benefits of regular physical activity · benefits of regular physical activity 1. reduces...

Exercise Guidelines

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Physical Activity Log

DATE TYPE OF

ACTIVITY

TIME IN

MINUTES

INTENSITY

RPE (0-10)

COMMENTS

Physical Activity Goal: Weekly Minutes of Exercise Documented Benefit

At least 150min/week Cardiac Risk Reduction

Total Week 1: Total Week 2: Total Week 3:

Recommendations based on ACSM’s Guidelines for Exercise Testing and Prescription, 9th, 2014

Exercise Guidelines

Prepared for the COACH Program by ACSM Registered Clinical Exercise Physiologists & Exercise Specialists Please do not copy without permission.

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Physical Activity Log

DATE TYPE OF

ACTIVITY

TIME IN

MINUTES

INTENSITY

RPE (0-10)

COMMENTS

Physical Activity Rating: Weekly Minutes of Exercise Documented Benefit

At least 150 min/week Cardiac Risk Reduction

Total Week 1: Total Week 2: Total Week 3:

Recommendations based on ACSM’s Guidelines for Exercise Testing and Prescription, 9th, 2014

Exercise Guidelines


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Benefits of Regular Physical Activity

1. Reduces Cardiovascular Risk

Factors

Smoking: Once you have adopted the

healthful habit of regular exercise, it is more likely that smoking will become less desirable.

Replace smoking habits with exercise habits!

Elevated Cholesterol Levels: Regular

exercise increases HDL (the good cholesterol). Healthy eating and

weight loss helps to lower LDL (the bad cholesterol) and triglycerides.

High Blood Pressure: Regular exercise has been shown to

reduce your resting & exercising blood pressure by 10-15 mmHg. The combination of a healthy eating plan, regular exercise and weight loss

can help control high blood pressure. Exercise provides a natural

reduction in blood pressure for 24 hours after your workout.

Diabetes: Regular exercise can help maintain blood sugars in a

desirable range in diabetics. For those who take diabetic medications regular exercise usually results in decreased medication requirements.

Increased Body Weight: Regular exercise and proper diet

can help control weight. (ie. calories in vs calories out). Exercising more than 300 min/week has been shown to help maintain and reduce

body weight. Decreasing abdominal fat through weight loss decreases cardiac risk.

Stress: Regular exercise along with stress management can help

reduce your stress levels. Exercise releases a natural “feel good”

hormone called endorphins. Learning stress management techniques (i.e. meditation, deep breathing, and prayer) can help you reduce

overall stress levels (see Stress Management section)

SMOKING

ELEVATED CHOLESTEROL

HIGH BLOOD PRESSURE

DIABETES(TYPE II)

INCREASED WEIGHT

STRESS LACK OF EXERCISE

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2. Increases Fitness/Endurance Level

Regular physical activity will also improve your exercise tolerance. Strength & endurance will be enhanced as your muscles &

circulation adapt to become more efficient when working.

When the muscle cell is put to work exercising it requires oxygen

for fuel and it must also rid itself of wastes (carbon dioxide/lactic acid). Over time, participation in regular aerobic exercise will

actually increase those chemical factors in the muscle cells that enhance this exchange. That is, extraction of oxygen by

exercising muscles and removal of carbon dioxide, lactic acid and other wastes improves. The end result is that your heart does not

have to pump as much oxygen rich blood to the exercising muscle, which in turn reduces the stress to your cardiac system.

The other beneficial change that occurs with regular exercise is that

the number of blood vessels (capillaries) that supply the muscles actually increases. That is, the density of blood vessels in the

muscle becomes greater so that overall circulation improves. Less demand is placed on your heart muscle and circulation to carry out

any given activity. Your capacity to perform regular daily and recreational activities improves and most of life’s physical tasks

become easier. This translates into being able to do more and feel better doing so.

3. Other Benefits of Exercise

There are numerous benefits of exercise that relate to many

aspects of health. Listed are a few important ones: Reduces risk for osteoporosis – weight bearing activity can

improve bone density levels i.e. walking, dancing, jogging. Reduces risk for cancer colon, breast cancer.

Helps boost immune function. Psychological benefits – decreases anxiety, low to moderate

levels of depression, increases endorphins, energy, and improves

sleep patterns. Improves posture, balance and decreases risk for falls.

Improves respiratory (lungs) muscle strength & endurance (important for asthmatics).

The bottom line is that participation in regular moderate to vigorous exercise can increase life expectancy and

quality of life!

