How should I feel before I exercise?

Before you start any exercise, make sure you feel rested and feel well.
You should not start any of the exercises and should contact your GP or the
cardiac rehabilitation team if:

• Your heart beat feels irregular, and this is not normal for you.
• You have a temperature or feel generally unwell.
• You have chest pain when at rest.

Warm up

The warm up should last 15 minutes and 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 to get to where it is needed.
The stretches at the end of the warm up improves your range of movement.
Your warm up should involve moving your arms and legs in most directions
and should include:

• Tapping your toes forward.
• Heel digs forward.
• Stepping one foot behind. Right foot then left foot.

Important Information

Conditioning phase

This is the main part of the exercise session and should last 20 minutes. This will help tone and strengthen your muscles and improve your heart’s efficiency. You will be able to progress through the different levels identified on the BHF videos after advice from your cardiac rehabilitation team. If you do not have internet access, exercise level sheets will be sent to you.

Cool Down

This part of the exercise session should last for 10 minutes and is about gradually slowing down the exercises so that your heart rate and blood pressure return to normal, as they will both have risen whilst you have been exercising. You repeat the stretches done in the warm up to try and help prevent any stiffness which you might feel later, and to improve your flexibility.

How hard should I be exercising?

During your assessment with the cardiac rehabilitation team, you should have discussed the Borg scale rating of perceived exertion (RPE) and how you should use it.

This is a safe and effective way to help you measure how hard your body is working when you exercise i.e. 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 aching during exercise. Using a scale from 6-20, you choose a rating number to describe how hard the activity feels. You base the number on how tired you are, how hard it is to breathe and how hard it is to do the exercise.

You should think about your RPE during the warm up, so you know you are at the right level to start the conditioning phase. During the conditioning phase you should record your RPE number every five minutes on the exercise Level sheet sent out to you. Try to appraise your feeling of exertion and fatigue as spontaneously and as honestly as possible.

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

• On the onset of chest pain, discomfort or tightness sit down and rest for 1-2
minutes. If the pain persists then spray GTN under the tongue once, close your mouth and relax.
• Wait 5 minutes.
• If pain is still there, repeat the GTN spray as above.
• If after 10 minutes you continue to have pain please contact 999, they will advise a further spray while you wait for the ambulance crew to arrive.

How you might be feeling when you exercise

When you are exercising it is normal to feel:
• Slightly sweaty.
• Warm or slightly flushed.
• That you are breathing deeper and faster.
• Your heart beating faster.

You should slow down and make the movements smaller if:
• Your breathing is uncomfortable.
• You feel excessively tired or are sweating a lot.
• Your rating of perceived exertion (RPE) identified on the BORG scale is higher than recommended by your cardiac rehabilitation team.

If your RPE does not go down when you have tried to slow down and reduce
the movements for a few minutes, walk on the spot slowly. If you are still feeling short of breath after a couple of minutes, stop and sit down in a supportive chair.

You should also stop, sit down, and not resume the exercise session again if:
• You feel dizzy.
• You feel chest pain.
• Your heart beat becomes irregular.
You can resume exercise tomorrow if the above symptoms have resolved.

Borg rating of perceived exertion

BORG rating sheet

If you do not have internet access

If you do not have access to the internet there is an exercise sheet on the below. Following the telephone assessment you will be sent an exercise level sheet in the post to guide you through the conditioning phase. You will be given an explanation of how to use this during your telephone assessment.
Perform each exercise for 1 minute.

Women doing exercise
Women doing exercise
Women doing exercise
Women doing exercise
Women doing exercise

Stretches for warm up and cool down

Perform each stretch for 5 seconds during the warm up and 20-30 seconds after cool down.

Women doing exercise
Women doing exercise

What if I have more questions?

If you would like any further information you can either visit us or call us between 9am – 5pm on 01274 364348

Physiotherapy Department, Bradford Royal Infirmary, Duckworth Lane, Bradford BD9 6RJ

People with hearing and speech difficulties you can contact us using the Relay UK app. Textphone users will need to dial 18001 ahead of the number to be contacted.

Resources

Visit the British Gymnastics Foundation page for seated exercises.

Bradford Teaching Hospitals NHS Foundation Trust is a smoke-free organisation. You are not permitted to smoke or use e-cigarettes in any of the hospital buildings or grounds.

This exercise booklet was developed by the Physiotherapy Cardiac Rehabilitation team at Bradford Teaching Hospitals NHS Foundation trust.