Cardiac Rehabilitation Exercise Programs Diabetic Management & Weight Loss Exercise Programs

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1 Cardiac Rehabilitation Exercise Programs Diabetic Management & Weight Loss Exercise Programs Information for participants Welcome to our cardiac rehabilitation, diabetic & weight loss exercise programs. No matter the state of your health, every individual will benefit from regular physical activity. A study conducted by the Centre for Disease Control and Prevention determined that a sedentary lifestyle was the leading cause of approximately 9 million cardiovascular disease reported cases, as well as associated obesity and diabetes. Not only will exercise improve your overall medical condition and limit various associated symptoms, it plays a vital role in recovery and ultimately betters your quality of life. Definitions Heart rate: is the average number of times the heart will beat per minute Rating of perceived exertion (RPE): is a subjective scale used to measure your level of exertion at a certain level of exercise intensity Cardiovascular exercise: is any form of physical activity that results in increased heart rate and improves overall cardiovascular capacity and fitness e.g. running and cycling Strength Exercises: aim to improve one s general skeletal muscle strength by use of gradual increases in resistance using equipment or one s own body weight Prescribed heart rate zone: is the specific heart rate prescribed to an individual determined as a percentage of one s maximum heart rate. th Rivonia Medical, Sports & Therapy Centre, 777 Rivonia Road, Cnr 7 Ave & Rivonia Rd, Rivonia

2 The benefits of physical activity Exercise is a planned and structured activity that involves the movement of limbs and results in the conditioning of various body parts and physical fitness characteristics. It functions as a drug-free approach to tackle a wide range of health conditions such as cardiovascular disease, diabetes, obesity and cancer and aids in overall physical functioning. Health related benefits of exercise is extensive and is especially beneficial for individuals suffering from above mentioned medical conditions. Among many others, benefits include: ü Decreased blood pressure ü Improved cholesterol levels ü Improved blood sugar levels ü Weight management ü Improved exercise thresholds for the onset of chest pain ü Increases in physical function and ability ü Alleviates feelings of anxiety and depression ü Improved self-confidence ü Improved sleeping patterns ü Decreased dependence on prescribed medical drugs ü Increased blood flow and energy levels ü Increased bone and muscle strength Exercise recommendations Many people spend their free time on the couch thus putting themselves at higher risk of developing health related problems. Thus The World Health Organization has set guidelines and recommendations for physical activity. What types of exercise should I do? A combination of strength and cardiovascular exercise should be performed on most days of the week. Strength training can be performed at home or in the gym and includes: Lifting weights Using resistance bands Using your own body weight such as push-ups and sit-ups Gardening such as digging and housework that requires lifting

3 Cardiovascular/aerobic training can also be performed at home or in the gym and includes: Walking, jogging and running Swimming Cycling Skipping Climbing stairs Take care not to aggravate your joints by choosing activities that are too advanced or place to much stress on your body. It is better to start with slower, controlled movements such as walking and resistance band exercises. How often should I be exercising? Every individual should participate in regular physical activity for a minimum of 150 minutes of moderate intensity cardiovascular activity and 120 minutes of strength training per week. Class schedule and program compliance (see addendum 1 for the full protocol) The program runs for 12 weeks. In order for the participant to gain maximal benefit, it is advised that one attends the classes at least 2-3 times per week. What to bring? ü Comfortable exercise clothing such as tracksuit pants, shorts and a t-shirt ü Exercise shoes ü A sweat towel ü A bottle of water ü Any necessary medication ü Glucometer and strips (if part of the diabetic program) Exercise Program Schedule (go to for our full schedule) TIME MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY Diabetic & Cardiac Diabetic & Cardiac Weight loss Rehab Weight loss Rehab Cardiac Diabetic & Cardiac Diabetic & Rehab Weight loss Rehab Weight loss