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Symptoms that may occur with exercise

If you have stable angina * or claudication * occurring during an

activity you may find that

participating in a regular exercise program can help improve these

symptoms. The point at which you usually experience these

symptoms may occur at higher levels of activity. In other words,

the threshold for angina/claudication is pushed

upwards allowing you to perform more activity safely and pain free.

It is always important to exercise well below the point at

which you experience angina or to stop/slow down activity when angina is present. As stated, over time

the level at which this occurs may improve.

* Angina is a symptom signifying lack of oxygen to the heart muscle due to lack of circulation in the coronary

arteries. It may present as chest, arm, shoulder, upper or lower back, jaw pain / discomfort/ heaviness or it may

feel like nausea, indigestion. It is termed stable when the onset of chest pain occurs consistently at a certain

level of exertion and usually subsides with rest or

nitroglycerin. Unstable angina is more serious and occurs at rest or when the regular pattern of pain

changes. Your doctor should be notified if this occurs.

*Claudication is a symptom signifying lack of oxygen to the calf

muscle usually due to poor circulation in the lower legs. When exercising with claudication symptoms it is advisable to exercise at a

level where you feel the symptoms (calf soreness is moderately strong) and then stop, rest, stop, and rest and so on. The threshold

will then improve over time. Weight bearing activity (i.e. walking) is the best activity to improve these symptoms.

Stop & Rest when you have:

1. Chest pain, pressure, or discomfort that radiates into arms, neck jaw or back. 2. Shortness of breath. 3. Excessive or unusual sweating. 4. Dizziness or lightheadedness. 5. Nausea.

If prescribed nitroglycerin (NTG) and you experience chest pain/angina be sure to:

1. STOP activity and SIT DOWN. 2. If angina is still present, take 1-2 puffs

of NTG. Wait 5 min. 3. If angina is still present, take 1-2 puffs

of NTG. Wait 5 min. 4. If angina is still present, take 1-2 puffs

of NTG. Wait 5 min.

5. If pain is still presents after 3 sprays of NTG call 911.

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*Dyspnea (shortness of breath) with exercise may be

symptoms of chronic lung disease (COPD), such as emphysema and asthma, or from general deconditioning. Regular exercise will help

strengthen the muscles of your arms and legs, as well as the muscles that assist in breathing, ultimately making exercise and daily living

easier! Learning the technique of pursed lip breathing can also help to increase your ability to breathe when exercising.

Pursed lip breathing exercise:

1. Relax your neck and shoulder muscles.

2. Breathe in for two seconds through your nose, keeping your mouth closed.

3. Breathe out for four seconds through pursed lips. If this is too long for you, simply

breathe out twice as long as you breathe in.

Aerobic Exercise

Regular aerobic exercise reduces this risk and has a favorable influence on

other risk factors such as increased blood pressure, poor cholesterol, increased body weight, and diabetes. The heart health benefits described are

achieved mostly from participating in Aerobic Exercises (also referred to cardiovascular or sometimes “cardio” exercise for short). In addition to

providing the most health benefits, aerobic exercise is the most effective way to burn calories and lose fat weight.

For an activity to be considered “aerobic” it must: 1. Increase the heart and breathing rate above

resting levels

2. Be sustained for at least 10 minutes at a time.

Exercise sessions should include an AEROBIC (warm up, conditioning phase

and cool down) component, a FLEXIILITY/ STRETCHING component. AEROBIC exercises require the body to use oxygen. Your heart pumps

oxygen-rich blood to the rest of your body. Since the heart itself is a muscle, aerobic exercise maintains and even increases your heart’s strength

and endurance.

Good Aerobic activities include:

♥ Walking ♥ Jogging (for some people)

♥ Cycling ♥ Swimming/water aerobics

♥ Skating ♥ Cross Country Skiing

♥ Low level Aerobics ♥ Rowing

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A number of activities that are considered leisure activities should

NOT replace your Aerobic Exercises these include (but are not limited to):

♥ Golf ♥ Bowling

♥ Curling ♥ Gardening

The F.I.T.T Principle

F Frequency how often do you exercise?

Daily 5-7 days / week

It is recommended that you exercise regularly to

significantly improve your cardiovascular (heart & lungs) system, and reduce your cardiovascular risk.

*minimum 150 min/week

I Intensity How do you feel while you exercise?

