cardiac rehabilitation

Introduction to Phase IV Cardiac Rehabilitation


This program is designed for individuals who have completed their Phase III cardiac rehabilitation program and wish to continue a healthy and active lifestyle.

Please ensure you have been referred to this program via your GP, the Cardiac Rehab team or your Phase IV instructor before you start using it.

IMPORTANT: The following exercises should be performed slowly and in a controlled manner. If you have any new symptoms, chest pains or any form of discomfort, please cease exercising immediately. Contact a medically professional if the new symptoms continue to trouble you after you have stopped exercising and a period of rest.

The Borg Rating of Perceived Exertion(RPE) Scale:

You should be familiar with the Borg scale from your Phase III cardiac rehabilitation classes.

The Borg RPE scale allows you to rate your level of exertion by choosing a number from the scale that best describes it during physical activity. 

We ask you to be honest with yourself and work within your limitations. Try to only work between 11 and 14. This should equate to breathing slightly heavier than when you do normal daily tasks.

  • The Borg RPE Scale

    1. No exertion at all
    2. Extremely light
    3. Very light
    4. Light
    5. Somewhat hard
    6. Hard (heavy)
    7. Very Hard
    8. Extremely hard
    9. Maximal exertion

Warm up

It is very important that you warm up gradually, to promote adequate blood supply to the heart. If you ignore this and jump straight into it, then you will increase the risk of suffering another cardiac event.

The warm up is divided in 4 parts, but the transitions and execution should flow seamlessly. Please watch the videos for clarification and assistance.

IMPORTANT: During stretches, the active recovery stations or if you are stationary at any point, please make sure you wiggle your toes at all times. This reduces the risk of developing any new signs or symptoms.

  • Part 1 – RPE from 7 to 8


    Slowly perform the following exercises in 30 seconds intervals.

    1. Slow March
    2. Heel Digs
    3. Slow March
    4. Toe Taps
    5. Slow March
    6. Side Taps
    7. Slow March
    8. Back Taps
    9. Slow March
  • Part 2 – RPE from 9 to 11


    Perform the exercises ever so slightly faster than previously and include small arm movements. In 20 seconds intervals.

    1. Slow March
    2. Heel Digs
    3. Slow March
    4. Toe Taps
    5. Slow March
    6. Side Taps
    7. Slow March
    8. Back Taps
    9. Slow March
  • Part 3 – RPE maintain 11


    Perform the following stretches in 10 seconds intervals and include 10 second marches between each stretch for the legs and 10 seconds intervals for the upper body stretches while marching on the spot. Remember to wiggle your toes while stretching.

    1. Left Calf – 10s
    2. Slow March – 10s
    3. Right Calf – 10s
    4. Slow March – 10s
    5. Left Hamstring – 10s
    6. Slow March – 10s
    7. Richt Hamstring – 10s
    8. Slow March – 10s
    9. Left Quad – 10s
    10. Slow March – 10s
    11. Right Quad – 10s
    12. Slow March – 10s
    13. Upper Back – 10s while marching
    14. Chest – 10s while marching
    15. Triceps Left – 10s while marching
    16. Triceps Right – 10s while marching
    17. Shoulders Left– 10s while marching
    18. Shoulder Right – 10s while marching
  • Part 4 – RPE from 11 to 14 (or target RPE)


    This is the same routine as Part 1 & 2, but this time include big arm movements and increase the pace until you reach your target RPE.

    1. Slow March
    2. Heel Digs
    3. Slow March
    4. Toe Taps
    5. Slow March
    6. Side Taps
    7. Slow March
    8. Back Taps
    9. Slow March
  • The entire warm up Part 1 – Part 4

Conditioning

CV

  • CV1 – Knee Raises

  • CV2 – Side Steps

  • CV3 – Back Taps

  • CV4 – Marching

  • CV5 – Hamstring Kicks

AR

  • AR1 – Rows

  • AR2 – Chest Press

  • AR3 – Lateral Raises

  • AR4 – Triceps Kick Backs

  • AR5 – Biceps Curls

The conditioning phase is based on interval training. It’s a circuit comprising of two exercise groups i.e. Cardiovascular Training (CV) and Active Recovery (AR). Remember to wiggle your toes when performing the AR exercises.