4 The programs running are Cardiac and Diabetic specific, however if pressed for time on your schedule, participants may attend either class. After 12 weeks (or medical clearance), we invite you to attend our other classes on our schedule. Precautions It is important for the participant to take the following into consideration: Do not exercise if you are feeling unwell or sick. Do not exercise on a full stomach; however make sure you eat a light meal at least 1-2 hours prior to exercising. Start off slowly and know your limitations. Do not exceed your recommendations. Wear the appropriate exercise attire in order to prevent over-heating and injury due to incorrect footwear If you forget to take your medication, please advise your Biokineticist before beginning the class. If at any time you are experiencing chest pain, STOP exercising IMMEDIATELY and advise your Biokineticist. You should not experience any chest pain during or after exercise. STOP exercising if you experience tightness in the chest, breathlessness, feelings of faintness, pain in the joints, feelings of nausea, palpitations and excessive sweating. Safety: What should you do if you experience chest pain whilst exercising on your own? If you are experiencing a tightness of the chest and radiating pain into the neck, face, jaw, arm, back or stomach, STOP exercising. Use your prescribed medication to alleviate the discomfort and contact or visit your doctor immediately. Basic session structure Warm up: 10 minutes and is performed before the main exercise. It serves to increase blood flow, warm up muscles and slowly increase heart workload to prepare the body and heart for increased exertion. It consists of any low-level intensity exercise such as a light cycle or walk as well as a few basic stretches. Session: 30 minutes in duration (unless individually scaled down for specific patients). The main body of the exercise session is to increase the heart rate and physical exertion and comprises of a combination of both aerobic and resistance training exercises.

5 Cool down: 10 minutes and functions to lower your pace and return the body back to its resting values. It gradually reduces your heart rate and blood pressure and decreases feelings of dizziness and muscle soreness. How hard should I be working? It is important that you follow the recommended exercise guidelines and know your exercise limitations. An easy way of measuring your level of exertion is using an effort scale or an RPE scale (rate of perceived exertion), where 1 is rated as easy and 10 is rated as your maximum effort. Effort Score Intensity 0 No effort at all No intensity 1 Very light 2 Light Light 3 Moderate 4 Somewhat strong 5 Moderately strong Heavy 6 7 Strong 8 Very strong 9 Extremely strong High 10 Absolute maximum Highest possible Another way of measuring your level of exertion is by using the Talk test. If you are able to carry out a conversation with a slight loss of breath, whilst exercising, then you are exerting yourself at the correct level. If you feel that you are short of breath and battle to talk, then you are working too hard. Structured eating plan (see addendum 2 for the food diary) Diet forms an integral part of achieving one s health target. We encourage you to fill out a food diary that can be monitored throughout the program. Exercise diary (see addendum 3 for the exercise diary) Every participant will receive an exercise diary in which the following will be recorded for each session.

6 Addendum 1 - Program protocol *Cardiac Rehabilitation Program **Diabetic Management & Weight Loss Program Initial Assessment with written report and goal setting. 60 minutes o General history taking o Basic parameters (, Cholesterol, blood pressure) o Anthropometry (Weight, height, circumferences, skinfolds, fat %) o *Resting & stress ECG (Bruce protocol / Modified Bruce Protocol) o **Fitness assessment (YMCA bike / step / treadmill protocol) o Functional Movement Analysis (posture) o Flexibility o Muscle endurance Attend program for 6 weeks (minimum 2 sessions per week) Basic evaluation (6 weeks). 30 minutes o General discussion and feedback o Basic parameters (, Cholesterol, blood pressure) o Anthropometry (Weight, height, circumferences, skinfolds, fat %) Attend program for 6 weeks Full Re-assessment (12 weeks). 60 minutes o Same as initial assessment Continue with maintenance program until 12 week re-assessment Session structure Check in 15 minutes prior to start of session o *Check Blood pressure & heart rate (record in logbook) o **Check (record in logbook) o Put on heart rate monitor Warm up (in your prescribed heart rate zone & RPE) o 10 light cardiovascular exercise o *Check Blood pressure & heart rate (screening only) o **Check heart rate (screening only) Main Exercise (in your prescribed heart rate zone & RPE) o 10 cardiovascular exercise o 10 strengthening exercises o 10 cardiovascular exercise o *Check Blood pressure & heart rate (screening only) o **Check heart rate (screening only) Cool down (in your prescribed heart rate zone & RPE) o 10 active stretches o *Check Blood pressure & heart rate (record in logbook) o **Check heart rate & (record in logbook) Finish session o Record session data in logbook o Remove heart rate monitor

7 Addendum 2 Food Diary Date: Breakfast Time of day: Mood: Qty Measure Food Calories (approx) Protein (g) Carbs (g) Fat (g) Lunch Time of day: Mood: Qty Measure Food Calories (approx) Protein (g) Carbs (g) Fat (g) Dinner Time of day: Mood: Qty Measure Food Calories (approx) Protein (g) Carbs (g) Fat (g) Snacks Time of day: Mood: Qty Measure Food Calories (approx) Protein (g) Carbs (g) Fat (g)

8 Addendum 3 Exercise Diary Date Time Weight Ave HR Start BP / End BP / Session details RPE Comments Date Time Weight Ave HR Start BP / End BP / Session details RPE Comments Date Time Weight Ave HR Start BP / End BP / Session details RPE Comments

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