Moderate intensity / 3-6 on the Rating of Perceived Exertion (RPE) scale (see RPE scale on next page)

Monitor symptoms of increased heat rate, increased body temperature, shortness of breath (talk test),

and comfort level. The level of exercise should not cause any discomfort, and you should be able to

carry out a conversation as you do it.

T Time How long do you exercise?

20 to 60 minutes / session

(Excluding warm-up & cool-down time) It is acceptable to accumulate the minutes

throughout the day. (ie. 3 sessions, 10 minutes each)

T Type What kind of exercise do you enjoy?

*Aerobic in nature

Large muscle group activity

Continuous & rhythmical (non-stop)

Raises your heart rate above rest

Done for min. of 10-15 minutes

e.g. Walking, cycling, swimming, rowing, X- country skiing

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Always:

Work at your own pace. Don’t compete or make up for lost time.

Wear comfortable clothing and footwear.

Do not hold your breath during ANY exercise, ever.

Keep your head above your heart when your heart rate is elevated (during exercise).

Take medications as prescribed. Take morning medications prior to exercise. Bring your nitro spray (if prescribed) and keep it with you during exercise.

Watch for symptoms of: Dizziness or light-headedness, Nausea,Chest pain/any other type of pain, Feeling excessively tired after a workout, Excessively short of breath and sweating more than usual

If you feel ill DO NOT EXERCISE. This will do you little good and is potentially dangerous. (i.e. Angina or Flu symptoms – REST is BEST!)

Intensity

R.P.E. (Rate of Perceived Exertion)

RPE is proven to be a valuable aid in determining exercise intensity for individuals

who have difficulty with palpating heart rate or in cases when the heart rate response to exercise may have been

altered due to changes in medications (i.e. beta blockers).

How hard you FEEL you are working is an effective way of gauging an appropriate

level of activity for you. The “Borg Scale” of R.P.E. may be used.

An appropriate and comfortable exercise level for most people is about 3 to 6 for

overall effort. Working above that level does not increase the benefits of exercise,

but it does increase the risk of muscle and joint injuries. Therefore, find a place that is suitable for you! You should be breathing quicker, but still able to exercise and

comfortably carry on a conversation.

Talk Test

Remember the TALK TEST, while exercising. If you are so short of breath that you would have difficulty talking, then you have pushed yourself too hard. This high

exercise intensity may put a strain on your heart, and can make your heart irritable. Slow down or reduce your workloads if experience extreme shortness of

breath, especially when accompanied by angina.

Borg Scale of RPE 0 Nothing at all (resting) 1 Very Light 2 Light (stroll)-you could sing! 3 Moderate (comfortable) 4 Somewhat Heavy-you can talk! 5 Heavy (comfortable but working) 6 7 Very Heavy (uncomfortable, Hard Work) 8 9 10 Very, very hard (almost maximum)

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MET levels (Metabolic Equivalents) A MET is a unit of measurement used to estimate the amount of oxygen used by the body

during exercise. The harder your body works during exercise, the more oxygen is

consumed, the higher the MET level. One MET is defined as the energy expenditure/oxygen

required for sitting quietly. Most people feel comfortable working at 50-70% of their

maximum M.E.T. level. Your M.E.T. level can be measured from your fitness assessment

and regular exercise sessions. (Refer to the M.E.T. ratings handout). This information is

used to help determine your personal exercise program.

