Cardiac Rehabilitation
Please do not use this patient information without instruction and guidance from your clinician or the cardiac rehab team

Why is exercise good for you?
Regular physical activity has been shown to help people stay healthy in many different ways. There are both short term and long term effects of exercise.
Short term effects occur during and immediately after exercise whereas long term effects are felt following a longer period of regular exercise.
Short term effects
- During exercise your heart rate and blood pressure will naturally increase as you work harder. This seems like something that should be avoided but is actually very beneficial for your heart.
- While you exercise your brain releases a series of ‘feel good’ chemicals into your blood stream which are associated with improving mood, happiness and making you feel more energetic.
- Your body uses calories while you exercise in order to fuel what you are doing, but this increased amount of calories being used by your body continues for up to 24 hours following exercise.
- Exercise can occasionally leave you feeling a tired and a little sore, but this is usually short lived and improves as you become fitter and exercise more regularly.
Long term benefits
- Physical activity halves the risk of developing coronary heart disease.
- Physical activity reduces the risk of having a stroke.
- Regular exercise causes the body to create more muscle tissue which in turn improves strength, balance and coordination but also makes general tasks such as walking much easier to perform.
- Muscle strength improves metabolism which means that the body uses more energy at all times. This helps you to lose weight, if you are overweight, which can take a lot of strain off your heart and make you more mobile and able to do more.
- Even if not overweight, exercise is extremely important to help avoid muscle loss that occurs due to aging and inactivity.
- Increasing muscle strength reduces the chances of developing diabetes.
- If you already have diabetes, physical activity can help you to control it.
- Physical strength lowers the risk of osteoporosis (thinning of the bones).
- Exercise helps lower blood pressure.
- Moderate, regular exercise improves your immune system and makes you less likely to develop things like cold and flu.
There are many fantastic benefits that exercising regularly can give your body and if you want to know about the changes that occur in more detail then please speak to your Physiotherapist or Exercise Instructor.
Sensible precautions
- It is very important to increase your physical activity gradually. This means both the amount of time you spend doing it and how intense the activity is. A sudden increase in physical activity, especially if it is vigorous, can carry risks.
- Warm up and cool down each time you do any physical activity. Begin slowly for the first few minutes and build up gradually. When you come to the end of your activity, take time to slow down and make sure you don’t stop suddenly.
- If you are doing any activity outdoors in very cold or windy weather, dress warmly with a hat and a scarf.
- If you get angina, take your GTN spray or tablets with you when you do any physical activity.
- It is not advisable to exercise when you have a viral infection (for example, a sore throat or a temperature).
- You should not feel pain, dizziness, nausea, muscle cramps or extreme fatigue when exercising.
Don’t
do not exercise after a heavy meal, wait 2 hours before exercising
do not exercise in extremes of hot or cold weather
do not compete with others
Always
Follow the Rate of Perceived Exertion scale (below).
All exercises must be done at your own pace when you feel well.
After exercise you may feel:
- That your muscles have worked
- That your breathing depth has increased
- That you feel warmer
Rate of Perceived Exertion (RPE)
How hard does it feel?
While you are exercising, we want you to try to estimate how hard you feel the work is; that is, we want you to rate the degree of perceived exertion you feel.
By perceived exertion we mean the total amount of exertion and physical fatigue. Don’t concern yourself with any one factor such as leg pain, shortness of breath, or work grade, but try to concentrate on your total, inner feeling of exertion.
6 | No exertion at all (sitting on the couch at home) |
7 | Extremely light |
8 to 9 | Slightly more effort |
10 | Light exercise (beginning to feel warmer) |
11 to 12 | Moderate exercise (starting to breathe more but in control) |
13 | Somewhat hard |
14 | Heavy exercise (breathless or puffed, struggle to talk) |
15 | Hard exercise |
16 | Very hard |
17 to 19 | Very severe (almost maximal) |
20 | Maximal effort (giving it everything you possibly have!) |
How to take your pulse
Pulse measuring can be an important tool for measuring your levels of exertion during exercise. If you can, measure your pulse accurately and use this number together with your RPE scores, your physiotherapist or exercise instructor will be able to better determine which exercise level is suitable for you.

