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The Secret to exercising right

As a Physiotherapist managing cardio-metabolic conditions and catering to individuals with various exercise needs I am often faced with questions like “How much of exercise do I need?” and “Can over-exercising be bad for me?”. If you have had similar questions, read on to find out the answer.

The short answer is: similar to medication, exercise requires the right dosage to be both secure and efficient. And just like how medicines are prescribed based on your clinical condition, medical history, weight and height, exercise prescription is also tailored to each individual’s health status and fitness level. So, how does one get the right dose of exercise?

The secret of exercising right lies in the FITT Principle – Frequency, Intensity, Time and Type of exercise.

Let me walk you through the FITT Principle, which is the basic framework that we as exercise professionals follow to determine the right dose of exercise for our clients.

  • Frequency – This is simply HOW OFTEN you exercise or the number of days per week dedicated to an exercise routine; eg. 1 or 2 days per week, at least 3 days per week, 5 or more days per week etc.

Intensity – this is nothing but HOW HARD you exercise. It can vary between light, moderate and vigorous intensity. You would usually assess the intensity of your exercise by simple measures such as how breathless you are, you much you sweat and how fast your heart is beating. Some of you may use mobile apps or wearable devices that tells you your heart rate, respiratory rate etc. A useful method to assess the intensity of your exercise is the talk test; you can easily sing a song during light exercise, you can talk sentences but not sing during moderate exercise, and you will not be able to say more than a few words without pausing for a breath during a vigorous exercise.

Here are some examples of exercises in each intensity category:

  • Light – normal walking, gentle yoga
  • Moderate – brisk walking, cycling, dancing
  • Vigorous – running, swimming, competitive sports
  • Time – this is simply HOW LONG you exercise each time. It could be as short as 5 minutes or as long as 2 hours! Having an idea of the time you usually spend on exercise on a regular day and on a busy day is a must.
  • Type – this refers to the TYPE of exercise such as cardio or aerobic exercise, resistance training or anaerobic exercise, balance exercise and flexibility exercise. Each and every exercise you normally engage in can be categorised into 1 or more of the above types. Having a varied exercise routine incorporating all the types of exercise is key to overall fitness.

Benefits of using a correct dosage (FITT principle) for exercise:

  • It provides a framework which you can follow for developing an effective exercise program
  • It allows you to design a routine that ensures that you will attain a high level of physical fitness
  • It can be customised to meet your specific fitness goals 

A sample Exercise Framework for individuals with Cardio-metabolic conditions like obesity, hypertension, diabetes, and cardiac issues, using the FITT principle is as below:

FREQUENCY 5 to 6 days / week
INTENSITY MODERATE INTENSITY
TIME 30-45 MINUTES
TYPE AEROBIC + STRENGTH TRAINING + BALANCE EXERCISES

In summary, the acronym FITT represents Frequency, Intensity, Time and Type. These are key factors in designing an exercise program which fits your fitness level and goal. Consulting your physician, getting your baseline parameters checked and seeking professional help for designing an exercise routine that is suitable for you is important for everyone, and more so if you have had a medical diagnosis and are under any medications.

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Role of Exercise in Hypertension

This World Hypertension Day, Cardiac Wellness Institute aims to improve awareness about hypertension and it’s causes and provide some practical tips to keep blood pressure under control.

World Hypertension Day: 17 May

The term blood pressure or BP refers to the force of blood flow in our arteries, produced by the pumping action of the heart, and should be lower than 120 / 80 mmHg in healthy adults. As a fitness expert, the most important parameter that I rely on to assess a person’s heart health is their BP.

High BP or hypertension is a silent killer as most people do not know their BP is high and may end up with a heart attack, heart failure, stroke, or renal failure without any warning. The only way to diagnose hypertension in an individual is by checking the BP using a BP monitor (at a doctor’s office or at home).

The factors known to cause hypertension are lack of physical activity, unhealthy diet along with excess salt intake, being overweight or obese, psychological stress, tobacco use, alcohol consumption, and a family history of hypertension.

There are 4 stages of hypertension as shown below.

Prehypertension:  120-139 / 80-89: At this stage we can control the BP by lifestyle modifications such as eating healthy fibre-rich foods, exercising regularly, reducing weight, and managing stress adequately.

