PATIENT EDUCATION patienteducation.osumc.edu Walking Guidelines for People with Cancer to Use While in the Hospital Exercise such as walking has several positive benefits for people dealing with the side effects of cancer and its treatment. Exercise has been shown to: Decrease fatigue and nausea Increase a person s sense of well being and energy level These walking guidelines were created to encourage you to remain active while in the hospital. Discuss how much walking you should do with your nurse, physical therapist and/or doctor. General guidelines for walking in the hospital Your doctor must write an order in your chart for you to be up and about. Tell your nurse that you are going for a walk. Your nurse will let you know about any special precautions you may need to follow. You must have an identification bracelet on your wrist. If your white blood cells are low, you may still be permitted to walk in the halls. Use the precautions you have been instructed to use to protect yourself from the risk of infection. Do not walk very far if your hemoglobin is less than 8.0 g/dl. You may be short of breath and your heart may beat too fast. If your platelet count is less than 20,000 mm 3, you may be restricted from walking in the halls. Check with your doctor or nurse. This handout is for informational purposes only. Talk with your doctor or health care team if you have any questions about your care. October 7, 2014. The Ohio State University Comprehensive Cancer Center Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.
Helpful Tips Wear comfortable, supportive shoes. Do not wear backless slippers that flop when you walk. If you do not have good shoes or slippers, ask your nurse for socks. They have traction which will help prevent falls. Walk at a steady slow pace. You only need to keep up with yourself. Let your nurse know if you leave the floor. Note which side of the wall has a railing in case you need support. If an hour after walking you are still tired, let your nurse know. If you feel you are having difficulty walking, if you feel weak, dizzy or lose your balance, ask your doctor if a referral to a physical therapist might be helpful. When to ask for help STOP exercising and rest if you have: An irregular pulse or heartbeat Chest pain or discomfort Dizziness Difficulty getting your breath Nausea If you have any of these symptoms, stop the exercise and rest. If the symptom continues, tell your nurse. Getting Started When beginning a walking or exercise program while in the hospital, your first goal should be to try to walk or exercise each day even for just a few minutes. Once you have reached this goal, increase your activity to several short walks or exercise periods throughout the day. Be sure to rest between each exercise session. As you get stronger, slowly increase how long you exercise during each session.
Rate of Perceived Exertion (RPE) To monitor the intensity of your walking, you will use the Rate of Perceived Exertion (RPE) scale. After you walk, choose a number between 0 and 10 to rate how much effort you had to use. 0 being no effort and 10 being maximum effort. See the RPE scale described on the Exercise Log. Aim for a RPE level of 6 and no higher. Decrease the time, distance or frequency of your walking if you: Become very tired while walking. Are still very tired or fatigued 1 hour after walking. Remember, rest well between each exercise session. Track Your Effort Chart your walking on the Exercise Log to help you see the progress you are making. For More Information If you want to continue walking at home, ask your nurse or physical therapist for the handout, Walking Guidelines for People with Cancer to Use at Home. Other helpful handouts: Cancer Therapy: Managing Side Effects - Fatigue Using Exercise to Fight Cancer-Related Fatigue The Do s and Don ts of Exercise
Exercise Log Oncology Rehabilitation Date / Time *RPE (0 10) Length of Time Walking Distanced Walked Comments * Rate of Perceived Exertion (RPE) RPE Scale Rate how you feel when you are exercising. Choose a number between 0 and 10 to rate how much effort you had to use. The lowest number 0 means no noticeable effort to exercise. A 5 means you had to use strong effort to exercise. Aim to exercise around a RPE level of 6 and no higher. 0 No effort 1 Light effort 2 Light effort 3 Moderate effort 4 Moderate effort 5 Strong effort 6 Strong effort 7 Very strong effort 8 Very strong effort 9 Very, very strong effort 10 Maximum effort
Date / Time *RPE (0 10) Length of Time Walking Distanced Walked Comments