Individuals who don't participate in cardiac rehabilitation will need to take the doctor's consent before starting to exercise. One could slowly begin by doing gentle exercises like walking

Cardiovascular Diseases claimed more than 17.5 million cases worldwide, of which at least a third of them previously had heart attacks. Surviving a major cardiac event is an extremely fortunate thing. However, most survivors go to a state of complete rest with no or minimal exercises soon after leaving the hospital. It is true that one must avoid excessive physical exertion after a heart attack. However, appropriate exercises along with medication and therapies including occupational and physical therapy, will help in improving blood circulation and overall well-being. Thus cardiac rehabilitation is a highly recommended program to eliminate the risk of a second cardiac event, or post operative complications in a survivor and improve overall emotional well-being of an individual.

Cardiac rehabilitation is a multidisciplinary recovery program designed to strengthen the heart, body and mind aof people who recovered from cardiac events.  With the intent to inculcate heart-healthy habits in an individual, a variety of physical activities are taught along with providing necessary one-on-one support and awareness to relieve stress and enhance mental health. Each patient has a different pace of recovery. In general, cardiac rehabilitation is offered for a period of 12 weeks, ideally in an inpatient setting. However, depending on the individual condition, the program could run for longer duration.

Studies observe, people who undergo cardiac rehabilitation have 30 per cent less repeat cardiac events. They were also found to be healthier and could walk longer distances. Supervised exercise programmes can reduce blood pressure, stress levels, body weight; at the same time improve balance and flexibility.

Although individual conditions decide the ideal time by when one could return to or start exercising after a heart attack, but in general you should be able to start in six weeks. Individuals who don’t participate in cardiac rehabilitation will need to take the doctor’s consent before starting to exercise. One could slowly begin by doing gentle exercises like walking. For the first week, you could walk for five minutes at a time. The momentum could be gradually built and extended to 10 minutes by next week and 30 minutes after six weeks. This again depends on how active you were previously. Hence, consulting a doctor in choosing the right type of physical activity is of paramount importance.

Listed below are few other safety tips that could be followed for safely resuming to or newly getting into active lifestyles,

• Start walking slowly, gradually increase speed and lower the pace before stopping completely.
• Don’t exert yourself at the end of the day when you are already worn out. The best time to exercise is early in the day or when you feel fresh and relaxed. Make sure you are hydrated before and during the activity. Never do any physical activity soon after a bath or taking meals.
• Gradually, minimise sitting time and aim to do moderate intensity activities for at least 40 minutes, 4 days a week.
• To feel more motivated and comfortable, you could consider exercising with a personal trainer or a close family member.
• Monitor your progress and continuously update doctor on the achieved and newly planned goals.
• Climb stairs slowly until you are able to do it at the same pace of a normal walking.
• As your fitness and confidence increases over the weeks, you can slowly move from mild to moderate intensity activities like cycling, swimming or even light weight training.

Here are some Cardiac Rehabilitation exercises you can do at home: elbow bends, bent arm raises, side elbow extensions, straight arm raises, arm circles, marching at a place, waist bends, waist twists, knee touches and knee bends.  Structured exercises, monitored and supervised by a medical team and custom tailored to the patient’s condition are helpful in reducing the risk of a repeat cardiac event.

The writer is Dr vijay janagama Director, New Initiatives SuVitas Holistic Healthcare