Home exercise programme

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1 Pulmonary Rehabilitation Service Home exercise programme Information for patients and carers

2

3 Introduction The North Somerset Pulmonary Rehabilitation Programme offers two supervised exercise sessions for the duration of the programme (six weeks). In addition to this, and to achieve most benefit from the programme, participants are encouraged to perform one home exercise session per week. Preparation for exercise is important. Before each exercise circuit the Pulmonary Rehabilitation Team will lead you through a warm up session and the exercise circuit will be followed by a cool down routine. The Pulmonary Rehabilitation team will demonstrate the home exercises. The same warm up and cool down routine should be followed when exercising at home. Reminders of the warm up and cool down exercises are given in this booklet as well as descriptions of the home exercises. Warm up in sitting Neck stretches 1. Extension and flexion, look up to the ceiling and back down to the ground. 2. Left and Right rotation looking as far behind you as possible. Shoulder rolls 1. Clockwise and anti-clockwise. Arm punches 1. Alternately punching arms towards the ceiling. Leg kicks 1. Alternating legs. Ankle and heel raises Marching on the spot in sitting, progress into standing and then to high knees. Cool Down Marching on the spot gradually slowing the pace.

4 Heel rises behind a chair. Calf stretches 1. Stand with one leg in front of the other, with both feet pointed forward. Place hands on the back of a chair or a wall for support. 2. Keep back knee straight, with the heel pressed to the floor. 3. Push your hips forward, while pressing your back heel to ground. 4. Hold the stretch. 5. Repeat on each leg. Seated marching on the spot Seated marching on the spot with arm punches. Back stretches with deep breathing 1. Link your fingers and push your hands away from your body. Hamstring stretch 1. Sit towards the front of your chair, place one leg out in front of you keeping your heel on the ground. 2. Keep your leg straight and bring your toes towards you. 3. Lean forward for a greater stretch. 4. Repeat on each leg. Ankle and heel raises. Neck exercises 1. Extension and flexion, look up to the ceiling and back down to the ground. 2. Left and Right rotation looking as far behind you as possible. Sit to stand Stand up and then sit down slowly on a chair. If able, keep arms crossed across your body. If you are finding this challenging, use either the arms of the chair or the seat of the chair to help you push up. Straight leg raise Sit on a chair, tighten your thigh muscle and straighten your knee to raise one leg up keeping your toes pointing to the ceiling. Hold for approximately five seconds and then slowly relax your leg back

5 down. Repeat with opposite leg. Step up Stand in front of a step, holding on to the bannister for support, step up and down alternating the leading leg. Marching on the spot March on the spot, you can make this exercise more difficult by lifting your knees higher. If you find this exercise challenging you may do it in a sitting position until you feel able to carry it out in a standing position. Shoulder raises Alternating arms lift weights from your chest straight up and down. Use a small weight (a small plastic bottle filled with water or sand is about the right size and weight) to work a little harder. to do a push ups against the wall keeping your body in a straight line. You can make this exercise harder by moving your feet further away from the wall or easier by moving them closer. Hip abduction Stand holding onto the back of a chair or a similar support and gently lift one leg out to the side about 1ft. Keep your torso up straight and do not bend. Repeat with opposite leg. Bicep curl Stand or sit with arms hanging down and palms facing upwards. Hold a small hand weight and gently bend alternate elbows to bring the weight up towards your chest. Wall press Stand facing a wall with your arms straight and hands flat on the wall. Gently bend your elbows down

6 The Modified BORG scale (1982) 0 Nothing at all 0.5 Very, very slight (just noticeable) 1 Very slight 2 Slight 3 Moderate 4 Somewhat severe 5 Severe 6 [what text should be here?] 7 Very severe 8 [what text should be here?] 9 [what text should be here?] 10 Very, very severe Maximal.

7 Contacting local health services If you want to make a comment about this service or need some advice or information about this or any other local NHS service, please contact: NSCP Patient Advice & Liaison Service (PALS) Freephone: nscp.pals@nsomersetcp-cic.nhs.uk Care Quality Commission (CQC) The quality of our service provision is monitored by the Care Quality Commission (CQC). For further information please visit: Care Connect The first point of call for all general health and social care enquiries in North Somerset, outside of those provided by your GP, call , or visit: NHS Direct If you are concerned your child is unwell, please telephone NHS Direct on 111. Social Care If you are concerned a child is being harmed or is at risk of abuse or neglect, please telephone Social Care on NSCP services may occasionally be unavoidably unavailable due to severe weather, staff sickness or other events outside of NSCP control.

8 North Somerset Community Partnership, Castlewood, PO Box 237, Tickenham Road, Clevedon, North Somerset BS21 9AX. NSCP/006/010/00x/001/0215

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