Hypertension Stage I (140-159 / 90-99) and Stage II (160/100 and above): The plan here is to bring the BP under control at the earliest with medications and lifestyle modifications.

Hypertensive crisis (above 180/110): This is a medical emergency and will need urgent intervention to avoid multi organ damage and sudden death.

How regular exercise affects BP:

Regular exercise makes the heart healthier. A strong heart can pump more blood with less effort. As a result, the force on the arteries decreases, lowering the BP.

Regular exercise also helps to maintain a healthy weight which is another important way to control BP. Even losing small amounts of weight can lower the BP. In fact, adequate BP control in heart patients paves the way for reducing medications and reversal of the heart disease.

To keep the BP under control, one has to exercise regularly. It takes about one to three months for regular exercise to have an impact on the BP. It is important to note that the benefits last only as long as you continue to exercise. A combination of aerobic and strength training exercises has been shown to provide the most heart health benefits.

As you see in the American Heart Association’s guidelines below, we have to engage in at least 30 minutes of aerobic activity such as brisk walking, cycling, swimming etc. on 5 days of the week and also do muscle strengthening exercises on 2-3 days per week. Examples of resistance exercises that will improve our muscle strength are exercises using our own body weight like pushups, planks, squats etc. or using equipment like weight cuffs, resistance bands, dumbbells etc.

American Heart Association Recommendations for Physical Activity -  Infographic

Practical tips to keep BP under control:

  • Taking medications as advised
  • Being physically active regularly
  • Reducing salt intake (to less than 5 grams daily)
  • Eating more fruit and vegetables
  • Limiting the intake of foods rich in unhealthy fats and trans fats (eg. fried / baked / packaged foods)
  • Staying hydrated
  • Getting at least 6-8 hours of sleep per day
  • Avoiding the use of tobacco in any form
  • Reducing alcohol consumption
  • Splitting your exercise session into short bouts of 10-15 minutes 2 or 3 times a day if you are hard pressed for time

Patient stories:

Let me share a couple of real-life examples of how a lifestyle approach has helped in controlling BP in our clients.

A 54-year-old Civil Engineer, treated for hypertension and cholesterol issues for about 20 years, suffered a heart attack and underwent a bypass surgery. He enrolled in a 3-month cardiac rehabilitation program with us during which time we focused on supervised exercise training along with dietary modification and stress management counselling. He showed a lot of dedication and commitment to improve his health and we were glad to see his BP, cholesterol and other parameters coming under control beautifully.

A middle-aged working mother enrolled in our lifestyle program with a desire to reverse her hypertension and come off her BP medications which she had been taking for about 8 years. She had a young child and a demanding job, both of which had slowed down her self care attempts. We guided her on strategies to reduce her BP through exercise (effective walking and strengthening exercises for the limbs and core), following a balanced healthy diet rich in fibre and whole grains and focusing on breathing exercises to manage her stress better. Her overall wellbeing and lifestyle choices have improving significantly within a few weeks of joining our program and she is well on her way to achieving her health goal.

To summarise, hypertension is a silent killer but we can prevent, control and reverse high BP by being aware and acting in a timely manner. The mantra to follow is know your BP, consult your doctor, modify your health behaviour and keep your heart healthy.

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Stay Fit at Home without any Equipment

Exercise is nothing but physical activity done in a structured, planned and repetitive manner. The importance of regular exercise in maintaining health and preventing disease is well known. But many of you might be of the impression that walking is the only exercise that can be done without equipment. While brisk walking is a great way to stay fit and can be done almost universally, there are infinite numbers of other exercises that do not require any equipment and can be performed at home.

In this current situation of being confined to your homes due to the COVID-19 outbreak and the work-from-home demands for many of you, keeping yourself active and exercising regularly should be your main goal. This habit of exercising will not only help avoid a sedentary lifestyle but will also help you be more productive in your work. Go ahead, read on and find out how to perform exercises at home without any equipment.

A robust exercise routine should include a warm-up phase (5-10 minutes), an active aerobic exercise phase (30-45 minutes) and a cool-down phase (5-10 minutes), adding up to a total of at least 40 minutes of exercise. This regime should be followed on at least 5 days weekly.

