cardiac rehab : I have been attending a... - British Heart Fou...

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cardiac rehab

Ticker26 profile image
51 Replies

I have been attending a cardiac rehab class weekly for a couple of months now but it’s not what I expected. It’s a group exercise class with sedate exercises plus weights for some of them. I had my blood pressure checked before the first class but that’s been it. No monitoring is done before, during or after the classes. Every couple of weeks either the repetitions are increased or the weight is increased without any dialogue, just noted on my sheet.

It hasn’t really given me any reassurance or the confidence I was looking to achieve because of the lack of personal monitoring. The people running the class, nice as they are, have no idea how our bodies are handling the exertions. We don’t even check our heart rates during the class.

What I’d like to know please is whether this is normal for rehab classes. Am I being unrealistic to expect more?

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Ticker26 profile image
Ticker26
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51 Replies
Stentrunner profile image
Stentrunner

Watch the BHF rehab videos on YouTube. I still do level 5 occasionally even 2 years later. They were introduced in the first lockdown, and I did them every day, not once a week. Started at L2 and worked my way up.

It doesn't fit the format of the cardio rehab group I attended, and I get the impression they are all different although something is better than nothing as is the case for some who don't have courses in their area. Anyway on mine there were a number of exercises each session, including exercise bikes, ball games, and weights which were suitable for people of mixed ability, with low key monitoring throughout by the staff. There were also low key 'lectures' regarding lifestyle post cardio event. If you are not happy with what you have on your course why not discuss it with your team and see what they have to say. Alternatively the BHF run an online rehab course as under which you could try.

bhf.org.uk/informationsuppo...

maggie80 profile image
maggie80 in reply toLowerfield_no_more

Good Morning. I attended rehab once a week for six weeks. I had a couple of excersises and on the bike. I found it easy. I went to Chester. The staff were wonderful.

Dannysnan profile image
Dannysnan in reply toLowerfield_no_more

Wish I'd known about this online course sooner. It's 9 weeks,since my HA and I start rehab tomorrow . I'd like to have started sooner than this.

EU95PTM profile image
EU95PTM

Good morning. I think cardiac rehab classes seem to vary area, to area. Mine was similar to yours in terms of the group exercise sessions. The exercises were really simple initially but the intensity did increase over time. I was given a heart rate monitor to wear around my chest, under my t-shirt and a wrist watch where I could monitor it during the session so I could make sure I was working within the HR range they had set for me (103-109 bpm). They checked my BP before each session and we had to record our HR and intensity level at regular intervals. I’m sorry to hear that there is no monitoring going on in your rehab. I found it really helpful and have since bought an Apple Watch so when I’m exercising now, I can make sure my exertion level is where it should be.

SNA4724 profile image
SNA4724 in reply toEU95PTM

Same here I get monitored for BP each time and heart during class.

That doesn't sound right to me at all, the gym I attended a few yrs back ran rehab classes and everyone was given individual attention support and monitoring bf during and aft the classNeeds investigating I think

Queenielover profile image
Queenielover

Hi I attend same and it's great we are checked b4 after and through the event we choose 3 sets 4 exercises an do the best we cw they are always asking if we r ok ectU may have to have a chat with them xx

Survivor1952 profile image
Survivor1952

Definitely doesn't match the classes I've just finished. BP and heart rate checked at start of class, HR checked at least twice during class and afterwards to record recovery. They even wrote to my doctor as my BP was/is a little on the high side.

Exercises vary from mild for warm up to as strenuous as you want to make them during the final 'all out' session (class is split into 3 sessions plus a cool down). The instructor was really enthusiastic and outgoing whilst actively talking to and encouraging us on a one to one basis.

They actually encouraged me to exercise independently of the class and to, if I wanted, aim to complete couch to 5k. Just done my sixth ParkRun (which is a 5k) this morning. Before my episode that resulted in 2 x PCI, AVR and 1 x CABG 18 weeks ago I would never have contemplated doing a ParkRun or 5k of any sort.

Rhinos67 profile image
Rhinos67

That sounds exactly like the rehab sessions that I attended, but know from others that it differs around the UK. I expected more monitoring than I got. The first instructor was great and kept a close eye on me, but he left after a few weeks and his replacement didn't even know my history and didn't monitor me at all.So, not what I was hoping for, but I enjoyed meeting others in the group and it did build my confidence a bit

Ticker26 profile image
Ticker26

Thank you all for your replies, I appreciate you all telling me your experiences. It certainly seems that rehab classes vary quite a lot. I’ll look into the BHF online course and now that I have a better idea of how other areas operate their rehab classes I’ll chat to the staff at my next class.

