Heart Failure Rehabilitation Information & Advice on Exercise Physiotherapy Department

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How do I exercise safely? Welcome to the heart failure rehabilitation programme. We hope you will enjoy it and feel free to ask any questions. It may be a while since many of you have exercised, so here are some tips to prepare you for your first session. Donts Dont exercise if you are feeling unwell or are feeling very tired. Dont carry on exercising if you feel dizzy or faint. Dont continue to exercise if you have any injuries. Dont continue to exercise through chest pain angina is a warning sign inform staff and take your GTN spray. Dont get too short of breath. Avoid exercising within 3 hours of smoking, 1hr of eating or drinking tea or coffee, or 1hr after a hot bath. Dos Warm up For 10 - 15 mins. This will raise your heart rate gradually and prevent injuries Start Gradually and build up level of activity slowly, if you are not normally very fit or have been unwell it is very important to pace yourself. Wear suitable clothing comfortable, loose layers of clothes, which may be removed as you get warm and comfortable, supportive shoes. Listen to your body it will tell you if you are doing too much. Progress by increasing your walking distance or speed slowly, not both at the same time. Cool down for 10 minutes to allow your pulse rate and blood pressure to return to normal gradually. Bring a bottle of water to keep yourself hydrated when exercising Exercise with somebody else its more fun and good for motivation.

How is the Exercise Class organised? The exercise component is monitored to see how your body is responding to the exercise. This enables us to tailor the exercises to suit you. During the sessions you should be exercising at a light to comfortable level. Please do not compare yourself with others, as everybody is different regarding heart condition and previous fitness level. Please work at your own pace. We use heart rate monitors and the Breathlessness Scale to monitor your response to exercise.

GHNHST/PIU750 July 2007 Expiry Date:- July 2010

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How is the Heart Rate monitored? When you are exercising your heart rate will increase to supply your muscles with enough blood and oxygen. The aim is to increase your heart rate steadily and to keep within your Training Zone one of the team members will calculate this. The highest figure is the maximum pulse rate you should reach while exercising. The upper limit should not be reached initially but you will gradually increase your heart rate and exercise intensity. In order to check your pulse, we will provide you with a monitor, which will be worn around your chest, next to the skin. A watch worn around the wrist will give you the heart rate reading. What is the Breathlessness Scale? While exercising we would like you to rate your perceived breathlessness levels, i.e. how breathless you feel during each exercise. Take into account how tired you feel and how fast and deep you are breathing while exercising. Look at the scale and note down the number, which corresponds to the phrase describing how breathless you felt. BREATHLESSNESS SCALE MAXIMAL VERY, VERY SEVERE VERY SEVERE SEVERE SOMEWHAT SEVERE MODERATE SLIGHT VERY SLIGHT JUST NOTICEABLE 10 9 8 7 6 5 4 3 2 1 0.5 0

Why do I need a Fitness Test? Prior to starting the programme, a fitness test is performed. This will show your current level of fitness so that suitable exercises can be given. The test is repeated when you finish rehab. This will show your level of fitness at the end of the programme so that further advice can be given. The test will involve walking for up to 6 minutes at your own pace on the flat. What sort of exercises will I be doing? Your aims and goals i.e. what is important to you, will be discussed on assessment. Any other conditions you may have, such as arthritis, will be taken into consideration while designing a suitable circuit of exercise for you. Following a group warm up, there will be approximately 10 individual exercises of 1-2 min duration; these will gradually be increased as your fitness improves. The circuit involves various exercises, some using equipment such as light weights, steps, rowing machine, exercise bike and trampet.

GHNHST/PIU750 July 2007 Expiry Date:- July 2010

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Whilst doing the arm exercises it is important to keep your feet moving to maintain the circulation in your legs. On your first session, a member of staff will guide you around the circuit, to introduce the new exercises and pieces of equipment and to help you settle in. For your safety, it is important to inform us of any changes in symptoms, changes in medication or treatment before you exercise. Our Aims are to help you: Reduce your risk of developing further heart disease. Increase your fitness levels Improve your confidence Improve your quality of life

If you have any concerns or worries about the exercises, please do not hesitate to contact your local heart failure rehabilitation team:Nevill Hall Hospital Tel. No: (01873) 732511 County Hospital Tel. No: (01495) 768713

GHNHST/PIU750 July 2007 Expiry Date:- July 2010

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