To reduce the risk of future heart problems, exercise is an integral component after heart bypass surgery. Light physical activity is typically initiated in the hospital, supervised by a cardiac rehab nurse or therapist. The medical staff will also provide discharge instructions, outlining activity guidelines. For most, light walking is the preferred mode of exercise for the first month after surgery.
Start With Aerobic Conditioning
According to the American College of Sports Medicine, the initial goal of cardiovascular conditioning is 20 minutes, about three times per week. The 20-minute sessions can be continuous or even cumulative. Exercise intensity should be low to moderate and can be assessed using a heart rate monitor or by periodically checking your pulse. For most, perceived exertion is also a valid gauge. Exercise should be "fairly light" to "somewhat hard," or an 11 to 13 on the 20-point Borg scale. Daily activity -- like parking farther away when going to the grocery store -- is encouraged.
Exercise Progression
By months two through six, as cardiovascular fitness improves, aerobic exercise should be performed three to five times per week, for 25 to 30 minutes. Exercise modes can include walking outside, or using cardio machines like a treadmill, cycle, rower, elliptical trainer or arm ergometer. The eventual goal is to achieve 60 minutes of continuous aerobic activity, three to five days per week. To maintain heart health and prevent future cardiac events, ACSM recommends expending 1,000 exercise calories every week.
Add Resistance Training
Resistance training can be initiated no sooner than five weeks after surgery. ACSM also recommends an aerobic training base of four weeks before starting any weight-lifting activities. The initial goal is to complete six to 10 different exercises at a light resistance -- low enough to enable eight to 15 repetitions. The major muscle groups to be worked include: quadriceps, hamstrings and glutes, abs, chest, back, shoulders, biceps and triceps. Resistance training can be performed on machines, but free weights and pulley systems are also effective. To reduce the likelihood of overtaxing the heart and cardiovascular system, do not grip the weights too tight or hold your breath while lifting weights. Both of these can cause a dangerous rise in blood pressure.
Program Design
It is important for your exercise session to include a five to 10-minute warmup before the aerobic or strength-training components. This allows the heart to gradually get ready for the exercise session. Equally important is a cool-down period, which also lasts for five to 10 minutes. It is appropriate to incorporate flexibility training at the end of the cool-down period. Before heading to the shower or resuming regular activity, the heart rate and breathing should be back to the normal, pre-exercise levels. Exercise should be immediately discontinued if you experience any chest pain or become dizzy or light-headed. Call 911 if symptoms worsen.
References
- "ACSM's Guidelines for Exercise Testing and Prescription, 7th Edition"; ACSM; 2006
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