How to Safely Exercise with Cardiopulmonary Complications

It is no secret that COVID-19 is on essentially everyone’s mind nowadays. While the focus is currently on prevention, vaccination, and immediate treatment for those affected, and rightfully so, a concept that has been discussed and that will likely become more forefront in the coming months and, perhaps, years is how COVID-19 might affect a person’s ability to effectively exercise. Whether because of COVID-19 or not, cardiopulmonary complications (i.e. issues due to heart and/or lung conditions) are important to think about when exercising. These potential complications should be considered whether you are going to start a new exercise program, looking to re-initiate a past workout routine, or interested in progressing a fitness program in which you are already engaged. Plus, cardiopulmonary complications should also be considered for all forms of exercise, including cardio exercise (e.g. biking, running, swimming, etc.) and strengthening exercise (e.g. weight training, band resisted training, body weight resisted training, etc.). Here are several tips to ensure that you are exercising safely, especially if you might have a cardiac (i.e. heart) or pulmonary (i.e. lung) history:

Monitor Heart Rate and Oxygen Saturation:
Purchase a pulse-oximeter finger probe. These are relatively inexpensive and can give you a snapshot look at your heart rate and oxygen saturation levels. Normal resting heart rate is between 60 and 100 beats per minute. A normal heart rate for exercise varies from person to person, but an easy way to determine your proper exercising heart rate is to calculate your theorized maximal heart rate by subtracting your age from 220 and then determining at what percentage you would like to exercise. For most people, this is anywhere from 60-80% of the maximal heart rate. (For example, maximal heart rate for a 50-year old is 220 – 50 = 170. 70% of 170 is 170 x 0.7 = 119. Therefore, if a 50-year-old wants to exercise at 70% of their maximal heart rate, they should do so by keeping their heart rate at or just around 119 beats per minute.) Oxygen saturation, whether resting or during exercise, should be as close to 100% as possible and should never dip under 90%. If oxygen saturation levels drop below 90%, the activity may be too taxing on the pulmonary system, and supplemental oxygen may be necessary, though supplemental oxygen must be specifically ordered by a physician.

Monitor Blood Pressure:
Purchase a blood pressure cuff (medically referred to as a sphygmometer). Manual cuffs, which require a stethoscope to properly read are quite accurate, though they are difficult for most to use independently. An automated blood pressure cuff is probably best for home use. The optimal blood pressure is 120/70, though blood pressure can rise with exercise. However, the top number of the blood pressure, known as the diastolic blood pressure, should not drop below 100 or rise above 160-170. The bottom number, known as the systolic blood pressure, should vary very little.

Monitor Perceived Exertion (or how you generally feel):
An easy way to measure how exertive an exercise is for a person is to use the Borg Scale, which asks the person to rate how they feel while performing that exercise. The scale traditionally ranges from a 6 (very, very light) to a 20 (maximum exertion), though more updated scales, which seem to be easier for people to comprehend, range from a score of 0 (rest) to 10 (maximal). Depending on how hard you want to work will determine how to structure an exercise to best fit your needs. If you want to start out slow, doing an exercise that causes you to feel an exertion level of 3 or 4 out of 10 (using the updated scale) might be a good place to start. Once you feel comfortable, you can either make that exercise harder or switch to a more challenging exercise, thereby eliciting a perceived exertion level of 7 or 8 out of 10. The point is, only do what you feel comfortable doing.

Hopefully, these tips for monitoring yourself when exercising can help you to put together an appropriate exercise program and allow you to, over time, progress that program, thereby ensuring that you continue to make gains. While these precautions are especially important for those with a compromised cardiac or pulmonary system (or both), this is applicable to anyone looking to exercise properly. And, as always, if you are unsure how to formulate an appropriate exercise program, feel free to consult with your physical therapist who will be happy to assist.

Rob Kohutanycz, PT, DPT

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