Warm-up is a pre-exercise phase which involves active movements of all joints right from your head to your toes. A good warm-up prepares you adequately for the exercise phase and also helps avoid injuries to muscles, joints and ligaments. Here are 6 warm-up exercises everyone should do. Each warm-up exercise should be done 10 times.

Aerobic exercises that you might have been doing are walking, running, cycling, swimming etc. Some alternatives that can be done inside your house are:

On spot jogging/marches (10 – 20 minutes)
On spot pogo jumps
Jumping jacks
High knees
Butt kicks
Step up & down

On spot marching or jogging can be done for 10-20 minutes. Each of the other 5 exercises can be done for 15 – 30 times (repetitions) per set for 2-3 sets. For step up & down, you can use your stairs as a platform to climb up an down. Repetition is the number of times you perform a particular exercise and Set is the number of cycles of repetitions one completes. A rest period of 30-60 seconds is advised in between each set.

Cool-down is a post-exercise phase which involves active stretching of the major joints to avoid muscle cramps or soreness after exercising. Each stretch position should be held for about 20-30 seconds and repeated 2-3 times. Remember to be gentle while releasing from the stretched position to avoid muscle catch.

Those who are acquainted with exercising in fitness centres and groups can perform these home exercises easily. However, beginners should take note of the following precautions to avoid injuries and other complications while exercising at home:

  • Start with 5-10 repetitions and take adequate rest in between each set
  • Total exercise time may be 15-20 minutes to begin with and gradually go up to 30-40 minutes within a months’ time
  • Keep a log of your exercise duration and the occurrence of pain, swelling, discomfort etc.
  • If you experience giddiness, chest pain, breathlessness or abnormal heartbeat, please stop the exercise immediately

In conclusion, you do not need modern equipment or machines to exercise but you definitely need the knowledge on how to perform the exercise, need to allot time for exercise and need dedication and determination to stay healthy without an external push.

Cardiac Wellness Institute has initiated the HeartHealth@Home program where we are open for online consultation and also provide home-based heart health programs and fitness and diet guidance for individuals. Please feel free to contact us for further information.

In fact, once you master these basic exercises, you can start incorporating strength training exercises and core strengthening exercises at home. I will guide you on these exercises in my subsequent blog post. Until then, STAY HOME, STAY FIT!

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Get set, Walk!

Believe it or not, walking is a great activity for physical and mental fitness. Being a physiotherapist, I will always recommend that my clients walk at least 40 minutes per day. And the cool part is it doesn’t need any equipment or trainer to monitor. That’s why walking is the best exercise to do whenever & wherever you are. It’s great for people who are trying to lose weight, the elderly, those who have diabetes, hypertension and other heart-related problems, and of course for anyone who wants to get fit. Brisk walking promotes good physical and mental health in middle-aged and elderly persons and hence it should become a priority to develop appropriate brisk walking programs in the community, say the authors of an article published in 2017 https://www.sciencedirect.com/science/article/pii/S1322769615001134.

Hippocrates, the Greek Physician born in 370 BC and fondly remembered as the “father of Medicine” said walking is the best medicine. It is the quintessential aerobic exercise that can be done by all irrespective of age, social status and cultural beliefs. The American Heart Association recommends brisk aerobic exercise for at least 30 minutes for 5 days a week to maintain health and fitness http://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults

Did you know? Regular walking has significant beneficial effects on our body. Here are just a few of the benefits of your daily walk:

  • Controls your body weight
  • Regulates your blood pressure
  • Improves your heart health
  • Boosts your immune system
  • Strengthens your bones & muscles
  • Reduces your risk of developing chronic disease like cancer and dementia
  • Uplifts your mood… and many more!

