Exercise Guidelines During Cardiac Rehabilitation

When you are recovering from a heart condition or surgery, it is important to have heart-healthy habits, including exercise routines. Discuss an appropriate exercise program with your heart specialist (cardiologist) and rehabilitation therapist.

The program should meet your specific abilities and needs. Walking, biking, jogging, and swimming are all good aerobic activities and take light to moderate effort. Aerobic activities cause your heart to beat faster. Adding some light resistance training is also good for you. Even simple lifestyle changes can help. These lifestyle changes may include parking farther from the store or taking the stairs instead of the elevator.

At first, you may begin exercising under supervision, such as at a hospital or clinic. Over time, you may begin exercising at home if your health care provider approves.

Types of exercise

Below are types of exercises that are an important part of cardiac rehabilitation. Follow your health care provider’s instructions on what types of exercises are good for you and your heart.

Aerobic exercise

Aerobic exercise keeps joints and muscles moving and is important to keep your heart healthy. It involves large muscle groups and improves blood flow (circulation) and endurance. It is also rhythmic and must be done for a longer period of time. Examples of aerobic exercise include:

  • Swimming.

  • Walking.

  • Hiking.

  • Jogging.

  • Cross-country skiing.

  • Dancing.

  • Biking.

Static exercise

Static exercise (isometric exercise) uses muscles at high intensities without moving the joints. Some examples of static exercise include pushing against a heavy couch that does not move, doing a wall sit, or holding a plank position. Static exercise improves strength but also quickly increases blood pressure. Follow these guidelines:

  • If you have circulation problems or high blood pressure, talk with your health care provider before starting any static exercise routines. Do not do static exercises if your health care provider tells you not to.

  • Do not hold your breath while doing static exercises. Holding your breath during static exercises can raise your blood pressure to a dangerously high level.

Weight-resistance exercise

Weight-resistance exercises are another important part of rehabilitation. These exercises strengthen your muscles by making them work against resistance. Resistance exercises may help you return to activities of daily living sooner and improve your quality of life. They also help reduce cardiac risk factors. Examples of weight-resistance exercise include using:

  • Free weights.

  • Weight-lifting machines.

  • Large, specially designed rubber bands.

You will usually do weight-resistance exercises 2 times a week, with a 2-day rest period between workouts.


Stretching before you exercise warms up your muscles and prevents injury. Stretching also improves your flexibility, balance, coordination, and range of motion. Follow these guidelines:

  • Stretch before and after exercising.

  • Do not force a muscle or joint into a painful angle. Stretching should be a relaxing part of your exercise routine.

  • When you feel resistance in your muscle, hold the stretch for a few seconds. Make sure you keep breathing while you hold the stretch.

  • Go slowly when doing all stretches.

Setting a pace

  • Choose a pace that is comfortable for you.

    • You should be able to talk while exercising. If you are short of breath or unable to speak while you exercise, slow down.

    • If you can sing while exercising, you are not exercising hard enough.

  • Keep track of how hard you are working as you exercise (exertion level). Your rehabilitation therapist can teach you to use a mental scale to measure your level of exertion (perceived exertion). Using a mental scale, you will think about your exertion level and rate it in a range from 6 to 20.

    • A rating of 6 to 10. This means that you are doing very light exercise and are not exerting yourself enough. For a healthy person, this may be walking at a slow pace.

    • A rating of 11 to 15. This is exercise that is somewhat hard. For a healthy exercise session, you should aim for an exertion rate that is within this range.

    • A rating of 16 to 18. This is considered very hard or strenuous. For a healthy person, exercise at this rating may start to feel heavy and difficult.

    • A rating of 19 or 20. This means that you are working extremely hard. For most people, these numbers represent the hardest you have ever worked to exercise.

  • Your health care provider or cardiac rehabilitation specialist may also recommend that you wear a heart rate monitor while you exercise. This will help keep track of your heart rate zones and how hard your heart is working.


As you are recovering, it is important to start exercising slowly and to gradually work up to your goal. Work with your health care provider to set up an exercise routine that works for you. Generally, cardiac rehabilitation exercise should include:

  • 40 minutes of aerobic activity 3–4 days a week.

  • Stretching and strength exercises 2–3 days a week.

Contact a health care provider if:

  • You have any of the following symptoms while exercising:

    • Pain, pressure, or burning in your chest, jaw, shoulder, or back (angina).

    • Feeling light-headed or dizzy.

    • Irregular or fast heartbeats (palpitations).

    • Shortness of breath.

  • You are extremely tired after exercising.

Get help right away if you:

  • Have angina that lasts for longer than 5 minutes and medicine does not help.

  • Have severe chest discomfort, especially if the pain is crushing or pressure-like and spreads to your arms, back, neck, or jaw. Do not wait to see if the pain will go away.

  • Have weakness or numbness in one or both legs.

  • Are confused.

  • Have trouble breathing or shortness of breath.

  • Have excessive sweating that is not caused by exercise.

  • Have any symptoms of a stroke. “BE FAST” is an easy way to remember the main warning signs of a stroke:

    • B – Balance. Signs are dizziness, sudden trouble walking, or loss of balance.

    • E – Eyes. Signs are trouble seeing or a sudden change in vision.

    • F – Face. Signs are sudden weakness or numbness of the face, or the face or eyelid drooping on one side.

    • A – Arms. Signs are weakness or numbness in an arm. This happens suddenly and usually on one side of the body.

    • S – Speech. Signs are sudden trouble speaking, slurred speech, or trouble understanding what people say.

    • T – Time. Time to call emergency services. Write down what time symptoms started.

  • Have other signs of a stroke, such as:

    • A sudden, severe headache with no known cause.

    • Nausea or vomiting.

    • Seizure.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.


  • When you are recovering from a heart condition, it is important to have heart-healthy habits, including exercise routines.

  • At first, you may begin exercising under supervision, such as at a hospital or clinic. Over time, you may begin exercising at home if your health care provider approves.

  • Choose a pace that is comfortable for you. You should be able to talk while exercising.

  • Aim for 40 minutes of aerobic exercises 3–4 days a week.

  • Aim to do stretching and strength exercises 2–3 days a week.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.

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