1 M.E.T = Body work at rest

METS Category Specific Activity

3.0 Aerobic Biking Stationary, 50 W, very light effort

5.5 Aerobic Biking Stationary, 100-150 W, modest effort

5.0 Aerobic Biking Stationary, uni-cycling

8.5 Aerobic Biking, mountain

3.5 Aerobic Rowing Stationary, 50 W, light effort

7.0 Aerobic Rowing Stationary, 100 W, moderate effort

6.0 Aerobic Stair treadmill ergometer

2.5 Aerobic Walking, 2.0 mph, level, slow pace

3.5 Aerobic Walking, 3.0 mph, level, moderate pace

6.0 Aerobic Walking, 3.5 mph, uphill

3.5 Aerobic Walking for pleasure, work break, walking the dog

4.0 Aerobic Walking to work or class

4.0 Aerobic Water aerobics, water calisthenics

6.0 Dancing Aerobic, modern, twist

5.0 Dancing Aerobic, low impact

3.0 Dancing Ballroom; waltz, foxtrot, slow dancing

5.0 Fishing From river bank and walking

2.5 Fishing From boat and sitting

6.0 Fishing In Stream, in waders

2.0 Fishing Ice, sitting

6.0 Hunting Deer, elk, large game, pheasants, grouse

2.5 Home Sweeping floors

4.5 Home Heavy major cleaning i.e. wash windows, mop, clean garage

2.3 Home Ironing

8.0 Home Carrying groceries upstairs

2.5 Home Putting away groceries

2.0 Home Making bed

7.0 Home Moving, carrying boxes

6.0 Home Moving furniture

5.5 Home Scrubbing floors on hands an knees

3.5 Home Child care; changing clothes, grooming, feeding

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5.0 Home Cleaning gutters

4.5 Home repair Laying or removing carpet

4.5 Home repair Laying tile or linoleum

5.0 Home repair Painting, outside house

6.0 Home repair Roofing

4.5 Home repair Scrape and paint sailboat or powerboat

6.0 Outdoors Chopping wood

5.0 Outdoors Gardening, general

5.0 Outdoors Laying sod or crushed rock

4.5 Outdoors Trimming trees shrubs with manual cutter

4.5 Outdoors Weeding, cultivating garden

2.0 Music Cello, flute, horn

2.5 Music Conduction, piano, organ, trumpet, violin, guitar

3.0 Occupation Automobile repair

3.5 Occupation Electrical work plumbing, carpentry/general, locksmith

4.0 Occupation Farming, feeding small animals. Forestry, weeding

4.5 Occupation Farming, feeding cattle. Forestry, sawing.

5.0 Occupation Forestry, axe chopping, hoeing

6.0 Occupation Horse grooming. Forestry, planting by hand.

7.0 Occupation Moving, pushing heavy objects(>75 lbs)

9.0 Shoveling Heavy > 16 lbs

6.0 Shoveling Light < 10 lbs

4.5 Strength Calisthenics, home exercise, light or moderate effort

8.0 Strength Circuit training, general

3.0 Strength Weight lifting, light to moderate level

4.0 Stretching Yoga, Hatha

6.5 Occupation Truck driving, loading and unloading truck (standing)

2.0 Occupation Walking 2.0 mph, light pace

3.5 Occupation Walking 3.0 mph, moderate pace carrying objects < 25 lbs

5.0 Occupation Walking or walk downstairs, carrying 25-49 lbs



7.0 Running Jogging, general

10.0 Running 6 mph (10 min. Mile)

2.0 Self care Talking and eating

4.0 Self care Showering and toweling off

1.5 Sexual activity Active, vigorous effort

4.5 Sports Badminton, social singles and doubles

4.0 Sports Curling

4.5 Sports Golf, general

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5.5 Sports Golf, carrying clubs

5.0 Sports Golf, pulling clubs

3.5 Sports Golf, using power cart

8.0 Sports Hockey, ice

4.0 Sports Horse back riding, general

6.5 Sports Horse back riding, trotting

3.0 Sports Horseshoe pitching

7.0 Sports Racquet ball, casual, general

10.0 Sports Racquet ball, competitive

3.0 Sports Shuffle board, lawn bowling

5.0 Sports Softball or baseball, fast or slow pitch

12.0 Sports Squash

6.0 Sports Tennis, doubles

8.0 Sports Tennis, singles

2.5 Transport Motor scooter or motorcycle

3.0 Transport Driving heavy tractor, truck or bus

7.0 Walking Backpacking, general

9.0 Walking Carrying load upstairs, general

5.0 Walking Carrying 1 to 15 lbs load upstairs



6.0 Walking Hiking, cross country

7.0 Water Canoeing, portaging, 4-6 mph, moderate effort

5.0 Water Kayaking

4.0 Water Paddleboat

7.0 Water Scuba diving, general

6.0 Water Water skiing

8.0 Water Swimming laps, slow to moderate

10.0 Water Swimming, breaststroke general

4.0 Water Treading water, light to moderate

5.5 Winter Skating, ice, 9 mph or less

7.0 Winter Skiing general, 2.5 mph cross country, sledding

5.0 Winter Skiing downhill, light effort

6.0 Winter Skiing downhill, moderate effort

8.0 Winter Snow shoeing

3.5 Winter Snowmobiling

Resource: ACSM’s Resource Manual for Guideline for Exercise testing and Prescription, 3rd ed., 1998.

