Cardiac Rehab: General Exercise Guidelines for Phase II
The following exercise guidelines for phase II cardiac
rehab may vary depending on your medical history, clinical status, symptoms,
and whether you have had heart surgery. These are just guidelines: Discuss any additional physical limitations or medical issues with your doctor before you start any exercise program.
rate of recovery depends on age, gender, and other health conditions. Depending
on your condition and how you respond to rehab, you may stay in a particular
phase or move back and forth among the various phases. There is no set length
of time that you must stay in a specific phase.
It’s dramatic when someone has a heart attack on television or in the movies. But in real life, symptoms can be more subtle and difficult to identify. And because heart attack and angina symptoms are so similar, it may be hard to tell what's going on.
But knowing the differences -- and the reasons behind them -- can result in seeking treatment sooner, and living longer.
Phase II is the
initial outpatient cardiac rehab program. A phase II program has many parts,
including supervised exercise and a variety of measurements and assessments.
For example, you may wear a portable heart monitor for all exercises in phase
In addition to restoring your physical function, the focus of
phase II is on reducing your risk of future heart conditions. You will receive
information and tools to change certain aspects of your lifestyle, such as
smoking, nutrition, stress, and taking your medicines. You may also receive
vocational rehabilitation so you can return to work safely and in a timely
Your progress will be monitored by several rehab staff
members. The frequency and duration of phase II rehab sessions for each week will
vary depending upon the structure of your personal program.
Phase II exercise program
Your exercise program will
include stretching, aerobic exercise, and an introduction to strength
Approximate length: 8 to
12 weeks (6 to 8 weeks following discharge)
Physical goals: Increasing aerobic capacity and overall
strength, self-monitoring of heart rate (HR) and rating of perceived exertion
(RPE), introduction to stretching, and strength exercises
Make stretching part of your
warm-up and cooldown every time you exercise. The benefits from an
increase in flexibility are numerous. And as part of your lifetime physical
maintenance program, stretching will help increase the length of time that you
can continue to be active. Enjoy the feeling of relaxation as you stretch. As
you do each exercise in a slow and controlled manner, focus on your
breathing and become more aware of your body's range of motion and positioning.
Continue to follow the recommended guidelines carefully.
General guidelines for flexibility exercises
Frequency: At least 3 days a
Intensity: Stretch to a position of mild
Duration: 10 to 30 seconds for each
Repetition: 3 to 5 for each stretch
Control and hold without resistance, emphasis on lower back and legs
Phase II rehab includes a carefully
monitored aerobic program that involves one or more types of exercise. Choose
an exercise that you enjoy and record how hard you exercise. Use your target
heart rate (THR) and
rating of perceived exertion (RPE).
You will exercise within a specific heart rate range. Over time,
your staff will probably ask you to work harder when you exercise.
Sometimes exercise may cause angina (such as chest pain or discomfort). It is important to know when you
reach an exercise intensity that causes angina and to exercise below that
threshold. So note your heart rate intensity at any signs of chest
discomfort or pain, and tell your doctor and the staff who is supervising your
exercise. It is suggested that you use heart rate monitors to accurately record
your heart rate and exercise 10 to 15 beats per minute (bpm) below the known
Strength training has been shown
to be very effective with cardiac patients for improving muscular strength and
endurance as well as help in improving coronary risk factors. It also decreases
the cardiac demands of daily activities such as lifting and increases your
endurance capacity for other activities. You should not start a strength-training program without discussing it with your doctor.
When you are strength training, be sure to follow guidelines
regarding correct technique, breathing, and appropriate intensity. Below is an
introductory program and guidelines to use to begin improving your muscular
strength and endurance.
Introductory program to increase strength
Strength training (hand weights, machines)
RPE: 11 to 13
1 to 10 pounds
10 to 12 reps for each set
1 to 2 sets
for each exercise
2 to 3 days a week
following aerobic exercise
rest period between sets.
Add more exercises.
General guidelines for strength training
Avoid holding your breath. Try to exhale upon
Be sure to warm up and cool down to prevent injury and
Complete a smooth, controlled, and full range of motion
with each activity.
Balance your exercise between complementary
Biceps and triceps
Chest and upper back
Always include exercises that strengthen your
trunk (lower back and abdomen).
Avoid gripping the weight handles
tightly to prevent an excessive blood pressure response to
Typically, weight training is done after aerobic exercise
and/or on alternate days.
Begin with exercises for major muscle
groups: work large muscles, such as chest and back, before smaller muscles,
such as biceps and triceps.
Delayed onset of muscular soreness may
occur, so progress slowly and allow for recovery time.
Do not do
strength training every day, because your muscle groups need at least one day to
Primary Medical Reviewer
E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer
Richard D. Zorowitz, MD - Physical Medicine and Rehabilitation
October 5, 2010
WebMD Medical Reference from Healthwise
October 05, 2010
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