Finding your pulse
You can find your pulse in places where an artery passes close to your skin, such as your wrist or neck.
To find your pulse in your wrist:

- Hold out one of your hands with your palm facing upwards and your elbow slightly bent.
- Put the first (index) and middle finger of your other hand on the inside of your wrist, at the base of your thumb (image 1).
Press your skin lightly until you can feel your pulse – if you can’t feel anything, you may need to press a little harder or move your fingers around.
To find your pulse in your neck, press the same two fingers on the side of your neck in the soft hollow area just beside your Adam’s apple (image 2).
Checking your pulse
When you find your pulse:
- Count the number of beats you feel for one full minute, or
- Count the number for 30 seconds and multiply by two
The figure you get is the number of times a minute your heart is beating. It’s known as your heart rate. You can also check if your pulse is regular or irregular by feeling its rhythm for about 20 to 30 seconds. Occasional irregular heartbeats, such as missed beats, are very common.
If you are concerned about your pulse, see your GP or speak to your Cardiac Nurse at your next Cardiac Rehab session or via the helpline. In an emergency it is always advised that you phone 999 to seek urgent medical attention.
Getting started
Think about your weekly routine; when can you fit in physical activity? Be positive; try to think about the benefits and not the drawbacks.
Doing some activity, even small amounts, is better than doing nothing. If you are inactive now you should slowly build up to 30 minutes of moderate physical activity on most days of the week. This might sound like a lot to begin with, but you could walk for ten minutes three times a day if you like.
“So, what is moderate activity?”
During moderate activity you should notice that you breathe a little faster, feel warmer with a little bit of a sweat and have a slightly faster heartbeat. You should be able to talk during your exercise. This can be any type of activity such as walking, gardening etc. It is important that you are still able to talk during your activity.
The exercise programme
The following programme is designed for patients following a cardiac event and has been laid out to closely mirror the exercises which patients perform when they attend a formal cardiac rehabilitation class. This can be done at home as a stand-alone programme or can be used to run alongside the classes which are run by the cardiac rehabilitation team.
Warm up
This is one of the most important parts of a workout and is often the most overlooked. If you warm up correctly you are giving your body chance to get ready for the exercise, this reduces the risk of injury and allows you to exercise at a higher level for longer.
Many of the cardiac medications, which are typically taken following an event, are designed to slow down your heart in order to protect it, this also means that the heart is slow to react when beginning exercise.
How to warm up?
A warm up can consist of a gentle walk to gradually increase your heart rate and prepare your body for exercise.
As a team we have also filmed an example warm up and posted it online on the cardiac rehabilitation website.

This can be accessed using the following link:
Cardiac Rehab South Tees – YouTube
Or by searching on Youtube.com for: South Tees Cardiac Rehabilitation
Look for our logo (image 3).
Exercise 1
Blue Level – 1 minute
Tricep extension
Extend arms behind maintaining good posture and keeping feet moving at all times.
Red Level – 1 minute 30 seconds
Lunge back
Add lunge back exercise to make legs work at the same time. See Red Circuit video for more info.
Green Level – 2 minutes
Increase weight
Add dumbbells or increase weight to make arms work


Exercise 2
Blue Level – 1 minute
Knee raise
Lift knee maintaining good balance. Use table or chair for support if needed.
Red Level – 1 minute 30 seconds
Increase height
Bring knees higher and add arm tap to knee.
Green Level – 2 minutes
Increase speed
Make movement faster. Try bringing opposite elbow to opposite knee.


Exercise 3
Blue Level – 1 minute
Bicep Curls
Bring hands up to shoulders, keep upper arm still bending at the elbow. Keep feet moving throughout by walking on the spot.
Red Level – 1 minute 30 seconds
Increase weight
Add larger weights.
Green Level – 2 minutes
Add toe tap
For more info on increasing intensity see Green Circuit video using the link provided at the beginning of the exercises.


Exercise 4
Blue Level – 1 minute
Lunge back
Step backward and try to keep weight on the front leg. Use a chair for support.
Red Level – 1 minute 30 seconds
Lunge forward
Step forward and allow front leg to bend. Try to keep knee straight.
Green Level – 2 minutes
Lunge forward with bicep curl
Add a bicep curl and increase the depth of the lunge as shown in the Green Circuit video online.


Exercise 5

Blue Level – 1 minute
Shoulder raise
Starting with your arms by your side. Keeping arms straight try to raise up to a comfortable height. Return arms to side, don’t hold for longer than 1 second. Maintain good posture throughout.
Red Level – 1 minute 30 seconds
Increase weight
Add dumbbells or increase the weight.
Green Level – 2 minutes
Add side step
Make large side steps back and forth while doing shoulder raises.
Exercise 6
Blue Level – 1 minute
Step up
Step up onto a step box or on to the bottom step of your stairs.
Use support if needed.
Red Level – 1 minute 30 seconds
Increase height
Step up two steps at once if possible. Increase step box height.
Green Level – 2 minutes
Add dumbbells bicep curl
Add a bicep curl and increase speed.