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Time

There are 3 important components to each aerobic session:

1. Warm up 2. Conditioning Phase

3. Cool down

1. Warm up: 5-10 minutes of activity at a slow easy pace whereby you gradually

increase your intensity to your conditioning phase. The purpose of a warm up is to prepare your body (and your heart) for a

more demanding workload. This is an essential component to any exercise program. An appropriate warm up opens blood vessels to increase blood flow

to the exercising muscles. It enhances the release of oxygen to the tissues, while increasing body temperature. A warm up also helps reduce injuries because warm and relaxed muscles are less likely to tear during vigorous exercise. A proper

warm up may also decrease angina, and dangerous arrhythmias.

2. Conditioning phase: 20 to 60 minutes of continuous aerobic activity at your

training intensity (refer to previous Intensity section).

3. Cool Down: 5 -10 minutes of gradually slowing down to an easy workload.

The purposes of a cool down are to safely and gradually allow the heart and lungs system to return to a resting state and alleviate any immediate or delayed muscle soreness. Stopping quickly after exercise causes blood to pool in the

legs which may lead to dizziness due to inadequate blood flow to the brain. Muscles may begin to cramp as they begin to cool and promote post-workout

muscle tenderness. To avoid these situations, continue to walk slowly for several minutes after exercising, until your heart rate approaches your pre-exercising level. Skipping the cool down is associated with cardiovascular complications

including angina, and arrhythmias. The last part of your cool down should include stretching exercises. You will probably note that stretching is more comfortable

during the cool down due to an increase in body temperature. The cool down is therefore, the best time to work on flexibility.

Time in Conditioning Phase (20-60 min)

Warm Up (5-10 min) Cool Down (5-10 min)

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Guidelines for Stretching The F.I.T.T. Principle for Flexibility:

F Frequency Stretching may be done everyday and should be a

part of each aerobic workout. (Stretch when muscles

are warm)

I Intensity Stretch to the level of tightness NOT pain.

T Time 1-3 sets of 8-10 stretches (all major muscle

groups)

T Type Slow, controlled, non-bouncy stretching

movement that allow the muscle to relax (held for

30-60 seconds).

3 Basic Walking Stretches:

Calve Stretch:

Back heel stays down, back leg straight; toes point forward, ease into front leg bending at the

knee until you feel the stretch in the back calf. (knee should not pass your shoe laces).

Quadricep Stretch:

Hamstring Stretch:

Bend forward slightly from the hips. Keep both hips even and facing forward. Keep

knees as neighbors. Feel stretch at front of bent thigh. Bend forward slightly from

the hips.

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Guidelines for Resistance Training

The F.I.T.T. Principle for Resistance Training:

F Frequency Each major muscle group should be trained 2-3 days per

week.

I Intensity Monitor any symptoms and work at an RPE or 3-6. The

weight should be easy enough to complete 1 set of 10-12 repetitions with the last few reps becoming difficult but

comfortable with proper position maintained. Increase the weight in 2-5 lb. increments once you can do 10-15 repetitions easily. Stay at the new weight for at least 1-2

weeks before progressing.

T Time No specific duration of training has been identified for

effectiveness.

T Type Dynamic (moving) exercises should be chosen. Avoid

isometric (non-moving) exercises, as these tend to raise

blood pressure. Movement should be slow, controlled & steady. The resistance chosen may be with equipment such as hand weights or thera-band tubing or against

body resistance (ie. wall push up).

Repetitions 10 to 15 repetitions is effective in improving strength in

Middle-aged and older individuals starting exercise.

Sets 2-4 sets are recommended for most adults to improve

strength and power. A single set of resistance exercise can be effective especially among older and novice exercisers.

Patterns Rest intervals of 2-3 minutes between each set of

repetitions are effective. A rest of > 48 hours between sessions for any single muscle group is recommended.

Progression A gradual progression of greater resistance, and/or more

repetitions per set, and/or increasing frequency is

recommended.

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When to start Resistance Training?

Patients, who have experienced open heart surgery (sternum opened), have the greatest length of time required for recovery. The sternum

bone healing to achieve adequate sternum stability/healing is usually seen by 8 weeks. Several factors may increase the healing time required

for the sternum such as diabetes, obesity, immunosuppressive therapy, advanced age, and osteoporosis, increasing the recovery time to 12

weeks. Because each patient differs in muscular strength and other

factors that may affect healing, no standard weight limits can be recommended during this early 8 to 12 week period. After an

individual appropriate evaluation, range of motion exercises and other activities that involve sternal/chest muscles can be gradually introduced

and progressed as long as there is no evidence of an unstable sternum. An unstable sternum may be indicated to you by pain, cracking, or

popping. If this occurs please speak to your health care providers.

