Your cardiovascular prevention and rehab team prescribes your aerobic exercise in a similar way to how your doctor prescribes your medication.
- Your doctor tells you to take a particular type of medication a certain number of times each day, at a certain dosage, and for a certain period of time.
- Your exercise prescription works the same way.
An easy way to remember how your program is prescribed is to use the FITT principle.
Frequency of Exercise
Complete your prescribed exercise 5 times per week.
- Doing your prescribed exercise less than 5 times per week may not giv you the full benefits of the exercise.
- Doing your prescribed exercise more than 5 times per week may increase your risk of developing muscle or joint injuries, feeling more tired or feeling unwell, and having more irregular heart rhythms.
It’s good to be active daily where you can do lower-level activities, sports or other recreational play. These types of activities are not considered “prescribed exercise” but activities of daily living.
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Intensity of Exercise
Determining how hard or at what level to exercise can be challenging.
If you are not attending a cardiac rehabilitation program, ask your doctor to refer you so that you can work with a team of experts that can set you on the right path to getting fitter and healthier.
A cardiovascular prevention and rehabilitation team can develop an exercise prescription with the best and safest level of exercise for you. Your exercise prescription will have:
- a training heart rate range with a lower and higher limit
- a walking speed if you are walking for exercise
Your exercise prescription is developed based on:
- your medical history, including:
- what happened to your heart
- other health concerns you have
- medicines you take
- the results of a cardiopulmonary assessment (stress test)
- The stress test tells us your V02, which is how well you take in oxygen and deliver it to your working or exercising muscles. V02 is an indicator of your fitness level.
- The assessment also tells us if you have any problems with your heart rate, blood pressure, or how your heart beats.
Your cardiovascular prevention and rehab team will make sure that your exercise is prescribed below any levels where you have problems.
Tips to make sure you are exercising at the right level
1. Check your heart rate
Each time your heart beats, you feel it in the large arteries of your body as a pulsing sensation. Heart rates can be different between people.
The heart rate increases during exercise because the heart needs to beat faster and harder to supply more oxygen to your working muscles.
Measuring your heart rate during exercise will allow you to know if it is within the target range given by your cardiovascular prevention and rehabilitation team.
- If it is above your target range, slow your pace or intensity and tell your cardiovascular prevention and rehabilitation team.
- If it is below your target range, tell your cardiovascular prevention and rehabilitation team so that they can modify your exercise prescription.
Where to find your heart rate
To feel your pulse, put 2 or 3 fingers on your skin at your wrist below the base of your thumb
You can also feel your pulse by putting 2 or 3 fingers on the side of your neck in the hollow area beside your Adam's apple.
There are 2 areas where you can find your heart rate:
- Wrist, below the base of the thumb (radial artery)
- Place 2 to 3 fingers on your wrist below the base of your thumb.
- Press lightly until you feel your heartbeat.
- Neck below the angle of the jaw (carotid artery)
- Place 2-3 fingers on the side of your neck (beside the groove under your jaw) in the hollow area.
- Press lightly until you feel your heartbeat.
How to count your heart rate
Using a stopwatch or the second hand on your watch:
- find your heart rate, either in your wrist or your neck
- count the number of beats you feel while you time yourself for 10 seconds
- multiply this number by 6 to get your heart rate in beats per minute (bpm)
When to take your heart rate
- Before you begin your exercise warm-up, when you are at rest.
- Immediately at the end of your exercise, before you cool down.
2. Use the rating of perceived exertion scale (RPE scale)
The Borg Rating of Perceived Exertion (RPE) scale will help you know how hard you’re working. See the scale below.
| Number Rating | Verbal Rating | Example |
|---|
| 6 | | No effort at all. Sitting and doing nothing. |
| 7 | Very, very light | Your effort is just noticeable. |
| 8 | | |
| 9 | Very light | Walking slowly at your own pace. |
| 10 | | Light effort. |
| 11 | Fairly light | Still feels like you have enough energy to continue exercising |
| 12 | | |
| 13 | Somewhat hard | |
| 14 | | Strong effort needed |
| 15 | Hard | |
| 16 | | Very strong effort needed. |
| 17 | Very Hard | You can still go on but you really have to push yourself. The exercise feels very heavy and you're very tired. |
| 18 | | |
| 19 | Very, very hard | For most people, this is the most strenuous exercise they have ever done. Almost maximal effort. |
| 20 | | Absolute maximal effort (highest possible). Exhaustion |
BORG, G. (1970) Perceived Exertion as an indicator of somatic stress.
Scandinavian journal of Rehabilitation Medicine, 2 (2), p. 92-98
To find your rating on the scale, think about your
overall feelings of physical stress, effort, and fatigue.
- Don’t focus too much on any single thing, like leg tiredness or shortness of breath.
- Try to concentrate on your total, inner feeling of exertion.
Find the best description of your level of effort from the examples on the right side of the table, and then find the number rating that matches that description.
- Ideally, your RPE will be between 11 and 14.
- If your RPE is above 14 then the intensity is too high and will need to be adjusted.
3. Do the walk/talk test
You should be able to exercise and carry on a conversation without being overly short of breath. If you are not able to talk comfortably then the intensity may be too high and you may need to lower it. It is okay to hear yourself breathe while exercising.
4. Aim to have no symptoms while exercising
The “no pain, no gain” philosophy will take you outside a safe and optimal exercise intensity level.
If you feel any symptoms during your exercise prescription, it is important to lower the intensity of your exercise and speak with your cardiovascular prevention and rehabilitation team so that your prescription can be adjusted.
Symptoms you should take note of include:
- angina
- chest pain
- excessive shortness of breath
- dizziness
- light-headedness
- muscle soreness
- joint soreness
5. Do not do more than your exercise prescription
Your exercise prescription is designed specifically for you and is set at a safe and optimal level.
If you have questions or concerns regarding the intensity of the exercise, discuss it with your cardiovascular prevention and rehabilitation team and they will be able to explain how your program was developed.
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Time/Duration of Exercise
For aerobic exercise, the duration of the activity could start at 10 minutes and progress up to 60 minutes. The duration of your exercise depends on your fitness level, medical history and goals.
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Type of Exercise
Aerobic exercise is continuous whole body rhythmic exercise that involves the large muscle groups of the body. This could include activities such as walking, cycling, jogging, and swimming.
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