Kenneth Gardner

Exercise that is properly prescribed can be an effective part of the treatment programme for persons with a heart condition.

The fundamental purpose of exercise for persons with a heart problem is threefold:

1. To prevent heart problems and enhance positive health.

2. To slow down the progression of the problem.

3. To rehabilitate or restore normal heart function.

Prescribing exercise for persons with a heart condition can follow the basic prescription guidelines used for the general population. Modifications can then be made to address the unique needs of those with the heart condition. The exercise routine should focus on the specific exercises that are required to bring about the changes that the individual will experience in improving his functional capacity.

The effort that the individual needs to exert will require one that is greater than that which he is accustomed. This will produce an increase in the functional capacity of the individual.

If the individual is extremely de-conditioned or has a serious heart condition it may be more appropriate to use lower work loads especially when designing the beginning or initial phase of the programme.

Safety is the most important factor that must be addressed when we are developing an exercise prescription for persons with a heart problem. Several methods can be used to compute an exercise work load for these individuals. However, the underlying guideline for developing an appropriate prescription is that the work load must be both safe and realistic.

Making a safe exercise prescription is based on the concept of a graded exercise test to evaluate the individual's ability to tolerate gradual increases in the intensity of the exercise. The point at which the individual demonstrates an abnormal response pattern to the work load can be assessed based on the maximum level of exercise before signs or symptoms of discomfort occur.

Unsafe to continue

Another important factor is identifying individuals whose participation may not be recommended because of specific health or medical conditions. Permission should be sought from a physician. Once we begin an exercise programme it is important to know when it is unsafe to continue to exercise.

Pain or discomfort in the chest, abdomen, back, neck, jaw or arms are important warning signs. We should never exercise to the point where we develop even a mild form of these symptoms. When we experience those discomforts we need to slow down or even stop and see if they subside within two or three minutes. If the symptoms continue for a prolonged period we run the risk of sustaining serious injuries. Unaccustomed shortness of breath during exercise is cause for alarm. If you become dizzy or experience fainting during or immediately after you exercise you should lie down on your back with your head either level with your body or below your feet.

Warning signs

Everybody who exercises should be familiar with certain warning signs that may indicate that your heart and blood vessels are not coping with or adapting to the exercise.

One of the first decisions to be made concerning an exercise prescription is the type of activity to be used. All physical activities can generally be classified into three types of exercises — aerobic, flexibility and resistance. We should be prudent in the choices made so that we get the best results.

Aerobic exercises are best for the heart and blood vessels. They are also the most beneficial for making changes to the body composition. Flexibility exercises are specific for improving the range of motion of the joints and muscles. Resistance exercises are specific for training the muscles to develop their strength and endurance. However, the most efficient exercise programme overall is one that incorporates activities that include each of the three types.

Kenneth Gardner is an exercise physiologist at the G. C. Foster College of Physical Education: email: yourhealth@gleanerjm.com.