Coronary Artery Disease: Physical Activity
Coronary Artery Disease: Physical Activity
Audrée Brookes, a physiotherapist at the Ottawa Heart Institute discusses physical activity during recovery from coronary artery disease for those who have been diagnosed with coronary artery disease or who want to learn more about the condition.
Content
1.533 -> My name is Audree Brookes.
3.166 -> I am a physiotherapist
at the Heart Institute.
6.233 -> In this section, we will
be talking about physical
8.533 -> activity during your recovery.
11.233 -> The focus will be on the
first six weeks after you
13.734 -> return home from the hospital.
16.667 -> If you are following along
in your patient guide,
19.133 -> I will be covering
pages 29 to 35.
24.133 -> A balance of rest and activity
should still be maintained to
27.767 -> allow for continued healing
and to conserve your energy.
32.433 -> Activity should be
increased gradually.
35.767 -> Everyone's recovery
is different.
38.633 -> The rate at which you progress
will depend on the severity
42.834 -> of your cardiac event and on
your previous activity level.
47.6 -> After four to six weeks, you
should be back to performing
50.967 -> your regular activities.
56.5 -> It is recommended that you do
regular physical activity as
59.767 -> it will improve the function
of your heart and lungs;
65.233 -> improve your HDL cholesterol
and triglycerides;
69.767 -> lower your blood pressure;
72.533 -> help you achieve a
healthier body weight;
75.567 -> improve your blood sugar;
78.1 -> improve your muscle
tone and bone density;
81.333 -> increase your endurance and
improve your confidence;
85.066 -> improve your ability
to cope with stress;
88.266 -> and decrease anxiety
and depression.
93.033 -> Walking is one of the earliest
activities you are allowed
96.166 -> to resume and it is one
of the best exercises for
99.1 -> improving your health.
101.8 -> Let's review the suggested
walking program.
104.834 -> For the first and second week
following discharge from the
108.233 -> hospital, we suggest you start
with 5-10 minutes of leisurely
113.3 -> walking once or twice a day.
116.8 -> For weeks three to six following
your discharge from hospital,
120.667 -> we suggest that you start
your walking program with
123.5 -> 10 minutes of slow walking.
126.233 -> Increase your walk by one
minute per day until you're
129.4 -> walking 20-30 minutes per walk.
133.934 -> Increase your speed and
distance as tolerated,
138.367 -> remembering that it
is important to avoid
140.8 -> shortness of breath,
and fatigue.
143.4 -> Always begin your walk
with a slow stroll for the
147 -> first 100 feet or so
then increase your pace.
151.667 -> Your walking time can be
maintained at 30 minutes
155.033 -> once or twice daily.
157.8 -> It is important to start
exercising for short periods
161.3 -> of time and at a slow pace.
164.3 -> Gradually increase the
length of your walk before
167.166 -> you increase the speed.
170.667 -> If you're having difficulty
following the above program,
174.633 -> use interval training.
177.6 -> Interval training consists
of walking 2 to 5 minutes,
183.433 -> and then resting
for 2 to 5 minutes.
188 -> Repeat this pattern as many
times as you are able to,
191.567 -> gradually increasing
the number of intervals.
197 -> After your walk, stretch
your calf muscle.
200.967 -> They are likely to get
tight as you begin to
203.4 -> increase your daily activity.
206.467 -> The picture on the
screen is an example of
209.867 -> someone stretching their calf.
212.767 -> Stand straight and close to a
solid surface on which you can
217.033 -> use your hands for balance.
220.166 -> Place one leg behind the other
with both feet pointing forward.
226.266 -> Bend the knee that is
forward while keeping the
229.166 -> back knee straight until
you feel a stretch in
232.2 -> the back of your calf.
235.066 -> Hold for 15 to 30 seconds and
then repeat with the other leg.
242.433 -> Next, we will talk about
exercise guidelines.
246.967 -> So these are guidelines to
follow especially when first
250.867 -> starting an exercise program.
253.7 -> Walk on flat ground initially.
256.734 -> If hills are unavoidable, walk
more slowly when going uphill.
261.867 -> It is best to wait about an
hour after a meal before you
265.6 -> exercise, as extra energy
is required for digestion.
270.8 -> You should be back to your
pre-walk or resting state within
275.233 -> 10 minutes of completing
your exercise.
278.567 -> If not, the next
time you exercise,
281.033 -> reduce your time or speed.
283.867 -> If you feel unwell,
shorten your walking time.
287.7 -> Go back to the previous level
of activity for a few days.
292.3 -> Listen to what your
body is telling you.
294.9 -> You may be trying to
do too much too soon.
299.567 -> Avoid exercising in extreme
temperatures such as hot humid
304.033 -> days or cold, windy ones.
307.2 -> During this time, exercise
indoors using stationary
311.166 -> equipment or walk in the
hallways of your house or
314.467 -> apartment or in a mall.
317.8 -> If you are using a
treadmill, keep it flat.
320.367 -> It is best not to
use the incline.
323.734 -> A stationary bicycle can also be
very valuable especially if you
329.233 -> have joint problems which may
make walking more difficult.
333.867 -> Make sure you peddle at a slow
speed with little or no tension.
338.8 -> Avoid exercises where you hold
your breath or bear down.
350.3 -> Remember to stop
and rest if you:
353.9 -> become very short of breath;
356.333 -> feel weak, tired,
lightheaded or dizzy;
361.266 -> have any discomfort,
especially chest pain;
364.8 -> have a fast heart rate
or palpitations or have
368.8 -> nausea or excessive sweating.
