Cardiology - Cardiac Rehabilitation Programme

If you have had a heart attack, heart failure or heart surgery, cardiac rehabilitation provides you and your family with the information, support and advice you need.

The aim of cardiac rehabilitation is to support you in your recovery and help you to resume as full a life as possible after a heart event. It aims to help you:

• To understand your condition
• To recover from your surgery or heart attack
• To make changes to your lifestyle which will help to improve the health of your heart
• To reduce the risk of another heart attack
• To increase your confidence

Who is it for?

Cardiac rehabilitation is available for anyone who’s had:

• Acute coronary syndrome including heart attack
• Coronary artery angioplasty, including a stent
• Heart surgery
• Heart Failure
• ICD
• Cardiology Consultant referral

It is not just exercise sessions that we offer and the options will be discussed.

Close friends or family are usually welcome to come along, speak to your Cardiac Rehabilitation Nurse for advice.

When do I start cardiac rehabilitation?

Cardiac rehabilitation may start as soon as you go into hospital for your heart problem.

A member of the cardiac rehabilitation team will normally visit you on the ward to give you information about your condition and the treatment you’ve had, as well as information about your recovery and how to get back to your usual activities.

You will be invited to join a cardiac rehabilitation programme, which starts approximately two to six weeks after you leave hospital.

Cardiac rehabilitation is Menu based and the options will be discussed with you. You will have an assessment to help individualise your programme to help you achieve any rehabilitation goals.This may be a programme of exercise classes and education sessions, telephone advice and monitoring, home exercises or a combination of the above.

A home visit may be available. Staff will help you to decide if the exercises are suitable for you.

We can also sign post you to other relevant services to help manage your lifestyle. This programme takes 6 to 8 weeks to achieve the full benefit, and at the end we will reassess you and advise on how you can continue with your progress.

Risks and benefits of the programme

Exercising in a professional programme is a safe environment in which to monitor your activity and gradually increase your exercise.

We monitor you regularly to ensure that you are working within safe limits. You may be concerned about the risk of exercise and physical activity after your heart attack/illness or surgery, but regular exercise reduces the risk of further events.

Increasing exercise provided in this programme will get you fitter, so that you are able to do more physical activity and make the activities of daily living easier. You will be less tired, more likely to sleep better and to wake up feeling more refreshed.

Sometimes increasing your physical activity affects the effectiveness of your tablets, and sometimes a change in your tablets may affect how you can exercise, so it is important for you to monitor any changes in signs and symptoms and report to the cardiac rehabilitation staff.

If there is any change to your medication or advice from a hospital or GP visit – please tell the cardiac rehabilitation staff.

General exercise advice following a heart event

The programme includes exercise in the class setting and work at home plan.

Exercise prescription

Regular exercise has many benefits, and exercising once a week is not enough. To get the most benefit within the 8 week programme, you need to walk alternate days and exercise alternate days or discuss alternatives with the cardiac rehabilitation staff. This exercise programme is as important as any prescription.

Simple tips to increase your activity safely:

• Walk instead of using the car
• Take the stairs instead of the lift
• Look for ways of making exercise enjoyable - involve your family and friends, go for a walk before dinner each evening, find new places to explore. This way you are more likely to make exercise a way of life and incorporate it into your daily activities
• Research findings indicate that it is desirable to exercise for 30 to 45 minutes 3 to 5 times a week to get the most benefit. This is better than a single two-hour walk
• Always warm up before the active exercise programme
• Always allow time for cool down exercises, or a cool down walk before resting
• Wear sensible and comfortable clothing and footwear. Slip-on shoes; trailing scarves or tight clothes are not advised
• Start any exercise slowly and gradually build up
• Gradually return to exercise after an absence for any reason
• If you are diabetic, check your glucose levels before you exercise. If you use Glyceryl Trinitrate (GTN) or a breathing inhaler, take it with you to the class
• Do not exercise if you suffer from chest discomfort, undue shortness of breath, dizziness, palpitations, nausea, muscle cramps or muscle fatigue. If you suffer from any of these symptoms during the programme, please inform the rehabilitation staff
• Do not exercise during an illness or infection (including the common cold). Ring to cancel the class until you feel better
• Avoid exercise outdoors on very cold or windy days; if you need to go out wrap a scarf around your face so you breathe in warm air not cold. Also warm up first, by either doing some of the warm up exercises or walk around your home a bit before setting off
• Avoid exercise in hot or humid weather. When doing physical activity take it more slowly, drink water and rest afterwards. For advice on travelling to hot countries ask for a leaflet or download from the British Heart Foundation (BHF) website
• It is important that you have your tablets and a light meal before you do any exercise
• Do not exercise for at least 1 hour after a meal, and do not exercise if you are very hungry. Do not drink alcohol before or after exercise. If you are fasting talk to the rehabilitation staff
• Avoid holding your breath during exercise
• Also avoid exercise (also called isometric exercise) that requires you to hold a muscle contraction for a long period
• Avoid very hot baths or showers after exercise

The Borg scale

This will be used throughout the programme and helps you to estimate how hard and strenuous the exercise feels to you. This depends on strain and fatigue in your muscles, feelings of breathlessness and aches in the chest. This is your perception, not what you believe you ought to feel.

How the scale works

6 = nothing at all - sitting at rest
20 = Absolute maximum - pushing the body to its physical limit
6 - no exertion at all
7
7.5 - extremely light
8
9 - very light 10
11 - light
12
13 - somewhat hard
14
15 - hard (heavy)
16
17 - very hard
18
19 - extremely hard
20 - maximum exertion
Borg scale 6- 20 © Gunnar Borg 1970, 1985,1998

Useful information

Local smoking cessation numbers:
Bury Lifestyle services - 0161 253 7554
Your Health Oldham - 0161 960 0255
Rochdale Living Well services - 01706 751190

Diabetes UK
Diabetes care line - 0345 123 2399
www.diabetes.org.uk

NHS Choices
Helpline 0845 606 4647
www.nhs.uk

British Heart Foundation
Helpline 0300 330 3311 or email hearthelpline@bhf.org.uk
Website: www.bhf.org.uk
https://www.bhf.org.uk/informationsupport/support/cardiac-rehabilitation-at-home

DVLA
DVLA drivers medical enquiries - 0300 790 6806
 
Bury Lifestyle Services
Tel: 0161 253 7575
www.lifestyleservice@bury.gov.uk

Your Health Oldham
Tel: 0161 960 0255 or contact online to self-refer for smoking cessation, weight loss and alcohol advice.

Cardiac Rehabilitation Programme contact numbers
Bury Cardiac Rehabilitation Programme
Telephone: 0161 778 2450/2686
Oldham Cardiac Rehabilitation Programme
Telephone: 0161 627 8339