Cardiovascular Rehabilitation
What is the Cardiac Rehabilitation Programme?
The cardiac rehabilitation programme at Bedford Hospital is an individualised cardiac recovery programme, delivered by a multi-disciplinary team of Cardiac Rehabilitation Specialist Nurses and Exercise Physiologists. Across our programme, we aim to provide you, and those close to you, the knowledge and confidence to return to normal life, following your cardiac event and/or surgery.
Modes of delivery:
- In-Person group sessions
- Home programme (telephone based)
- Virtual programme (online)
- Hybrid sessions (a combination of the above)
Who can access the Cardiac Rehabilitation Programme?
If you have recently had a cardiac event and/or surgery, and registered to a GP practice within the Bedford area, you are eligible to access the service.
Components of the Cardiac Rehabilitation Programme:
Initial Assessment:
First, you will have an initial assessment. This is a chance for us to find out a little bit more about you, and discuss the best version of the cardiac rehabilitation programme for you. During this appointment, we will discuss your cardiac diagnosis, treatments and medications, alongside your cardiac risk factors, including: diet, exercise, sedentary behaviour patterns, alcohol intake, smoking and your psychological well-being.
Functional Capacity Assessments:
Regardless of which mode of delivery you opt for with your cardiac rehabilitation programme, we will offer two functional capacity assessments; one at the start of your course, and one following your final session. The results from the assessment are used by the Exercise Physiologists to formulate a tailored exercise plan for you. There is no pass or fail to these assessments, they are simply in-place to ensure all your exercise is prescribed safely and effectively, to allow you to get the most out of the rehabilitation programme.
Circuit Exercise:
Within the cardiac rehabilitation programme, we utilise a variety of exercises to focus on all aspects of your fitness. All circuit exercise can be fully tailored to meet the requirements of all exercise capabilities. All of these exercises can be progressed and regressed, as we work with you to allow you to exercise at an appropriate intensity to gain the most benefit. All circuit exercises have been recorded and are sent out via an email or DVD to allow you to complete all of your exercises at home.
Additional Exercise Plans:
We also have additional exercise plans to help you safely return to other activities. These include: walking, cycling and running plans, as well as further guidance about returning to the gym or swimming. All of these can be discussed with the cardiac rehabilitation team at any point throughout your cardiac rehabilitation course.
Relaxation:
We utilise a variety of relaxation techniques to best manage any physical or psychological stressors. Led by the cardiac rehabilitation specialist nurses, our relaxation sessions have also been recorded for home use.
Health Education:
The health education component of the cardiac rehabilitation programme is delivered in group based or 1-to-1 discussions. Weekly health education topics include:
- Heart Disease
- Cardiac Risk Factors
- Cardiac Medications
- Exercise and Physical Activity
- Lipid Profiles and Food Labels
- Healthy Eating
- Stress Management
- Back to Normal and Goal Setting
In addition to the delivered health education topics, you will have access to further information resources to provide supplementary health education information.
Lifestyle change & support
Goal Setting:
Our cardiac rehabilitation team provide you with the structure and support to achieve your goals. By setting and achieving positive cardiac behaviour changes, you will improve your recovery and reduce the risk of any further cardiac complications.
Lifestyle Support:
The cardiac rehabilitation team have developed close links to a variety of support services to aid you in your cardiac recovery, these include: Bedfordshire Talking Therapies service, Stop Smoking Service, Diabetes Team, as well as community cardiac exercises classes.
Cardiovascular Rehabilitation Home Exercise Programme
To get the most benefit from the cardiovascular rehabilitation programme we recommend that you do some form of exercise on the days you are not attending class. You may like to take a brisk walk or do some gardening, or use this sheet to give you some ideas.
Over time, you should aim for 20 to 30 minutes of moderate intensity physical activity five times a week. However, for some, a less intense programme may be more suitable (for example building up to 10 to 15 minutes over time).
Always do the warm-up exercises first. Then complete the exercises before finishing with the cool down. Before you start to exercise, remember to enjoy it and:
- Wait 1 hour after a meal before exercising
- Monitor your levels of exertion. Aim to achieve no more than 5 on the ‘How it feels breathing scale’ scale. This means that the exercise should feel ‘somewhat hard’.
- If you usually carry a GTN spray, keep it with you when exercising. If you experience symptoms of angina, stop exercising and follow the instructions for the use of the GTN spray
- Wear comfortable, loose clothing
- Drink water to rehydrate the body. If you are on a fluid restriction, please discuss this with cardiac rehabilitation team
- Prepare the environment before your exercise by rolling up any rugs or mats. Have a sturdy chair close by for support.
- For exercises that involve weights, you could use bags of sugar, tins or plastic bottles of water. If you have your own set of weights – start off at 1kg (2.2lbs) and increase as able
- Don’t begin to exercise if you feel unwell.
- Don’t continue to exercise if you have chest pain, nausea, dizziness, unusual joint pain, become very breathless, or cold and clammy
- If you are unsure about any exercise or stretch, do not attempt it and ask a member of the team
The exercise programme is based on a circuit. You should start with the warm-up which last around 15mins, followed by the main exercises component for between 15-40mins (dependent on your ability) and then a cool down for 10mins.
We recommend you start the exercise programme at Level 1, regardless of your previous abilities. Progress to level 2 and 3 when you are able to complete 40mins at the previous level without feeling too short of breath (how it feels breathing scale below 4).
The main exercise component is continuous, doing each exercise for the allocated time and then moving straight onto the next. Depending on your ability you may not initially complete a full circuit, but as your ability improves and you’re able to exercise longer, you may be able to complete more than one circuit.
Below is the how it feels breathing scale. You should measure how hard you are working by using this scale.
- Aiming for 2- 3 by end of warm-up
- Aiming for 3-4 during the main exercise.
How it feels to breath
| 0 | Nothing at all |
| 0.5 | Very, very light/just noticeable |
| 1 | Very light/very easy |
| 2 | Light/easy |
| 3 | Moderate/beginning to feel a bit puffed |
| 4 | Somewhat strong/fairly hard
Feeling a bit puffed but able to talk |
| 5 | Strong/hard/out of breath |
| 6 | |
| 7 | Very strong/very tiring/very out of breath |
| 8 | |
| 9 | |
| 10 | Very, very strong/extremely hard
Almost maximal Maximal Highest possible |
Referrals to Cardiac Rehabilitation are accepted via your Consultant or GP. For any further information contact the Cardiac Rehabilitation team on 01582 497469.