So let me help you start walking with some easy tips: For beginners, I recommend the “five front, five back” walk plan. That’s right, you walk out for five minutes, turn around, and walk back. Increase by five minutes per week and reach 40 minutes of walking in a day. I think this is a realistic and achievable way to get started for an aerobic exercise. And remember to warm-up and cool-down before and after your brisk walking. If you would like to know more about warm-up and cool-down exercises, please click the link to our earlier newsletter http://cardiacwellnessinstitute.com/images/Newsletter-June2017.pdf

How to implement the Habit of Walking and stay motivated:

  • Use stairs instead of lifts/escalators
  • Park your vehicle far away from your office/grocery store and walk for a while
  • Arrange a walking meeting and walking phone calls
  • Walk with your kids or dogs
  • Join in walking groups
  • Walk with your friends but focus on your walk
  • Chose 2 to 3 different areas for your walks so you feel motivated and enjoy your daily walk without getting bored

Guess you are convinced enough to start walking! We have planned a Walkathon just to get you started. Cardiac Wellness Institute is organising Walk Chennai Walk on 29th September 2018 (World Heart Day) from 6.00-7.30 am in Elliot’s beach, Besant Nagar, Chennai. We have some fun events and cool sponsors lined up for the event. So join in and be a part of a healthy society and a better future. Please register yourself, your friends and walking buddies on https://www.townscript.com/e/walk-chennai-walk-324404.

Please contact us for group bookings of more than 10 participants.

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Your first step to a healthy heart

Exercise is the best tool to live healthy; that too aerobic exercise plays a major role in strengthening the heart without stressing your body much. Aerobic exercise is the key for a long and healthy life. Aerobic activities improve the pumping capacity of the heart and make all your organs to work in a more efficient way.

What is Aerobic Exercise?

Aerobic exercise is defined as continuous movement of the body with moderate exertion for a long duration of time. These types of exercises, when practiced regularly prevent and control cardiovascular diseases such as hypertension, stroke and heart attack, as well other chronic ailments. The unique characteristics of aerobic exercises are:

  • Large muscle groups are used in our body
  • It delivers oxygen faster to the working muscles
  • It is a rhythmic sustained type of exercise less prone to injuries

Benefits of Aerobic Exercise

  • Lowers blood pressure
  • Improves blood circulation
  • Lowers resting heart rate
  • Improves functional capacity
  • Reduces shortness of breath
  • Improves cardio respiratory endurance
  • Improves heart and lung function
  • Reduces obesity
  • Improves quality of life
  • Reduces joint pains
  • Increases bone density and strength
  • Improves mental health
  • Prevents many cancers
  • Enables healthy aging

 Examples of Aerobic exercise

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Types of Aerobic Exercises

  • Continuous: Exercise should be done continuously for particular duration
  • Interval: Exercise should be done with proper rest periods for particular duration
  • Circuit: Series of exercises are repeated for particular duration
  • Circuit interval: Series of exercises repeated for particular duration with proper rest periods

How to start Aerobic Exercises?

Begin slowly and progress gradually.

Start with 5-10 min of aerobic exercise for 3-5 days/ week and progress to 5-7 days/week.

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Note:

Individuals with the following conditions should seek the advice of their doctor before beginning any exercise plan:

  • Uncontrolled hypertension
  • Myocardial infarction (heart attack, bypass surgery, stent procedure)
  • Chest pain or unexplained breathlessness
  • Fainting or giddiness
  • Cardiomyopathy (heart muscle disease)
  • Heart failure
  • Heart valve problems
  • Any cardiac surgery or procedure

If you would like to know more about what type of exercise is best suited for your health condition, please feel free to reach out to us by email info@cardiacwellnessinstitute.com or by phone +9144 43192828, +91 9940408828.

Don’t find time to exercise?

Make time for exercise!

 

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Fitness mantra for heart patients

Exercise is the most important aspect of life for staying healthy and being active for all human beings irrespective of age and gender. It helps and improves the functioning of the whole body in a much better way. The activity of exercise enhances the fitness of the body physically and mentally. If you have observed heart patients, most of them are advised to do exercise to overcome the risk of heart attacks or cardiac arrest further. One should not forget that heart patients are only eligible to do some particular exercises and not all are applicable and advisable for them.

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There are different types of exercises for Heart Patients to follow:

The simplest, yet an effective exercise for a heart patient is walking. It can improve the energy levels and keep them active throughout the day. It is the basic step towards the journey of beginning an exercise.

Aerobics plays an important part of exercise as it is highly advisable for almost all heart patients with mild movements. It shows better results in a very short span of time.

