Wellness – CHD and Exercise
With the brand new year, many of us are making resolutions to better ourselves and our lives. Exercising more is often at the top of the list! Kathleen Baschen, an exercise physiologist at Ann & Robert H. Lurie Children’s Hospital of Chicago, shares tips on how patients with CHD can get FITT.
Your cardiologist suggests that you start exercising regularly, but where do you start? What type of exercise can an adult with congenital heart disease even do? You can do much more than you think! The key is to start small and build it up gradually as your body adapts.
We all have heard the benefits from regular exercise; how it improves lean mass in the body, lowers body fat and reduces stress. But how can it help adults with CHD specifically? It can help decrease shortness of breath and fatigue in day to day tasks, it lowers blood pressure and heart rate and has been shown to reduce hospitalization stays (and duration of stays). The benefits of exercise span from your head to your toes, with having positive effects for most systems in the body. It sounds like a no-brainer, but developing and executing an exercise plan can be hard. Here are some areas that will help you become more FITT, focusing specially on how to incorporate more aerobic, resistance and flexibility exercises into your weekly regiment.
Frequency: How often should I exercise? For a beginner, it is recommended to participate in aerobic exercise 3 days out of the week, resistance exercise 1-2 days out of the week and flexibility at least 2 days out of the week. These can be spread out over the week or can be combined into 4-5 days to allow yourself breaks through the week. For example, you could complete aerobic exercise and flexibility on the same day, or resistance and flexibility on the same day. For those who have busy schedules, it can be more time efficient to complete two types of exercise in one day.
Intensity: How hard should I be exercising? For patients with CHD, using heart rate during exercise can be inaccurate due to medications or pacemakers. For these patients, it is recommended to use the Borg Scale (see chart below) for aerobic activity. During your warm up and cool down stages, you should be working from 8-10 on the scale (mild intensity). During the bulk of your aerobic exercise, the intensity should increase to 11-14 (moderate intensity). For resistance training, beginners can start with body weight or light hand weights. Increase your resistance every 2-3 weeks to progress strength. When stretching or performing other flexibility exercises, be safe and stretch to a point of feeling a tightness.
https://www.cdc.gov/physicalactivity/basics/measuring/exertion.htm
Time: How long should I exercise for? The ultimate goal is to exercise continuously for 30 minutes. When starting this program, start with any aerobic activity for 10-15 minutes and gradually increase your time over the course of 4-6 weeks. Take breaks when necessary or complete aerobic exercises in an interval format to allow for periods of rest. For resistance training, complete exercises in 10-15 repetitions and 2-3 sets. If you exceed 15 repetitions, it’s time to increase your intensity! When performing flexibility exercises, hold stretches for 10-30 seconds and repeat stretches 2-4 times.
Type: What kinds of exercise should I be doing? Whatever you like to do! Aerobic exercises include running, walking, swimming, elliptical, biking, stair master, aerobic classes, Zumba and many more! Resistance training should consist of major muscle groups (upper body, lower body and core). There are countless exercises that you can do right at home with little or no equipment. Flexibility exercise can be anything from traditional static stretching to yoga.
Use this FITT principle when you are ready to start your exercise program and make time in your week to complete it. Set a goal and stick to it. Find what you enjoy and do it! Remember to be safe when exercising. Check with your physician prior to starting an exercise plan, and if you ever experience symptoms while exercising, stop immediately or contact your physician if they persist.
Kathleen Baschen received her MS from Benedictine University. She is currently an Exercise Physiologist at Ann & Robert H. Lurie Children’s Hospital of Chicago, and her focus is in cardiopulmonary diagnostic testing, pulmonary rehabilitation and cardiac rehabilitation.