Patients, who have experienced percutaneous coronary angiogram (PTCA) with stent placement, should complete 2 weeks of aerobic activity

(90-150 minutes per week) prior to starting a resistance training program.

Patients, who have experienced a myocardial infarction (heart attack),

should complete 5 weeks of aerobic activity (90-150 minutes per week)

prior to starting a resistance training program.

Patients, who have experienced an irregular heart rate or rhythm requiring a pacemaker or implantable cardioverter defibrillator, should wait

approximately 3 to 4 weeks to maintain the device and incision integrity. Rigorous upper extremity activities such as swimming, bowling, lifting

weights, elliptical machines, and golfing should be avoided. However, lower extremity activities are allowed.

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Band Exercises

Squat:

Feet shoulder width apart.

Squat slowly as if you were going to sit

on a chair.

Keep your knees aligned over your

ankles.

Do not let your knees pass over your

toes!

Bicep Curl:

Feet shoulder width apart, belly button

pulled in towards your spine.

Arms at your side, palms facing

forward.

Curl palms toward your shoulder.

Keep elbows stationary, no chicken

wings!

Triceps Extension:

Feet shoulder width apart, belly button

pulled into your spine.

Grasp the rubber band in one hand and

place on your opposite shoulder.

With opposite hand, grasp the rubber

band with your elbow bent between 45°

and 90° angles.

One Arm Row:

Hinge forward at your waist, keeping

your back flat.

Keep your body stationary as you pull

upper arm back.

Keep elbows in, no chicken wings!

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Shoulder Raise:

Stand tall with your feet shoulder width

apart.

Arms at your side, palms facing in.

Slight bend in your arm.

Raise one arm up to shoulder height.

Wall Push-Up:

Stand tall, feet shoulder width apart.

Stand arm’s length from the wall.

Palms against wall at shoulder height.

Bend arms and move towards the wall

slowly.

Straighten arms to push yourself back

up.

Wall Push-Up:





slowly.


up.

Wall Push-Up:





slowly.


up.

Calf Raises:

Stand up tall.

Raise body weight up onto toes

maintaining balance.

Obliques:

Stand up tall, feet shoulder width apart.

Hold band at hip and hinge towards the

opposite side.

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Common Myths About Exercise (NOT TRUE!):

No pain, no gain. Pain is a sign of injury, which can slow your training progress!

More is always better. Too much intensity or volume can lead to injury!

Sweating is an indication that you are working at the right intensity. Unless you are training to tolerate a hot climate, you are better off minimizing

the heat load on your body (see section on Hot Weather), so that it responds better to the exercise.

Sweating helps you lose weight. This is only temporary, as the weight lost is

mostly water weight. Excessive sweating without replacement of lost fluids can be dangerous to your body!

Shortness of breath is an indication that you’re getting the maximum benefit from your exercise. Breathlessness, whereby you have difficulty talking, is a sign that you are working too hard! This can result in excessive

fatigue with exercise. Doing sit-ups is the best way to lose fat around the mid-section.

Unfortunately you cannot “spot” reduce fatty areas! Although abdominal exercises are important for improving low back stability, they do not burn significant amounts of calories to reduce excess fat; aerobic exercise is the best

way to burn fat!

Abdominal Crunch:

Bend your knees at a 45° angle and

keep your feet flat on the floor.

Place hands on your thighs.

Draw your belly button towards the

base of your spine.

Curl up, bringing your hands closer

to your knees, and lift your upper

back up off the mat.

Back Extension:

Lie down on your stomach face

down.

Place forearms on mat below you for

assistance if needed.

Lift your chest off the mat a few

inches, hold a moment, then slowly

lower back down.

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Tips for Staying Active:

Exercise with a friend Pick activities you enjoy

If you desire you can buy equipment you enjoy for home or join a fitness center Vary your activities to reduce injury, and keep your program more interesting Keep your exercise intensity at a comfortable level

Set aside time for exercise each week (e.g. before work, during lunch hour, before /after

supper)

Set short term, realistic goals and keep a journal of your activities minutes or

days exercised (i.e. check marks on your calendar)

Important Points to Remember When Exercising:

Rest Periods - When starting an exercise program be sure to begin slowly

and take adequate rest periods as needed. As a general rule for inactive individuals, take equal periods of rest and exercise (i.e. 3 min rest = 3 min

exercise). As your exercise tolerance improves the rest periods can be shortened and exercise periods extended.

