Cardiac rehab: Examples of phase I exercises after a heart attack

As your strength gradually increases, your recovery team (nurses and physical therapists) will encourage you to progress from basic postural exercises in your bed to walking in the halls and down stairs. An example of daily activity following a heart attack is shown below.

**Initial inpatient daily activity**
Step 1	Rest in bed until stable. Sit up in bed with assistance. Stand at bedside with assistance. Perform self-care activities while seated.
Step 2	Sit up in bed independently. Walk in room and to bathroom. Perform self-care activities in bathroom.
Step 3	Sit and stand independently. Walk in hall with assistance; 5 to 10 minutes, 2 to 3 times a day.
Step 4	Walk in hall; 5 to 10 minutes, 3 to 4 times a day. Walk down flight of stairs with assistance.

As you become stronger, walking in the halls should become an important part of your recovery. An example of a progressive program that may be used is shown below:

**Increase in daily activity**
Mode	Walking in hospital hall
Frequency	Early mobile (days 1 to 3) 1 to 2 times a day (always warm up and cool down) Later mobile (begin on day 4) 3 to 4 times a day
Intensity	Heart rate greater than 120 bpm (beats per minute), or 20 bpm above resting heart rate (RHR) Rating of perceived exertion (RPE) greater than 13 Stop when you get tired.
Time	Intermittent bouts, 3 to 5 min. Rest periods at your discretion, 1 to 2 min. shorter than exercise bout To progress, initially increase to 10 to 15 min., then increase intensity. Include stair climbing when your doctor says it’s okay.

Credits

Author	Robin Parks, MS
Editor	Kathleen M. Ariss, MS
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	Caroline S. Rhoads, MD - Internal Medicine
Specialist Medical Reviewer	Richard D. Zorowitz, MD - Physical Medicine and Rehabilitation
Last Updated	October 8, 2008