Heart Failure: Exercise for a Healthy Heart

A sedentary (inactive) lifestyle is one of the top risk factors for heart disease. Fortunately, it's a risk factor that you can do something about. Regular exercise, especially aerobic exercise, has many benefits. It can:
  • Strengthen your heart and cardiovascular system.
  • Improve your circulation and help your body use oxygen better.
  • Improve your heart failure symptoms.
  • Increase energy levels so you can do more activities without becoming tired or short of breath.
  • Increase endurance.
  • Lower blood pressure.
  • Improve muscle tone and strength.
  • Improve balance and joint flexibility.
  • Strengthen bones.
  • Help reduce body fat and help you reach a healthy weight.
  • Help reduce stress, tension, anxiety and depression.
  • Boost self-image and self-esteem.
  • Improve sleep.
  • Make you feel more relaxed and rested.
  • Make you look fit and feel healthy.

How Do I Get Started?
Before starting an exercise program, talk to your doctor about:
  • Medication changes. New medications can greatly affect your response to exercise; your doctor can tell you if your normal exercise routine is still safe.
  • Heavy lifting. Make sure that lifting or pushing heavy objects and chores such as raking, shoveling, mowing, or scrubbing aren't off limits. Chores around the house can be tiring for some people; make sure you only do what you are able to do without getting tired.
  • Safe exercises. Get the doctor's approval before you lift weights, use a weight machine, jog, or swim.

What Type of Exercise Is Best?
Exercise can be divided into three basic types:
  • Stretching: slow lengthening of the muscles. Stretching the arms and legs before and after exercising helps prepare the muscles for activity and helps prevent injury and muscle strain. Regular stretching also increases your range of motion and flexibility.
  • Cardiovascular or aerobic: steady physical activity using large muscle groups. This type of exercise strengthens the heart and lungs and improves the body's ability to use oxygen. Aerobic exercise has the most benefits for your heart. Over time, aerobic exercise can help decrease your heart rate and blood pressure and improve your breathing.
  • Strengthening: repeated muscle contractions (tightening) until the muscle becomes tired. For people with heart failure, many strengthening exercises are not recommended. (See below)

What Are Examples of Aerobic Exercises?
Aerobic exercises include: walking, jogging, jumping rope, bicycling (stationary or outdoor), cross-country skiing, skating, rowing and low-impact aerobics or water aerobics.
How Often Should I Exercise For A Healthy Heart?
In general, to achieve maximum benefits, you should gradually work up to an aerobic session lasting 20 to 30 minutes, at least three to four times a week. Exercising every other day will help you keep a regular aerobic exercise schedule.
What Should I Include in My Program?
Every exercise session should include a warm-up, conditioning phase and a cool-down.
  • Warm-up. This helps your body adjust slowly from rest to exercise. A warm-up reduces the stress on your heart and muscles, slowly increases your breathing, circulation (heart rate) and body temperature. It also helps improve flexibility and reduce muscle soreness. The best warm-up includes stretching, range of motion activities and the beginning of the activity at a low intensity level.
  • Conditioning. This follows the warm-up. During the conditioning phase, the benefits of exercise are gained and calories are burned. Be sure to monitor the intensity of the activity (check your heart rate). Don't over do it.
  • Cool-down. This is the last phase of your exercise session. It allows your body to gradually recover from the conditioning phase. Your heart rate and blood pressure will return to near resting values. Cool-down does not mean to sit down! In fact, do not sit, stand still or lie down right after exercise. This may cause you to feel dizzy or lightheaded or have heart palpitations (fluttering in your chest). The best cool-down is to slowly decrease the intensity of your activity. You may also do some of the same stretching activities you did in the warm-up phase.

What Is the Rated Perceived Exertion Scale?
The Rated Perceived Exertion (RPE) scale is used to measure the intensity of your exercise. The RPE scale runs from 0-10. The numbers below relate to phrases used to rate how easy or difficult you find an activity. For example, 0 (nothing at all) would be how you feel when sitting in a chair; 10 (very, very heavy) would be how you feel at the end of an exercise stress test or after a very difficult activity.

Rated Perceived Exertion (RPE) scale

0

Nothing at all

0.5

Just noticeable

1

Very light

2

Light

3

Moderate

4

Somewhat heavy

5-6

Heavy

7-9

Very heavy

10

Very, very heavy

In most cases, you should exercise at a level that feels 3 (moderate) to 4 (somewhat heavy). When using this rating scale, remember to include feelings of shortness of breath, as well as how tired you feel in your legs and overall.
What Are Some Warm-Up Exercises?
Every exercise session should start with a warm-up. Here are some stretching exercises you can try to get yourself started. Please check with your doctor before starting any exercise program. If any of the following exercises causes pain, do not continue the activity and seek the advice of a doctor or physical therapist.
Exercise while sitting
While performing these exercises, maintain good posture. Keep your back straight; do not curve or slump your back. Make sure your movements are controlled and slow. Avoid quick, jerking movements. Do not bounce. Do not hold your breath during these exercises.
  • Ankle pumping. Sit on the floor with your feet straight out in front of you. Keeping your heels on the floor, lift your toes up as far as you can. Hold for a count of five.
  • Knee straightening. Raise your foot to fully straighten your knee out in front of you. Hold for a count of five. Lower your foot to the floor. Repeat on other side.
  • Hip bending. Lift one knee up toward the ceiling. As you lower this knee, raise your other knee. Alternate each leg as if you were marching in place (while sitting.)
  • Overhead reaching. Raise one arm straight over your head, with your palm facing away from you. Keep your elbow straight. Slowly lower your arm to your side. Repeat with other arm.
  • Shoulder touching. Sit with your arms at your sides and your palms facing up. Bend your elbows until your hands are touching your shoulders. Lower your hands to your sides.
  • Single arm lifts. Sit with your arms at your sides, fingers pointing toward the floor. Raise one arm out to your side, keeping your elbow straight and your palm facing down. Slowly lower your arm to your side. Repeat with your other arm.
  • Shoulder shrugs. Keeping your back straight, lift your shoulders up and forward toward your ears. Release your shoulders down and back in a smooth circular motion.
  • Arm circles. Sit with your arms at your sides, fingers pointing toward the floor. Raise both arms out from your sides (about 1 or 2 feet from your body). Keeping your elbows straight and your palms facing toward you, rotate your arms in small circles.
  • Single shoulder circles. Bending one elbow, put your fingertips on your shoulder. Rotate your shoulder and elbow clockwise, then counter clockwise. Repeat with each arm.