Please watch the exercise demonstration videos for clarification and assistance. Each exercise is to be performed for 60 seconds until moving on to the next one. The sequence will differ for each progression level. Please see table below:

  • Progression table

    Progression level

    CV : AR

    Total CV time

    Total AR Time

    Total time

    Level 1

    1:1

    15

    15

    30

    Level 2

    2:1

    20

    10

    30

    Level 3

    3:1

    23

    7

    30

    Level 4

    4:1

    24

    6

    30

    Level 5

    5:1

    25

    5

    30

    Level 6

    6:1

    26

    4

    30

    Level 7

    7:1

    27

    3

    30

    Level 8

    8:1

    28

    2

    30

    Level 9

    9:1

    29

    1

    30

    Level 10

    10:0

    30

    0

    30

For example, if your progression level is 3, then the sequence will look like this:

CV1, CV2, CV3, AR1, CV4, CV5, CV1, AR2, CV2, CV3, CV4, AR3… etc.

It’s important that you stay in your RPE range 11-14. Please let your Phase IV instructor advice you on which level you should be doing.

Cool down

Here we concentrate on slowly reducing the intensity and aim to return to pre-exercise levels i.e. 6 on the Borg Scale.

Please watch the videos for clarification and assistance.

  • Part 1 – RPE from 14 to 11


    Perform the following exercises in 30 seconds intervals, include big arm movements and gradually decrease the pace and movements.

    1. Side Taps
    2. Back Taps
    3. Heel Digs
    4. Toe Taps
    5. Slow March
  • Part 2 – RPE from 11 to 9


    If you’ve reached Level 7 to 10 then perform the AR exercises in 30 seconds interval.

    • AR1: Seated Band Row
    • AR2: Seated Band Chest Press
    • AR3: Band Lateral Raise
    • AR4: Band Triceps Kick Backs


    For all other levels perform the exercises slightly slower than previously and make arm movements smaller. In 30 seconds intervals.

    1. Side Taps
    2. Back Taps
    3. Heel Digs
    4. Toe Taps
    5. Slow March
  • Part 3 – RPE from 9 to 8


    Perform the following exercises calmly and slowly without arm movements. In 30 seconds intervals.

    1. Side Taps
    2. Back Taps
    3. Heel Digs
    4. Toe Taps
  • Part 4 – RPE from 8 to 6 (pre-exercise level)


    By now you should be at a pre-exercise level. Perform the following stretches in 15 seconds intervals.

    1. Right Calf
    2. Left Calf
    3. Right Hamstring
    4. Left Hamstring
    5. Right Quad
    6. Left Quad
    7. Upper Back
    8. Chest
    9. Right Triceps
    10. Left Triceps
    11. Right Shoulders
    12. Left Shoulders
  • The entire cool down Part 1 – Part 4


    Progression Level 7 – 10 cool down


    Standard cool down

It is recommended that you self-observe for any signs and symptoms. Ensure you feel as if you could repeat the routine. 

Online Home Cardiac Rehab Programs

Below you’ll find a list of Online Home Programs for each progression level. These are easy to follow and great to log your activity. They even include exercise demonstration videos for every exercise. Please sign up and simply add them to your profile.

It is free; you are welcome!

  • Progression Level 1 workout

    Log your activity on our web app. Sign up for free and add the program to your profile.

  • Progression Level 2 workout

    Log your activity on our web app. Sign up for free and add the program to your profile.

  • Progression Level 3 workout

    Log your activity on our web app. Sign up for free and add the program to your profile.

  • Progression Level 4 workout

    Log your activity on our web app. Sign up for free and add the program to your profile.

  • Progression Level 5 workout

    Log your activity on our web app. Sign up for free and add the program to your profile.

  • Progression Level 6 workout

    Log your activity on our web app. Sign up for free and add the program to your profile.

  • Progression Level 7 workout

    Log your activity on our web app. Sign up for free and add the program to your profile.

  • Progression Level 8 workout

    Log your activity on our web app. Sign up for free and add the program to your profile.

  • Progression Level 9 workout

    Log your activity on our web app. Sign up for free and add the program to your profile.

  • Progression Level 10 workout

    Log your activity on our web app. Sign up for free and add the program to your profile.

CategoryRehab
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