What you need to know about cardiac rehab at home

What’s the Cardiac Rehab at Home exercise programme?

Cardiac Rehab at Home features a series of exercise videos led by cardiac rehab professionals that are safe for you to do at home. If you’re new to exercise, want to slowly build up your activity levels or have difficulty with mobility or balance, this programme is here to help you.

Cardiac rehab is a vital part of your long-term recovery. Research has shown that cardiac rehab has a positive impact on your wellbeing and quality of life. It also reduces your risk of having another cardiac event.

Cardiac rehab should form an essential part of your lifestyle just like taking your medication. There are lots of ways to keep active but it’s important to exercise in a way that’s safe for you. As well as helping to lose weight, improve fitness and boost mental health, being active can also help to reduce or maintain a healthy blood pressure and lower cholesterol levels. 

Who is the Cardiac Rehab at Home exercise programme for?

The exercise programme is only for people who’ve had a cardiac rehabilitation assessment. This is because your cardiac rehab team need to check it’s safe for you to start exercising. 

During your cardiac rehab assessment, you’ll meet with your cardiac rehab team and talk about:

• how you feel doing everyday tasks
• your medications
• your emotional wellbeing and your goals for the future.  

If you’re not sure you’ve had this assessment, speak to your cardiac rehab team.

What happens in the Cardiac Rehab at Home exercise programme?

The programme has three different levels so you can do the one that's suitable for you:

• Level one - a chaired based session.
• Level two - similar exercises and movements to level one, but you do them standing 
• Level three – If you want to work a little bit harder. There’s the option to use light weights or equipment you may have at home.

Your cardiac rehab team will advise which level is right for you.

When do I start the Cardiac Rehab at Home exercise programme?

Your cardiac rehab team will advise on when you can start. It’s usually four to eight weeks after your diagnosis, cardiac event, or surgery, but it can be different for everyone.

How long are the exercise sessions?

Each session lasts for about 45 minutes.

This is made up of:

• a 15-minute warm up
• up to 25 minutes of conditioning 
• a 10-minute cool down.

Do I need to do the whole 45-minute exercise session?

Yes. Give yourself enough time to finish all the stages in the order we’ve shown. Each stage is designed to give you a safe and effective exercise session.

Did you know? 

• The warm up prepares your body for exercise.  The gradual build-up of activity improves the blood flow to your heart  and working muscles. 
• Conditioning helps to tone and strengthen your muscles, gradually build up your fitness and improves the way your heart pumps blood around your body.
• The cool down is about slowing down your exercise so that your heart rate and blood pressure return to normal. The stretches help to prevent any stiffness and to increase your flexibility

If you’re short of time or can’t do a full 45-minute session, you could shorten the conditioning phase and complete a full warm up and cool down. 

How often should I do the exercise videos?

Start off gradually and build up to two to three sessions a week. You may be doing this as well as other activities. Discuss with your cardiac rehab team about spacing these out during the week. 

How long does a Cardiac Rehab exercise programme last?

Your cardiac rehab team will help you to plan some short, medium and longer-term goals. Some people may do the programme for some weeks to build up their fitness, others may use it for longer as part of their healthier lifestyle.

Are the Cardiac Rehab at Home exercise videos safe for me to use?

All the exercises have been created by cardiac rehab experts. We advise you to only take part in the programme after having a cardiac rehab assessment. This is carried out by your cardiac rehab team to find out how much exercise you can do safely.

During your assessment, you’ll meet with your local cardiac rehab team and talk about: 

• how you feel doing everyday tasks
• your medications
• your emotional wellbeing and your goals for the future.

If you’re not sure you’ve had this assessment, you can speak to your local cardiac rehab team.

How should I prepare to exercise?

Before you start any exercise, make sure you are rested and feel well.  You’ll need:

• loose fitting comfortable clothes 
• a clear safe space for you to exercise
• the room at a comfortable temperature 
• water to have during the session
• light weights around 2kg such as dumbbells or you can use cans of baked beans or water bottles (weights are optional, and the exercises can be done without them).

How can I be sure I am safe when I’m doing exercise?

The exercises have been developed for those who've had diagnosis of a heart condition, a cardiac event or surgery.  Your healthcare professional may advise you not to start exercising on your own (this could be for a number of reasons).  

Don’t start exercising and contact your GP or cardiac rehab team straight away if:

• your heartbeat feels irregular, and this isn’t normal for you
• you have a temperature or feel generally unwell 
• you have chest pain when resting.