Thanks again.

HenryTudor profile image
HenryTudor in reply toTicker26

The BHF online courses are good. My rehab seemed to be much better than your experience. At least come away with your target maximum heart rate to use when you are doing your own exercises. Ask if you’ve not been told.

benjijen profile image
benjijen

Nothing like I had. The first 6 weeks there were 2 groups depending on when you had your treatment. BP and pulse taken at beginning and end of each lesson. Not allowed out until it had gone back to nearly normal. Those classes were free and run by cardiac nurses. Stage 2 onwards were in a room in our local gym with a qualified trainer. They were more individual and had to be paid for. Well worth doing if you can.

Mavdogfav profile image
Mavdogfav

The whole point of rehab classes is to give you confidence to excercise without fear of heart issues and give you clear advice on diet, stress relief and ways you can deal with anxiety etc

I had a pre assessment before I started with a nurse and fitness professional. BP taken before and after each class, heart rate monitored during the class and after my 6 weeks , a post assessment showing improvement and given advice on carrying on my fitness journey in the gym . Have to say your class doesn’t seem to do the job you need .

Plum44 profile image
Plum44

I had a brilliant cardiac rehab team you visit the nurse who will be in charge of your rehab prior to beginning the exercises, and they give you a medical exam, if like me you’ve had OHS they check your scar for healing etc a week or before you begin, I really couldn’t fault them. On arrival the cardiac nurse really took time to take everyone’s BP, pulse but also chat as to how they were getting on, meds etc.

There was obviously a very wide range of ages, and heart conditions. A few of us had had open heart surgery, some with stents , etc. On your first session ( 1 of seven ) the exercise instructor questioned you, asking about level of fitness prior to heart problem, and any joint issues, he suggested adaptions to the exercises , and also pushed those he felt were fitter.

I used to be a regular runner, and considered myself “fairly fit” so yes the exercises were gentle, but I think the assumption is you then continue to do the same at home, increasing reps and weights. He suggested 5 times a week exercise that made you a bit sweaty and got your heart rate up. As the cardiac nurse said, you’ve all had things done now to make your hearts work more efficiently, it’s a muscle and needs to be exercised”

During the exercises we had to rate our level of comfort/ breathing etc on a scale if 1-10 . So if we said 2 it’s easy , they encouraged you to push yourself more. She kept a very good eye on everyone, as did the exercise instructor. We did x2 rounds of x9 exercises with warm up and cool down. Then each week we had a talk on something heart related.

It really gave me confidence to know what I could then go home and do safely, weights etc

I asked one week if I could swim yet, and was told very firmly “ absolutely not” ( obviously after OHS it’s not ideal) but I thought surely by now I could . So they are very aware of your individual capabilities.

I really encourage everyone to go to their cardiac rehab, I looked forward to it each week and have kept in touch with a couple of people, also the cardiac nurses say we can always phone them with any queries even after we finish the course

Circular profile image
Circular

For me the Cardiac Rehab class was the turning point in my recovery from bypass surgery.

We were in a group of six and were constantly monitored by staff and wearable sensors which showed each person’s vital stats on a monitor throughout the session. It felt very safe.

A physio took us through graded exercises each week. It went from simple to challenging. We had one-to-one input from dietitian, psychologist and pharmacist . All really helpful after the trauma of major surgery.

The course lasted over six weeks. Overall a great experience and a good opportunity to meet others with similar challenges.

I live in Ireland so maybe the approach taken in other countries is not so thorough.

Have you considered finding a private provider?

momander profile image
momander

My classis the same if that helps

El-Tel1990 profile image
El-Tel1990

You should be hooked up to a portable heart monitor and this is read by the nurses on site whilst exercising. BP taken before and after exercise, treadmill, bike, rowing machine and stair master. If you are not happy with the provider you can always go private if it’s an option. Good luck with your rehab. Walking for 30/40 minutes per day is really good as an aid to your recovery.

Take care

Drummer20 profile image
Drummer20

I’ve been to two sessions now run by physiotherapists.I was starting to feel much stronger anyway before I went.We do warm ups then a mixture of cardio and resistance exercises like circuit training.They check our heart rate and oxygen saturations a few times.They emphasise how important it is after a heart operation or cardiac event to warm up and gradually slow down when exercising I really enjoy going and can continue at the local leisure centre with paid classes when the 6weeks are completed.

edplayer profile image
edplayer

If you are willing and able to go private CP+R offer superb personalised rehab at home over Zoom. I’ve been going over 2 years now. Worth the cost in my experience, they are excellent.