For example, an individual just starting a walking program may start out walking for 5-10 min continuously at a low to moderate pace and repeat this

2 -3X in the day with adequate rest in between. After a week or so, it will be easy to lengthen the session to 15 min twice a day. The next progression

in a week may be to lengthen the 15 min to 20-30 min of continuous walking once a day. It is beneficial to progress to the point where you can

walk comfortably 30-60 min most days of the week.

Eating Meals - Never exercise on a full stomach. Approximately 2 hours should be allowed between a large meal and exercise. A small meal 30

minutes prior to exercise (i.e. 1 whole wheat toast) is acceptable, especially if medications need to be taken.

Intake of Fluids - As you exercise your body loses water through evaporation, breathing and sweat. This fluid loss must be replaced in order

for the cells to function properly (Do not take alcohol, tobacco, or caffeine before exercising). Recommendations for fluid intake are 6-8 glasses per

day. If you are on a fluid restriction follow your specific required intake.

Arm Activity - There are several points to keep in mind when doing arm

activities such as mowing the lawn, lifting, carpentry work, gardening, vacuuming, housework, etc.

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1. Do not hold your breath when lifting or moving

objects. This causes an increase in your blood pressure and may cause dizziness. Exhale on effort (as you lift).

2. Keep the activity at chest height. Use a stool to avoid arms being overhead. (Overhead activity substantially increases blood

pressure and workload). 3. Keep the intensity of the activity low. Use less weight and

make more trips when carrying/moving items. Keep equipment settings low.

4. Pace yourself. Allow yourself to do a reasonable amount of work – REST – then resume the activity. WORK – REST -

WORK - REST 5. Keep your hand grip loose. Gripping an object tightly may

cause your blood pressure to increase, which will increase the workload on your heart.

Hot and Cold Weather - Both may tend to increase your heart rate.

In COLD weather: ♥ An extended warm up and cool down are important during cold

temperatures.

♥ Be sure to slow your pace and dress warmly, especially when there is the

added resistance of snow and wind.

♥ Always wear something on your head.

♥ If you are troubled by angina pain in cold weather and you cannot avoid

going outdoors, wear a scarf around your mouth and nose. This will warm and moisten the air before it reaches your lungs.

♥ Remember to consider the effects of wind chill.

In HOT weather: ♥ Your heart rate may also increase and tire you more easily.

♥ A longer warm up and cool down are beneficial.

♥ Avoid exercising during the hottest part of the day.

♥ Decrease intensity and/or duration of exercise session or try to exercise in

cooler environments (i.e. shaded, air-conditioned) when the heat is intense. ♥ Remember to hydrate well (read hydration section)

♥ * People with heart disease need to be especially careful to reduce the

heat load on their bodies: Saunas, hot tubs, and in some cases, overly hot showers are not recommended due to the dilation of the arteries

lowering your blood pressure. It will result in dizziness which may cause you to faint.

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When to Call your Doctor

♥ If you get pressure, burning, or discomfort in your chest, shoulders, arms,

jaw, throat, or between your shoulder blades that is new for you, and your doctor does not know about it yet.

♥ If there is an increase or change in your normal pattern of angina (e.g.

it comes more often, lasts longer, feels worse, or there is a change in the causes of your angina).

♥ if you experience unusual shortness of breath or sudden weight gain.

Hydration

Water is a required nutrient. If you do not have heart failure, be sure to

drink at least 6-8 glasses per day or enough to yield clear or pale-colored urine. You may be on a fluid restriction in which case follow doctors orders.

The human body is about 60% water in adult males and 55% in adult females

Drinking water is important because it:

digests food and dissolves nutrients

carries waste products away and determines urine production

sends electrical messages between cells which is important for muscle contractions, vision and brain function

acts as a coolant for working muscles as it maintains body temperature

lubricates joints

maintains normal circulation

850-1200 ml is lost in breath / respiration

600-1600 ml is lost in urine 50-200 ml is lost in feces

Volume Fluid Loss If you allow yourself to get dehydrated, your blood volume decreases. This

causes a decrease in blood pressure and your heart has to work harder to

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pump blood through the body. Because blood flow decreases,

there is less oxygen circulating through the system and energy level drops! Make sure and follow the recommendations for fluid intake as noted above.

Sedentary behavior; the new risk factor?

