising use this experience to monitor the intensity. An exertion 11–15 is for most people a good range of exercise. If you have a chronic heart condition, you will need to check with your GP if this level of activity is suitable for you.

Look at the scale and the expressions and then give a number. Use any number you like on the scale, not just one of those with an explanation behind it.

09

Borg Rpe scale®

6 no exertion at all

7

8

9 Very light

10

11 light

12

13 Somewhat hard

14

15 Hard (heavy)

16

17 Very hard

18

19 extremely hard

20 Maximal exertion

extremely light

Borg-Rpe-skalan®

© Gunnar Borg, 1970, 1985, 1994, 1998

When you are excercising it’s normal to feel...

• slightlysweaty

• warmorslightlyflushed

• you’rebreathingdeeperandfaster, but can still talk

• yourheartbeatingfaster.

However, you should slow down and make the movements smaller if

• yourbreathingisuncomfortable

• youfeelexcessivelytiredoraresweatingalot

• yourperceivedexertionscoreishigher than recommended by your cardiac rehabilitation team.

If your RPE doesn’t go down when you have tried to slow down and reduce the movements for a few minutes, walk on the spot slowly.

If you’re still having problems after a couple of minutes, stop and sit down in a supportive chair.

Youshouldalsostop, sit down, and not resume the exercise programme that day if

• youfeeldizzy

• youfeelchest pain

• yourheartbeatbecomesveryirregular.

These are abnormal responses to exercise and may bearesultofoverdoingit.Youshoulddiscussanyof these responses with your cardiac rehabilitation team before your next exercise session.

How you might be feeling when you exercise

10

What to do if you have chest pain, discomfort or tightness

Stop what you are doing.

Sit down and rest.

If you do not have a GTN (glyceryl trinitrate) spray, you should rest, stay calm and call 999.

If you have a GTN spray or tablets, use it as your doctor or cardiac rehabilitation team have told you to. If the pain, discomfort or tightness doesn’t ease after five minutes, take another dose. If the pain does not ease within five minutes of your second dose, call 999 straight away.

If you’re not allergic to aspirin, chew one adult tablet (300mg). If you don’t have any aspirin to hand (or nearby) or you are not sure if you’re allergic or not, you should rest until the ambulance arrives.

11

MYtH UGHtSWorries and concerns… answering your questions

this section looks at some worries and concerns that you may have about becoming more active. Remember that you can talk to your cardiac rehabilitation team at any time.

12

is it safe for me to

become more active?

13

If you have a heart condition, it is still very important to keep physically active. It will help to maintain your heart health, and may prevent your heart disease from getting worse. There are many different ways to keep active, and it’s important to find activities which are safe and right for you. It is also important that you build your activity levels up gradually.

YourcardiacrehabilitationteamhavegivenyouthisexerciseDVDafterathoroughassessmentof your fitness and recovery so far; they have explained which level of exercise to follow and how to record your progress and your RPE. These exercises are a safe and effective way of becoming more active following a heart condition.

We also have more general booklets that look at physical activity as part of a heart healthy lifestyle.

• Get active, stay active• Be active for life. This is a resource designed with people over 50 in mind• Put your heart into walking

14

If you have a heart condition, you may be advised to avoid some everyday activities. It’s worth talking with your cardiac rehabilitation team to find out if they want you to avoid any activities for the moment.Youshouldalsoavoidcompetitivesportslike squash that require sudden bursts of energy.

This is very common. Those close to you may be scared that you will overdo it. Show them your exerciseDVDandthisbooklet.Itshouldhelpsettheir minds at rest knowing that it has been given to you by your cardiac rehabilitation team.

Yourfamilywillbemorelikelytoencourageyou to keep up the exercise. It may also help them, and make it more fun, if they do the exercise with you. However, they should check first with their family doctor that it is fine for them to take part.

My family don’t want me to do anything active

are there any activities i should avoid?

Where can i find

more information?

15

For more detailed information on cardiac rehabilitation, please read our Heart Information Series booklet Cardiac rehabilitation. For more information on caring, please have a look at our Heart Information Series booklet Caring for someone with a heart problem. All of the booklets mentioned are available to order through our Publications Orderline on 0870 600 6566. Youcanalsodownloadororderthemthrough our website at bhf.org.uk/publications. More physical activity and exercise record sheets are also available to download on our website.

MY ReC RDS

alongside the exercise DVD you could do other activities such as walking, light gardening or housework. Remember to make a note of the type of activity, the time you spent doing it and the average exertion level you felt when doing it.

the ‘comments’ section helps you to make a note of anything particular to that activity. for example, what time of day you exercised or how you felt after it.

16

to record how you feel while exercising

Type of activity

Comments

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RPE or heart rate check 1


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Well D neCongratulations on completing your step-by-step guide

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my pers nal trainer · my pers nal trainer your step-by-step guide active heart, healthy heart....

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