Tinbird profile image
Tinbird

Cardiac rehab phase 3 that lasted 3 months for me we all had our blood pressure and beats per minute and a 15 minute lesson everytime before and after exercise with heart monitor straps fitted with a watch to check during exercise . I'm now on phase 4 which is optional but it's just the exercise with a physical instructor and no cardiac nurse present.

Thanksnhs profile image
Thanksnhs

Hi my rehab was during lockdown and it was done online not ideal but you could ask questions if there was anything bothering you. They used BHF videos and obviously no monitoring for anything. I was wondering if it worked like that for years and everyone was alright that they have decided just to keep it that way . Char

CyclingTime profile image
CyclingTime

Mine were done at home. I was sent a heart monitor to track every session and then once a week had a call with the team to discuss how I was feeling and whether it was right to move on to the next set of exercises

gorillaqueen profile image
gorillaqueen

Good morning Ticker my rehab class was pretty good, Bp heart rate checked before during and after exercise. Asking how we felt during exercise and always watching us. It was run by cardiac nurses who we’re lovely and so helpful, if you needed advice or anything explained they were there. We had talks on diet, medication, stress, exercise etc.

I’m sorry you don’t feel your rehab is providing what you need and to be honest I do not understand why they are not monitoring everyone. On one occasion my BP was a bit low so I was not allowed to start the class until it had stabilised, there was another occasion when one man’s BP dropped quite low and he felt unwell during our exercise they immediately knew what to do and were attending to him. I think it varies from area to area and some are obviously better than others. I agree with what lowerfield and others are saying have a chat with them and also see if there are alternatives. Good luck I wish you well 😊X

Julie_O profile image
Julie_O

Hi there. Where is this?

12like profile image
12like

My classes focus on your own perceived exertion on the Borg Score scale and they give you easier or harder exercise options so you can choose how to get to the target exertion. Group classes really motivated me to carry on exercising and it’s amazing how far you can progress over 12 months after a bypass. Where are you based?

Pouchielou1972 profile image
Pouchielou1972

The format sounds totally different to mine which was run by 2 cardiac nurses and a physio. We had our blood pressure and weight checked at the beginning of each class, we were asked if we'd tajen our meds that day and what time we last ate and wore heart rate watches and had to write down our heart rate on a form after each and every exercise. We also weren't allowed to leave the class until our heart rate was down to a particular minimum level.

Hendrix1 profile image
Hendrix1

My husband had a bypass in 2020 no rehab just sent home with a few excercises to do. I was diagnosed with severe Heart Failure with Lbbb at the same time, neither of us have ever been offered Rehab. We just had to manage as best we could but we live in Cumbria and there are hills all around us. We would have welcomed any sort of programme.

Butterfly_flutterby profile image
Butterfly_flutterby in reply toHendrix1

Hi Hendrix1. My bypass was July 2020 and like you, I had no rehab either and just had to get on with it.

Peter-l-h profile image
Peter-l-h

My experience was opposite. Reading before. During and after. Physio and 2 nurses from cardio dept always there to advise. PLH

Qualipop profile image
Qualipop

I didn't even get rehab of any kind because I'm in a wheelchair. Totally refused.

cappachina profile image
cappachina

It isn't like the one I attended that was similar type exercises and you were monitored several times during sessions you were promoted when your heart wasn't exerting itself enough I started on level2 and finished at the top level 6 by the end I was then told how much I could push my heart too 125 beats a min by then and what level and type of exercise I could do eg no badminton competing swimming etc It really gave me confidence to know what I could do

BicuspidBloke profile image
BicuspidBloke

Mine was brilliant. A good physical check up & chat before & after each session. A Bleep Test at the start and end of the course. Monitored at all times with chest and wrist monitors connected to a laptop they kept an eye on. After each session was a good talk about different subjects around heart health. Run by three cardiac nurses, each with a background in cardiac critical care and sport.

Qualipop profile image
Qualipop in reply toBicuspidBloke

Just as it should be. That sounds perfect.

Badger132 profile image
Badger132

Well the one I went to they all train physiotherapist and part nurses were really good you don't get the one-to-one but trust me there are monitoring you they check what you doing and how your improving 😉 Yours

Paul

Deejay62 profile image
Deejay62

Hi I never even heard about cardiac rehab until I came on here. There’s only one rehab I’ve heard about so when I first heard it mentioned on the heading of a post I had to click on it and see why the person with a heart condition ended up in rehab. Now I’m used to hearing that word associated with heart conditions.