371.834 -> If these symptoms
persist, call 911.
382.1 -> In this section, we're going to
review self monitoring tools.
386.867 -> So the following tools will help
guide you with the progression
390.633 -> of your exercise program.
393.533 -> The first is the
walk and talk test.
396.834 -> This is the simplest
test of all.
399.166 -> At all times, you should be
able to carry on a light
402.033 -> conversation while exercising.
405.934 -> The next one is the
rate of perceived
408.2 -> exertion scale or RPE scale.
412.7 -> This is a number based scale
used to describe how you feel
416.6 -> during your exercise session.
419.3 -> The number you choose
should reflect your overall
422.433 -> level of effort,
including your breathing.
425.7 -> There is no right
or wrong answer.
428.266 -> For exercise, you
should be between
430.9 -> 3 and 5 on a scale of 0 to 10.
436.333 -> As your recovery
and fitness improve,
439.166 -> so too will your
perceived level of effort.
442.9 -> The change in effort
you feel overtime,
445.734 -> for the same exercise, is a
measure of your improvement.
449.266 -> On pages 32-33 of
your patient guide,
455.066 -> you will find an activity log.
457.467 -> We suggest you use this activity
log to track your progress.
461.266 -> It can be very motivating as
you're working on a walking
464.8 -> program, to track your progress.
470.6 -> We suggest you work on
the walking program we
474.1 -> discussed until you start
cardiac rehabilitation.
478.333 -> You are strongly encouraged to
participate in this program.
482.233 -> Cardiac rehabilitation is a
program offering any combination
486.1 -> of exercise, education and
counselling with the goal of
490.166 -> helping you learn how to
make heart healthy living a
493.8 -> part of your everyday life.
496.5 -> Research demonstrates that
people who participate in
499.767 -> cardiac rehabilitation are
more successful at managing
503.633 -> their risk factors compared
to those who do not.
507.9 -> In most cases, your
cardiologist will automatically
511.367 -> refer you to a cardiac
rehabilitation program.
515.033 -> If you have not received your
appointment while in hospital
519.433 -> or within a few weeks of being
discharged from the hospital,
522.767 -> you should contact your
doctor and discuss whether
525.967 -> this program is right for you.
529.533 -> Cardiac rehabilitation programs
are designed to assist you in
533.6 -> achieving and maintaining a
heart healthy lifestyle
537.433 -> and to help you return
to everyday life.
540.4 -> There are a number of program
options available to residents
543.734 -> living in the Ottawa-Carleton
area and surrounding regions.
549.4 -> There is no cost for
participation in these programs.
553.367 -> For more detailed information
about cardiac rehabilitation,
557.667 -> please refer to pages 57-61
in your patient guide.
567.233 -> In this next section,
we will talk about rest
569.9 -> and activity at home.
571.9 -> The following guidelines
offer some helpful advice
574.4 -> about activity in general.
576.9 -> First of all, try to get 8
hours of sleep every night
580.7 -> during your recovery period.
583.467 -> Minimize activity after meals,
sit and watch television
586.9 -> or read the newspaper.
589.5 -> Stop and rest when
you feel tired.
592.934 -> Give yourself enough time
for activities so that you
596.4 -> won't feel tense or rushed.
599.367 -> Plan your day to achieve balance
between active periods
602.967 -> and quiet times.
605.734 -> Spread out more difficult
tasks and alternate an easy
609.033 -> task with a difficult one.
612.1 -> House work is not advised for
the first week you are home.
615.433 -> After that, you may resume
light house work such as
618.967 -> helping with meals and increase
as your tolerance improves.
624.967 -> Standing still for any length
of time is very tiring.
628.633 -> During your recovery, sit for
as many activities as possible,
632.467 -> for example while washing
dishes or preparing food.
638.166 -> Here are some additional
guidelines for resuming
641.467 -> activities for daily living.
644.4 -> So for weeks 1 to 3, you can
start doing some walking at a
650.967 -> slow pace; writing; drawing;
reading; watching television;
657.367 -> knitting; needle work; climbing
stairs, slowly; short outings;
665.1 -> lifting 5 to 10
pounds when necessary.
669.767 -> What this means is not
lifting more than 5 to 10
673.266 -> pounds for the first 3 weeks.
676.734 -> At week 2, you can start tasks
such as laundry; sweeping;
683.166 -> dusting; washing dishes;
and preparing light meals.
688.6 -> For weeks 3 to 6, you can start
activities such as cleaning
693.567 -> sinks and toilets; mopping the
floor; vacuuming; ironing;
699.5 -> bed-making; light
gardening; raking leaves;
704.5 -> pushing a light power mower;
lifting up to 20 pounds when
709.433 -> necessary; bowling and
golfing with the power cart.
718.133 -> Some people may have
questions about sexual
720.266 -> activity after a heart attack.
722.867 -> If you have recently
had a heart attack,
725.066 -> your doctor might ask you to
wait up to 6 weeks before
728.467 -> resuming sexual activity.
731.567 -> From a cardiac stand-point,
sexual intercourse is
735.133 -> like any other physical
activity, your heart rate
738.166 -> and blood pressure increase.
741.633 -> The activity is compared
to walking at 3 to 6
745.266 -> kilometers per hour on a
level surface or climbing
749.533 -> 20 stairs in 10 seconds.
753.133 -> For more information, please
see pages 42-44 in your guide.
Source: https://www.youtube.com/watch?v=qqiOPa12uG0