Regardless of the level you’re on, exercise at a pace and intensity that feels right for you. 

You should see how you’re feeling in each session by using a scale called The Borg Rate of Perceived Exertion (or RPE for short).  

What's The Borg Rate of Perceived Exertion (RPE)?

Rate of Perceived Exertion (RPE), helps you measure how hard your body is working when you exercise.  It will help you stay within a range that’s safe

Using the scale below, choose a number to describe how hard the activity feels. You base the number on how tired you are, how hard it is to breathe and how hard it is to do the activity.

Exertion is mainly felt as: 

• strain and tiredness in your muscles
• how breathless the activity is making you feel
• generally, how difficult the activity is to do.

Your cardiac rehab team will give you an assessment of your fitness and recovery so far and will explain how to record your progress and RPE. We recommend understanding the RPE scale before you start and take mental of notes of how you’re feeling during the exercises. We’ll remind you to do this during the videos.  

Is there a rating number I should aim for?

Everyone is different and it’s your own feelings of effort that’s important. We recommend:

• Before you start - you should feel rested (6 or a 7 on the scale).
• Warm up – the exercises should feel fairly light. The aim of the warm-up is to gradually raise your heart rate and warm up your muscles (no higher than 10 or 11 on the scale by the end of this section).
• Conditioning phase – work at a rate where the exercises feel between light and somewhat hard (11-14 on the scale).
• Cool down – the exercises should feel light. The cool down will safely take you back down to how you felt before starting the session (11 and below on the scale).

How will I know if I'm doing too much exercise and I need to slow down?

When you’re exercising it’s normal if you’re:

• slightly sweaty
• warm or slightly flushed
• breathing deeper and faster, but can still talk
• feeling your heart beating faster.

However, you should slow down and make the movements smaller if:

• your breathing is uncomfortable
• you feel excessively tired or sweating a lot
• your RPE is higher than recommended (in our guidance above) or by your cardiac rehab team.

What shall I do if I feel unwell during exercise?

If you feel too breathless:

• slow down your movements 
• walk on the spot slowly or tap your feet in the chair for a few minutes. 

Sit down and rest if you feel faint in discomfort or in pain.

If your RPE doesn’t go down after you’ve tried to slow down for a few minutes, walk on the spot slowly. 

If you’re not recovering after a couple of minutes stop and sit down speak to your cardiac rehab team or doctor before exercising again.

What if I get chest pain, discomfort, or tightness when I’m exercising?

If you experience pain, tightness or discomfort you should stop what you are doing and sit down and rest.

If you have a glyceryl trinitrate (GTN) spray or tablets, use it as advised by your doctor. If  the pain, discomfort, or tightness doesn’t ease after five minutes take another dose. If the pain doesn’t ease within five minutes of your second dose, call 999 straight away.

If you don’t have a glyceryl trinitrate (GTN ) spray, you should try to stay calm and call 999.

Are there any activities I shouldn’t do?

Your cardiac rehab team will talk you to you about any activities that may not be right for you i.e. sports that need sudden bursts of energy like squash. If you have any worries or concerns, you can contact them at any time.

I recently had heart surgery, can I do all the exercises in the videos?

The videos feature movements such as breaststroke arms and chest stretch exercises. If you’ve recently had heart surgery or suffer from joint pains and conditions, work in a range that’s comfortable for you. This may mean smaller movements or not lifting your arms higher than your shoulders. 

How do I store my weights safely between the exercises?

Keep weights on a raised flat surface close by such as a secure chair or table. Slowly lift them in a controlled way.

Where can I go if I have more questions?

We’re here to help and support you every step of the way:

• Sign up to our award-winning online magazine, Heart Matters, to receive free, weekly emails packed with the latest and most popular articles. 
• Join our online community, HealthUnlocked. Here you can meet people with heart and circulatory conditions and ask any questions you might have.
• Our cardiac nurses are just a call or a click away on the Heart Helpline. 

Supporting you to get the care you need

We know that many of you are experiencing delays to treatment at this time, or have questions and concerns about getting medical help. We've created this set of information to help you with these issues.

If you are having emergency heart attack symptoms, do not wait for an appointment and call 999 immediately.

• Where to get medical help if your appointment is delayed or cancelled
• Appointment and surgery delays
• When do you still need to get medical help?
• Making the most of phone and video appointments