Cardiovascular Exercise

Recommendations for cardiovascular exercise should always include the:

An appropriate exercise recommendation is one that includes the types of exercise that will meet your needs and promote regular participation, progresses gradually in frequency (to a goal of 5 or more days per week) and duration to a goal of 30 – 60 minutes per session) and is at an appropriate intensity (or effort) that facilitates safety, adaptation and regular participation.

Recommendations for overall health is to do some type of physical activity on most, if not all days per week.  A structured exercise program for developing fitness it is recommended that you do some cardiovascular exercise 3 – 5 times per week.  Strength or resistance training is recommended for 2 – 3 times per week (rest days between strength exercise sessions are important for adaptations in the muscle to occur).  Flexibility exercises are recommended 3 times per week.

If you are just getting started and have been inactive for a while, it might be good to try doing short bouts (5 – 10min bouts) of your cardiovascular exercise twice a day until you have worked up in duration to 20 – 30 minutes.  Then you can cut back to once a day and begin to increase your exercise intensity.

The goal for cardiovascular exercise is 30 – 60 minutes per session.  You may need to work up to this level. You can start with as little as 5 minutes per session and increase in time 2 – 3 minutes per session each week.  This will allow your body to adapt to the increase in exercise and get you into the habit of exercise in a way that is comfortable, and achievable. If you feel good, you can progress at a faster pace (i.e. 5 or 10 minutes more per session every week) until you reach your goal of at least 30 minutes.  A goal of 30 minutes is recommended for improving fitness, for weight management longer durations are recommended.

Exercise intensity (or level of effort or exertion) is often the most difficult to gauge, however, it is an important consideration when developing fitness.

Heart rate:

It is possible to monitor your pulse (heart) rate during exercise, however, there are several medications that affect your pulse rate during exercise, making this method of monitoring intensity unreliable. If you work with an exercise specialist or personal trainer, this individual can provide guidance on heart rate monitoring.

Age 55% 60% 70% 80% 85%
15 19 21 24 27 29
20 18 20 23 27 28
25 18 19 23 26 28
30 17 19 22 25 27
35 17 19 22 25 26
40 17 18 21 24 26
45 16 18 20 23 25
45 16 18 20 23 25
50 16 17 20 23 24
55 15 17 20 23 24
60 15 16 19 21 23
65 14 16 18 21 22
70 14 15 18 20 21
75 13 15 17 19 21
80 13 14 16 19 20

The “talk test”:

In getting started, and perhaps throughout any exercise program for developing fitness, the most important thing to monitor is how you are feeling.  A really good way to gauge your effort is by your breathing.  Breathing is important during cardiovascular exercise and you should warm up at a low level of cardio for 3 – 5 minutes at a level that increases your breathing somewhat – you could possibly still sing a tune during your warm up.  Your effort should then increase (by walking or cycling faster or increasing the resistance on the cycle or cardio machine) to a level of breathing that is such that you are breathing harder, but could still carry on a conversation with someone next to you.  For general fitness training, there is never a need for exercising so hard that you are gasping for breath, or feeling fully winded during your exercise.  If exercise is done at that level, a) it is uncomfortable and unenjoyable, b) will be difficult to sustain for the recommended duration (30 – 60 minutes), and c) may increase the risk of injury.

Perceived exertion:

This is a monitoring method that is referred to as “Work Effort”’ – it is how you rate the level of exertion or effort.  To give you an idea of how to rate your effort, below is a scale from 0 to 5 with descriptors for each level of effort.

WORK EFFORT SCALE

0 = no effort (rest)
1 = minimal effort
2 = easy effort (warm up)
3 = moderate effort (conditioning level)
4 = hard effort (advanced conditioning level)
5 = very hard effort (not recommended)

  • Sitting at rest the effort level would be rated as “0”.

  • Getting up and moving around would be “minimal effort” or a rating of “1”.

  • Moving a bit faster (but breathing level such that you could still sing a tune) would be described as an “easy effort” or a rating of “2”.

  • Exercising a bit harder (walking faster, or putting on some resistance to your movement) (breathing level that is increased but you could still talk to someone next to you) would be described as “moderate effort” or a rating of “3”.

  • Further increasing the speed and/or resistance will further increase breathing to a point that it is difficult to carry on a conversation and would be described as “hard effort” or a rating of “4”.

  • Exercise that is described as “very hard effort” or rated a “5” is near maximal level, and not necessary or recommended for fitness development.

Using the Work Effort Scale: Here’s how you can use this type of rating system to guide how hard you should exercise.  Your cardiovascular exercise session should start out with a warm-up period for 3 – 5 minutes at an effort level of ‘easy effort” or “2”. You will then increase the speed and/or resistance to your conditioning level, which is a level that you would describe as “moderate” effort or “3”.  You will work up to sustaining this level of effort for 30 – 60 minutes.  At the end of the conditioning period, the effort is lowered to ‘2’ or ‘1’ for a cool-down that lasts for 3 – 5 minutes.

Overview of a Cardiovascular Exercise Session: Duration and Intensity

How Long How Hard Work Scale
Warm Up 3-5 minutes Easy Effort 2
Conditioning Period 30-60 minutes Moderate Effort 3*
Cool Down 3-5 minutes Easy Effort 2

* you could eventually, after you can comfortably do 30-45 min at an intensity of  “2” continuously, move to “hard”  or “4” using intervals.

Strengthening Exercise

Specific exercises are used to strengthen each muscle or muscle group.
The strengthening program is made up of:

  • Your starting level should be a weight that can be lifted comfortably 10 times, once (or one set).  The starting level may vary between muscle groups.

  • The progression is to first increase the number of repetitions of each exercise, by 2 – 3 repetitions/session.

  • Once 10 – 12 repetitions is achieved, then do another set of the exercises (go through the exercises again.

  • The goal is 10 – 12 repetitions of each exercise – 3 times (or sets).  Once this is achieved, the amount of weight is increased, conservatively, by 0.5 – 1 kg.

  • When using your own body weight against gravity for resistance, the increase in resistance may be to reduce support from hands (i.e. if doing chair stands), or gradually start doing heel lifts (toe raises) using one leg at a time.

Help your organ work better and live longer…
get Refit post your transplant!

START THE PROGRAM