Exercise 7
Blue Level – 1 minute
Slow extension, hold for 1 second
Straighten the leg and make the large thigh muscle squeeze.
Red Level – 1 minute 30 seconds
As above – Concentrate on making the muscle squeeze.
Green Level – 2 minutes
Add alternate punch
Add a punch in front with opposite arm. Concentrate on maintaining upright sitting.


Exercise 8
Blue Level – 1 minute
Sit to stand
Maintaining good upper body posture, stand up and sit down into the chair slowly.
Use support or a slightly higher chair with arms if needed.
Red Level – 1 minute 30 seconds
Increase pace
With no support try to increase the speed you stand up and try to still go slowly back down.
Green Level – 2 minutes
Don’t fully sit
Try to touch the chair with your bottom but don’t put your full weight down.




Exercise 9

Blue Level – 1 minute
Dumbbell Punches
Maintaining good upper body posture, punch alternate arms out in front in a slow and controlled manner. Punch at shoulder height, no higher.
Red Level – 1 minute 30 seconds
Add heel dig
Kick alternate legs out in front of your body making the heel hit the floor with the toes raised.
Green Level – 2 minutes
Increase weight
Add dumbbells or increase the weight.
Exercise 10
Blue Level – 1 minute
Walking
Walk on the spot at a comfortable pace. Try to maintain good posture.
Red Level – 1 minute 30 seconds
Increase speed
Try to go faster and increase the speed of your arm swing.
Green Level – 2 minutes
Add weights
Add dumbbells or increase the weight. Try to jog on the spot if able.


Exercise 11
Blue Level – 1 minute
Upright row
Starting with palms facing you and hands on top of thighs, bring the hands up to the chin. Keeping the elbows higher than the hands throughout the movement.
Keep your feet moving by walking on the spot throughout.
Red Level – 1 minute 30 seconds
Add heel curl
While doing upright rows, try to side step and kick your heel up behind you. See the Red circuit video online for more information.
Green Level – 2 minutes
Increase weight
Add dumbbells or increase the weight.


Exercise 12
Blue Level – 1 minute
Use chair for support
Maintaining good upper body posture and using the chair for support try to sit your bottom down behind you bending at the knee. Try to keep your feet flat on the floor.
Red Level – 1 minute 30 seconds
Go lower
Try to go lower with your bottom without allowing your knees to go forward over your toe line.
Green Level – 2 minutes
No support
Try to repeat the standing squats without a chair and using your arms stretched out.