Cycling is the best remedial exercise for avoiding heart problems. The heart patient based on their health condition can either use a regular cycle or stationary cycle. Water aerobics and water cycling helps a lot for heart patients and relieves them from joint pains.

Stretching is important exercise for heart patients as it makes the body muscles flexible and increases your range of mobility. Also stretching the arms and legs after the exercise helps the patient to relax and avoid any muscle strain or injury.

Strength Training is also a part of exercise program where patients start with low resistance and gradually increase to higher resistance.

Flexibility exercises are very simple and unique for heart patients like neck exercise. It relaxes your body and helps to improve your flexibility.

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Precautions for Heart patients while exercising:

Isometric exercises like push-ups and sit-ups should be avoided for heart patients as it strains the muscles and increases blood pressure rapidly.

It is not advisable for heart patients to do exercises in extreme temperatures like too cold, hot or humid. Avoid extremely hot and cold showers or sauna baths immediately after the exercise as it might affect the pressure on heart.

Benefits of doing exercises by heart patients:

  • It makes your body flexible and improves your mobility levels.
  • It helps in improving the circulation of blood that in turn regulates oxygen in your body in a better way.
  • Makes your heart and cardio vascular system strong.
  • It boosts your energy levels and endurance.
  • It maintains and controls your blood pressure.
  • It reduces your body excess fat, cholesterol and helps you gain healthy weight.
  • It relieves you from stress, tension, anxiety and depression.
  • Overcomes your sleeping disorder problems
  • Last but not the least, makes you feel more comfortable with relaxed state of mind.

Note: Any exercise chosen by heart patients needs to be strictly followed under the guidance of physician/physiotherapist

To know more details about the exercise for heart health please mail us at info@cardiacwellnessinstitute.com

Or call us at 9940408828/044-43192828.

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The heart-healthy exercise plan

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Can you name the most important muscle in your body? No, it’s not your abs, thigh muscle or arms. It’s your heart!

The human heart is an amazing muscle, capable of pumping about five litres of blood throughout the body every minute—that’s approximately 7,200 litres of blood each day! In fact, the average heart beats about 100,000 times each day, too, which is why it’s so important to have a strong and healthy heart.

And just like you can exercise to build strength in your arm and thigh muscles, you can also train your heart to become stronger, healthier and more efficient at doing its function. The right exercise plan is like strength-training for your heart, which helps it pump more blood with less effort.

The Facts
According to the American Heart Association (AHA),physical inactivity is a major risk factor for developing coronary artery disease (CAD). CAD is caused by deposits of fatty substances, cholesterol, calcium and other substances in the inner lining of the arteries that supply blood to the heart muscle. This build-up makes the arteries narrowed or blocked, and when oxygen-rich blood can’t reach the heart, the result is chest pain or a heart attack. Over time, CAD can weaken the heart muscle and lead to heart failure.

While CAD is the most common type of heart disease and the leading cause of death in the World for both men and women, the good news is that lifestyle changes like exercise can help prevent or treat CAD in most people.

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How to Exercise for a Healthy Heart
Fortunately, it doesn’t take hours in the gym to get the heart-healthy benefits of exercise. As little as 30 minutes of moderate-intensity aerobic exercise, such as walking, most days of the week can substantially reduce your risk of heart disease. Additionally, the habit can help improve your mental well being and manage your weight, blood pressure, blood sugar and cholesterol levels better.

While previous recommendations have focused mainly on cardio (aerobic) conditioning for heart health, new guidelines developed by the American College of Sports Medicine (ACSM) and the AHA also take into account higher levels of intensity and the benefits that strength training offers your heart. These recommendations are for healthy adults under the age of 65 who want to improve heart health, prevent heart disease, and increase overall well-being.

Cardio (aerobic) exercise guidelines: Perform moderately-intense cardio exercise for 30 minutes a day, five days a week. If weight-loss is your goal as well, increase this number up to 60 minutes at a moderate intensity. Moderate intensity is defined by ACSM as a target heart rate range of 55-59% of your maximum heart rate which is roughly the pace where you break a sweat but are still able to carry on a conversation.

Strength training guidelines: Do 8-10 strength-training exercises with 8-12 repetitions of each exercise twice a week.

For more details about exercise plans contact us at www.cardiacwellnessinstitute.com