Ticker26 profile image
Ticker26

Thank you all so much for your replies. It definitely appears that the standards vary greatly - from non existent classes to proactive, close monitoring.

I’m in Scotland and wasn’t actually informed about these classes, it was only after seeing them mentioned on this forum that I made some enquiries and was then referred.

Best wishes to you all

Winter4519 profile image
Winter4519

That's interesting as I was put forward to go on this programme From what you have describe it sounds like a keep fit class or going to a gym. It would make sense as the general consensus is to keep fit but surely there should be more monitoring then what you have said. It does make you wonder the purpose of the programme. Oh by the way I did have high hopes that going to the classes I would get a lot of my questions answered.

Lowerfield_no_more profile image
Lowerfield_no_more in reply toWinter4519

On the course I attended it was certainly not like going to a keep fit class or going to the gym. On the contrary on my course there were people who would have struggled to carry out the basic exercises even before their heart event through body weight, age or being physically compromised etc etc. And as far the purpose of the programme it is to educate attendees on what they should be doing post heart event, life style, exercise etc to give them the best chance going forward. What seems to be amiss however is how this objective is delivered, no doubt governed in part by budgets and resources down to postcode, and the methods thought appropriate by the organisers, all of which means a huge diversity in course content, assuming of course your NHS Trust even offers a cardio rehab programme.

trafar profile image
trafar

My experience is pretty much the same experience as everyone else. HR taken before, during and after the class. A 15 minute warm up and warm down is included as that’s very important for your heart. We also get keep in for 15 mins afterwards where we talk about various subjects.

The exercises are very easy especially at the start but they are there as the foundation to getting your heart rate up again, so that when you exercise alone you will have confidence that you are safe.

Qualipop profile image
Qualipop in reply totrafar

YOu just mentioned what I think shoudl be the main priority ( it certainly was for me. CONFIDENCE. Rehab should give you the confidence to start doing normal activities without thinking that the first activity you try will give you another heart attack. Even if they don't admit it I believe that's how most people feel

trafar profile image
trafar in reply toQualipop

I totally agree.

JK5AEO profile image
JK5AEO

My cardio rehabilitation course lasted 10-weeks and was life changing. I was fully monitored throughout. That was in London, so perhaps it varies between health trusts?

Brht profile image
Brht

You should expect more. BP& Hr check start and finish and checks each week to see how you're coping. Speak to the person in charge and let them know your concerns.

Sprinty_Nige profile image
Sprinty_Nige

It's certainly not like the one I attended. Took pulse on arrival and you couldn't leave at end of session until it was within 10 of the starting one. Good long tutored group warm-up session, followed by timed or certain reps at each of ten stations. Up to three circuits, with BP taken at the end of each. They would call each of us in turn for a chat about how our week was and any changes in meds. Also ran talks before sessions about nutrition, heart health and much more.

Nothing but praise for the East Kent cardiac rehab team.

QuadroVEINia profile image
QuadroVEINia

Your post brought back memories of my own experience!

Not sure where you live but you are welcome to join our increasingly popular peer-to-peer exercise programme which by heart patients for heart patients. Have attached some info, you can also find more info on social media under the name DodgyTickers including on YouTube. Hope this helps.

Heart patients from the DodgyTickers programme.
doktordru profile image
doktordru

Talk to the organisers and share your concerns. I do a similar class which I really enjoy and find valuable. Heart Rate is taken at the beginning, middle and end of the class and I really feel looked after. Additionally I bought a smart watch to give me reassurance on what my heart was doing. Keep at it. But do talk to the organisers. They can only change/ adapt with feedback. Good luck.

Qualipop profile image
Qualipop

It's t oo late to do it now. They just said that I wouldn't be able to do it. Not eth fault of the department but the specific nurse I saw. who took one look and made an assumption.

Qualipop profile image
Qualipop

Thank you but my HA was 5years ago now. I've pretty much done my own rehab by now and I've just today seen a physio to help slow down the deterioration of my joints and spine which can only help ,me get more mobile.

anke123 profile image
anke123

The class I went to did BP and weight check at each session, only at the start and the first 6 weeks one time it was just walking around a small circuit and the next one on a bike, did get a bit boring. After that other things were added. Never told what my heart rate should be when exercising. Did give good talks on medication, life style, food etc. The first session I went to I was the only female there, never more than 4 or 5 I think.

Bobbymrg profile image
Bobbymrg

They are designed to take you slowly from stage to stage. I wasn’t moitored for heart rate but taken through a series of work stations around the room from sit ups on chairs and many other cardio excersises. It depends on your stage some are well on others just beginning. Take it slowly and after the sessions you will progress.

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