Phase 2 Cardiac Rehabilitation. Physiotherapy Instructions. Physiotherapy Department

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1 Cardiac Rehabilitation Page 1 of 10 Phase 2 Cardiac Rehabilitation Physiotherapy Instructions Physiotherapy Department Phase II Cardiac Rehabilitation is the phase immediately following discharge from hospital. It is the time when you work on gradually increasing your exercise tolerance following your operation. Try to walk in flat areas for at least the first six weeks, avoiding hills and gradients where possible. It is a very important part of your recovery and it is important that you try to achieve your goals. Below are guidelines to show how to progress your endurance over the coming weeks. Week one post discharge: Week Two: Week Three: Week Four: Week Five: day. Week Six: Aim to walk for five minutes each day. If you find that this is very easy, you can do two fiveminute walks in the one day before increasing your walking time. Aim to walk for 10 minutes non-stop each day, as it becomes easier, you may increase the time by a minute or two. Aim to walk for minutes non-stop each day. Aim to walk for minutes non-stop each day. Aim to walk for minutes non-stop each Aim to walk for minutes non-stop each day. It is important to exercise most days. You are advised to exercise at least 5 out of 7 days, and not to take two days off in a row. This is because you start to lose the benefits of exercise within 48 hours, so it is important to avoid this.

2 Cardiac Rehabilitation Page 2 of 10 After week six you can progress your walking as tolerated. There are Sli na Slainte routes available throughout Dublin and many parts of the country, please see the Irish Heart Foundation website for details. Here are a couple of tips to help you to gauge what level of exercise is the correct level for you. When you are walking you should be able to talk but not sing. You should feel slightly to moderately breathless immediately post exercise, and you should recover from this breathlessness after a short rest (you can rate this using the Borg on Page 3). You should not feel so tired after your walk that you need to go to bed to recover. You may need to take a daily nap in the weeks following your surgery, which is normal, but should not be related to your walking. You should stop exercise if you experience any of the following: Dizziness Palpitations Chest discomfort Sickness Cramps Extreme fatigue Other useful tips for your return to exercise: Walking is the best exercise for the first eight weeks post discharge. Do not walk before your breakfast as you will have been fasting for a long time and your blood sugars may be low, resulting in you feeling weak or faint. Do not walk directly after a large meal; give yourself an hour to an hour and a half to digest your food. If you are walking with someone, ensure that you dictate the pace. Too fast and you may feel tired and unable to keep going, too slow and you are not getting the benefits. Do not bring the dog on a lead with you for at least six weeks. Start off walking on the flat only, and as you achieve your goals, and your fitness improves, you can add in gentle gradients to your walks. Do not exercise in extremes of temperature or weather conditions. Cold, heat, rain and wind can affect your exercise tolerance considerably, so it is a good idea to have an indoor alternative in mind in case you get a run of bad weather e.g. marching on the spot, step ups, squats, sit to stands. Do not push the lawn mower or dig the garden for at least three months post surgery

3 Cardiac Rehabilitation Page 3 of 10 Do not return to golf without clearance from your consultant. Avoid swimming until your wound is fully healed and you have clearance from your consultant. The Borg is a rate of perceived exertion and it helps us to gauge how you are tolerating your return to exercise. Please see Borg on Page 4. You have also been provided with a home exercise diary (see Page 5), and you are advised to complete it daily. It is useful for your consultant to see how you are progressing in the weeks following your surgery and it can also help to motivate you to keep exercising, as you will be able to see how you are progressing over the weeks. Driving Remember that physical inactivity is a major risk factory for coronary artery disease. Regular exercise helps to protect you and can reduce the risk of heart or other health problems in the future. It is important to exercise sensibly, please follow the guidelines laid out for you above Most people are allowed to return to driving at six weeks post surgery, however, this should be cleared with your consultant. Do not go out driving alone for your first few trips and remain in your local area. You must tell your insurance company, your employer and the licensing authority that you have had heart surgery. If you drive a heavy vehicle, you will not be able to return to driving it for a much longer time, and your doctor may require you to undergo and exercise stress test prior to permitting you to drive.

4 Cardiac Rehabilitation Page 4 of 10 Borg Rate of Perceived Exertion Scale 6 No exertion at all 7 Extremely light 8 9 Very light Light Somewhat hard Hard (heavy) Very hard Extremely hard 20 Maximal exertion Please ask your physiotherapist is you have any questions about any of this information. Should you need any further advice, once you are discharged, please contact Beacon Physiotherapy on This Patient Education leaflet was developed by the Chartered Physiotherapists in Beacon Hospital. Beacon Hospital.

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