Along with a sedentary lifestyle, sedentary behavior could also be considered

a risk factor for cardiovascular disease and is associated with significant

health risks, cancer development, morbidity and mortality. Sedentary

behavior is best described as expending 1.0-1.5 METs **DOUBLE CHECK

IF METS HAVE BEEN DESCRIBED IN MANUAL** on a given task (for

example, prolonged [2+ hours] sitting periods, driving, desk work, screen

time, prolonged recline position).

Active couch potato: Regardless of how much aerobic activity a person

accumulates throughout the day, (moderate to vigorous physical activity of

3-8 METS, or light activity 1.9-2.9 METs, while biking, walking, or jogging to

a destination) if the majority of time spent during the day is sitting,

researchers would consider this as physical inactivity. One behavior

Sleep sedentary behavior light activity moderate physical activity intense exercise

— METs

+

Sedentary Physiology Exercise Physiology

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(sedentary to intense exercise) does not take place of the other.

For example, individuals that participate in 30 min/day of brisk walking or

jogging can be sedentary for the rest of his/her waking hours.

Sedentary behaviors and physical inactivity are closely related to

decreased HDL (good cholesterol) in men, hypertension in women, and in

both sexes, increased waist circumference.

What we need to do:

Assess SITT principle:

S—sedentary behavior frequency (number of times in sedentary

positions for certain duration

I—interruptions (getting up from sedentary position)

T—time (time spent in position)

T—Type, mode of sedentary behavior (sitting in car, TV viewing,

computer work)

Get up and walk around during prolonged sitting periods

o 5-10 minutes of standing/ walking about

Reduce screen time

o At home and within occupations

Stand while preparing meals

o Cutting and washing vegetables

o Standing while at the stove

Advocate for less time for sedentary behaviors and stress the

importance of moderate to vigorous physical activity throughout the

day

o This is especially important for men 18-75 years and women ≥

45 years.

By reducing sitting time, we could potentially reduce CVD

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What are some consequences of sedentary behavior?

The muscles that hold up your skeleton become weaker.

o Your back rounds forward, muscles become “tight” and shorten;

making physical activity become a task rather than an enjoyable

time.

o The body becomes less efficient to produce HDL’s and intake

triglycerides, and less glucose (sugar) can be utilized.

Foods are used to fuel our bodies. If we do not use the fuel in which

we eat, they will be stored as excess weight.

Because our muscles are not being stimulated to move our bodies,

bone reabsorption occurs as a faster rate, causing bone mineral

content to decrease. This decrease in bone mineral content leads to a

higher risk of osteoporosis, bone breaks, and other skeletal injuries.

Increase in resting blood pressure.

Good things about reducing sedentary behaviors:

Even the smallest movements can stimulate muscles to increase the

use of glucose within the body (and can help manage diabetes much

better).

Moderate to vigorous physical activity stimulates healthy bone

growth/maintenance

Control blood pressure.

We are all at risk! Be the change and start your own movement!

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References:

ACSM’s Guidelines for exercise testing and prescription, 9th ed., 2014.

Lu, B., Ph, D. R., Sands-lincoln, M., Going, S. B., Garcia, L., Allison, M. A., … California, S. D. (2013). Relationship of Sedentary Behavior and Physical Activity to Incident Cardiovascular Disease Results From the Women ’ s Health Initiative, 61(23).

Owen, N., Healy, G. N., Matthews, C. E., & Dunstan, D. W. (2010). Too much sitting: the population health science of sedentary behavior. Exercise and sport sciences reviews, 38(3), 105–13. doi:10.1097/JES.0b013e3181e373a2

Pate, R. R., O’Neill, J. R., & Lobelo, F. (2008). The evolving definition of “sedentary”. Exercise and sport sciences reviews, 36(4), 173–8. doi:10.1097/JES.0b013e3181877d1a

Tremblay, M. S., Colley, R. C., Saunders, T. J., Healy, G. N., & Owen, N. (2010). Physiological and health implications of a sedentary lifestyle. Applied physiology, nutrition, and metabolism = Physiologie appliquée, nutrition et métabolisme, 35(6), 725–40. doi:10.1139/H10-079

Wijndaele, K., Duvigneaud, N., Matton, L., Duquet, W., Delecluse, C., Thomis, M., … Philippaerts, R. M. (2009). Sedentary behaviour, physical activity and a continuous metabolic syndrome risk score in adults. European journal of clinical nutrition, 63(3), 421–9. doi:10.1038/sj.ejcn.1602944

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