Cool Down
The cool down is extremely important to allow the body to return to normal following a hard bout of physical exercise.
During the cool down your heart rate should return to normal, your body removes the waste products which could have built up inside your muscles and you also stretch out the muscles which you have worked, this stops them from becoming stiff.
A video of the Cardiac rehabilitation team class cool down is available online at: Cardiac Rehab South Tees – YouTube
Or by searching Youtube.com for: South Tees Cardiac Rehabilitation
Well done! Your exercise session is complete
Have a drink of water and relax, you should be feeling like your breathing has returned to normal and your heart rate has settled. Occasionally, after exercise, your cardiac medications can contribute to your blood pressure dropping too rapidly which can make you feel light headed. If this happens sit down and try to raise your legs on a chair in front of you, if you continue to feel light headed have a lie down on the floor and put your legs on a chair.
Walking plan
Here is a gentle, progressive walking plan that you could start from your own home. Walking is a great activity because:
- Its free and almost everyone can do it.
- You can walk almost anywhere and anytime.
- You don’t need any equipment – apart from a comfortable pair of shoes.
- There is very little risk of injury.
- You can start slowly and gradually build up time, distance and speed.
It is very important that you walk at a pace which you find comfortable. The pace should be brisk, but you should always be able to hold a conversation so you should not feel very breathless or out of control. It is safe and desirable to be slightly short of breath.
You can use the RPE (rate of perceived exertion scale) to judge the intensity of your walking.
Look at the chart during or immediately after your walk and decide which statement and number best says how your whole body feels. The walking programme will give you an idea of how you should feel as you progress.
Beginners walking plan
This programme aims to introduce you to walking regularly and to take you to a level at which you can walk for 30 minutes at a moderate-to- brisk pace, at least 5 times a week, which are the government’s current recommendations.
Remember:
Build up your walking gradually
Stick to a pace and distance which is comfortable for you
You should always be able to carry on a conversation while you’re walking but it is okay to be slightly short of breath
You should not experience any pain
Day 1 | Day 2 | Day 3 | Day 4 | Day 5 | Day 6 | Day 7 | |
---|---|---|---|---|---|---|---|
Week 1 | 10 mins | 10 mins | 10 mins | 10 mins | 10 mins | 10 mins | Rest Day |
Week 2 | 15 mins | 15 mins | 15 mins | 15 mins | 15 mins | 15 mins | Rest Day |
Week 3 | 20 mins | 20 mins | 20 mins | 20 mins | 20 mins | 20 mins | Rest Day |
Week 4 | 25 mins | 25 mins | 25 mins | 25 mins | 25 mins | 25 mins | Rest Day |
Week 5 | 30 mins | 30 mins | 30 mins | 30 mins | 30 mins | Rest Day | Rest Day |
Week 6 | 30 mins | 30 mins | 30 mins | 30 mins | 30 mins | 30 mins | Rest Day |
Weekly exercise log
You can use the following tables to keep track of your exercise week by week and take note of how you are improving. This is helpful when discussing your exercise with the cardiac rehabilitation team.
Week 1 | Exercise | Duration | How it felt RPE (6 to 20) | Heart Rate |
---|---|---|---|---|
Monday | ||||
Tuesday | ||||
Wednesday | ||||
Thursday | ||||
Friday | ||||
Saturday | ||||
Sunday |
Exercise log – Week 2
Week 2 | Exercise | Duration | How it felt RPE (6 to 20) | Heart Rate |
---|---|---|---|---|
Monday | ||||
Tuesday | ||||
Wednesday | ||||
Thursday | ||||
Friday | ||||
Saturday | ||||
Sunday |
Goals
Have you achieved your targets for week 2? |
If not why not? |
What do you want to achieve in week 3? |
Exercise log – Week 3
Week 3 | Exercise | Duration | How it felt RPE (6 to 20) | Heart Rate |
---|---|---|---|---|
Monday | ||||
Tuesday | ||||
Wednesday | ||||
Thursday | ||||
Friday | ||||
Saturday | ||||
Sunday |
Goals
Have you achieved your targets for week 3? |
If not why not? |
What do you want to achieve in week 4? |
Exercise log – Week 4
Week 4 | Exercise | Duration | How it felt RPE (6 to 20) | Heart Rate |
---|---|---|---|---|
Monday | ||||
Tuesday | ||||
Wednesday | ||||
Thursday | ||||
Friday | ||||
Saturday | ||||
Sunday |
Goals
Have you achieved your targets for week 4? |
If not why not? |
What do you want to achieve in week 5? |
Exercise log – Week 5
Week 5 | Exercise | Duration | How it felt RPE (6 to 20) | Heart Rate |
---|---|---|---|---|
Monday | ||||
Tuesday | ||||
Wednesday | ||||
Thursday | ||||
Friday | ||||
Saturday | ||||
Sunday |
Goals
Have you achieved your targets for week 5? |
If not why not? |
What do you want to achieve in week 6? |
Exercise log – Week 6
Week 6 | Exercise | Duration | How it felt RPE (6 to 20) | Heart Rate |
---|---|---|---|---|
Monday | ||||
Tuesday | ||||
Wednesday | ||||
Thursday | ||||
Friday | ||||
Saturday | ||||
Sunday |
Goals
Have you achieved your targets for week 6? |
If not why not? |
What do you want to achieve in week 7? |
Exercise log – Week 7
Week 7 | Exercise | Duration | How it felt RPE (6 to 20) | Heart Rate |
---|---|---|---|---|
Monday | ||||
Tuesday | ||||
Wednesday | ||||
Thursday | ||||
Friday | ||||
Saturday | ||||
Sunday |
Goals
Have you achieved your targets for week 7? |
If not why not? |
What do you want to achieve in week 8? |
Exercise log – Week 8
Week 8 | Exercise | Duration | How it felt RPE (6 to 20) | Heart Rate |
---|---|---|---|---|
Monday | ||||
Tuesday | ||||
Wednesday | ||||
Thursday | ||||
Friday | ||||
Saturday | ||||
Sunday |
Goals
Have you achieved your targets for week 8? |
If not why not? |
What do you want to achieve Longterm? |
Contact us
If you require further information please contact us on:
Telephone: 01642 854644
Email: [email protected]
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