Physical Activity & Heart Function. USE IT OR LOSE IT A presentation by Simon Mark Daley & Christopher Rudge. 

INTRODUCTION WHAT IS PHYSICAL ACTIVITY? WHY IS IT IMPORTANT? PHYSICAL ACTIVITY WITH A HEART OR OTHER HEALTH CONDITION SUMMARISE / WHAT HAVE WE LEARNED? OPPORTUNITY FOR QUESTIONS 

Physical activity is a broad term for anything that involves getting up, moving the body & increasing the heart rate - even if only slightly. It doesn't have to mean leaving the house, although it often does. It doesn't have to mean running a marathon or competitive sport - although for some it might; it can be a simple walk, or meeting friends for gentle exercise such as yoga, swimming or bowles etc. It can be as simple as gardening or housework. WHAT IS PHYSICAL ACTIVITY? 

You might hear people using the terms "physical activity" and "exercise" interchangeably, as well as "physical inactivity" and being "sedentary". Not being physically active enough - or being sedentary - over a period of time, contributes to a range of health problems, including cardiovascular disease - circulatory disorders such as heart disease (heart attacks and angina) and stroke. WHAT IS PHYSICAL INACTIVITY? "BEING SEDENTARY IS THE NEW SMOKING". 

Aim to be physically active every day. Any activity is better than none, more is better still. Strengthening activities that concentrate on strength, balance and flexibility, 2 days weekly 150 minutes of moderate intensity activity weekly or 75 minutes of vigorous activity. Reduce time sitting or laying down for long periods; break up long periods of not moving with some activity. TO AVOID BEING SEDENTARY 

LIGHT Walking at a slow pace, getting up to make a cup of tea, cleaning and dusting, making the bed, standing up, and vacuuming. Brisk walking, water aerobics, riding a bike, dancing, table tennis, pushing a lawnmower, and hiking. Jogging or running, aerobics, swimming fast, singles tennis, football, energetic dancing, and martial arts. MODERATE VIGOROUS INTENSITY INTENSITY INTENSITY Yoga, pilates, tai chi, carrying heavy shopping bags, working out with resistance bands, lifting weights, gardening such as digging and shovelling. MUSCLE STRENGTHENING 150 MINUTES 75 MINUTES 2 DAYS 

Regular physical activity reduces your risk of heart & circulatory diseases by up to 35%. 75 mins of moderate intensity activity per week equates to an average of 1.8 additional years life expectancy. This effect increases with a relative increase in activity. Exercise can - perhaps should - be a social activity. It also improves sleep & symptoms of multiple ailments such as arthritis, anaemia & hypermobility. Many studies have shown the positive impact of exercise on mood, stress & anxiety levels, WHY IS PHYSICAL ACTIVITY IMPORTANT? LOWERS RISK. LENGTHENS LIFESPAN. IMPROVES QUALITY OF LIFE. SUPPORTS MENTAL HEALTH. 

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For many thousands of years people have been aware of the benefits of physical activity. They may not have known or understood the science behind it like we do today, but Sedentary existence has only been possible for great numbers of people during the last century and represents a deviation from the natural activity for which our bodies have evolved. There are endless bodies of evidence which support and promote physical activity as a building block for it would have been an integral component of religious, social and cultural expression. health. EVIDENCE FOR PHYSICAL ACTIVITY AND ASSOCIATED HEALTH BENEFITS 

FRAMINGHAM HEART STUDY 

One of the longest, most important epidemiological studies in medical history. It began in 1948 and has spanned 3 generations, including >5,000 participants. Conclusively found that regular physical activity improves life expectancy for those people who have cardiovascular disease. Physical activity is not only reductive in those with underlying cardiovascular disease but protective for those without underlying disease. 

PHYSICAL ACTIVITY AND RISK OF DISEASE 

ADULTS ACHIEVING THE RECOMMENDED PHYSICAL ACTIVITY GUIDELINES BY AGE AND GENDER 

PERCENTAGE OF PEOPLE WHO WALK (20 MINUTES OR MORE) LESS THAN ONCE A YEAR OR NEVER 

DISEASE PREVENTION AND MAINTENANCE OF INDEPENDENCE 

PHYSICAL ACTIVITY WITH AN UNDERLYING HEALTH OR HEART CONDITION. 

Hippocrates. “THAT WHICH IS USED DEVELOPS AND THAT WHICH IS NOT WASTES AWAY”. “MAN DOES NOT CEASE TO PLAY BECAUSE HE GROWS OLD. MAN GROWS OLD BECAUSE HE CEASES TO PLAY” George Bernard Shaw. 

IF I HAVE A HEALTH CONDITION CAN I STILL EXERCISE, AND IS IT SAFE? 

THE SIMPLE ANSWER IS YES! If you have a health condition regular exercise can help you manage symptoms and improve your health physically and mentally. The leading health organisations across the world strongly advocate regular physical activity in all age groups irrespective of physical ability or underlying health condition. It’s important that before undertaking any new exercise you seek advice from your responsible health professional, or an exercise specialist who can advise you on the best and safest forms of exercise to undertake if you are unsure. 

Heart Disease – Myocardial Valvular Heart Disease Atrial Fibrillation/Flutter/Other Heart Failure/Cardiomyopathies Pacemakers/ICDs Infarction/Angina Arrhythmia COMMON HEART CONDITIONS 

Asthma/COPD Stroke Arthritis/Osteoporosis Chronic Pain conditions Diabetes Obesity OTHER COMMON HEALTH CONDITIONS 

HEART DISEASE AND PHYSICAL ACTIVITY Physical activity plays an important role Improves your capacity to exercise and Builds up strength and stamina. Improves confidence and feelings of well Regular physical activity can reduce the in helping you recover after a heart attack. reduces tiredness. being. risk of dying from a further attack. 

HEART DISEASE CONTINUED If you have angina physical activity can Increases your exercise capacity, which Can prevent coronary disease from getting help with symptoms as it improves blood supply to the heart. can reduce frequency and severity of symptoms. worse. Keep your GTN to hand Find out how much physical activity you can manage without getting symptoms Warm up Try to avoid physical activity after a heavy meal or in either very cold or very Pay attention to a change in symptoms Attend offered Cardiac rehabilitation programmes Important points to remember: hot weather. 

Regular physical activity will improve your stamina and fitness. Reduce symptoms such as shortness of breath and fatigue. Raise energy levels. Reduce your blood pressure. 40% reduction in hospitalisation with heart failure. HEART FAILURE AND PHYSICAL ACTIVITY Spread your physical activities throughout the day. Don’t over do it. Choose activity that suits your level of heart failure. Make an activity plan. Set goals. Don’t give up. Any exercise programme should be individually tailored, rather than a "one size fits all" approach. Tips: 

VALVE DISEASE AND PHYSICAL ACTIVITY Symptoms may vary from one person to another. Someone with heart valve disease can achieve a good level of activity although this is very dependent on the severity of disease. Some valve disease patients may require or have had surgery. Speak to your health professional if you are currently taking anticoagulation. 

There are a many different types of heart rhythms, with multiple causes for each. Exercise can improve symptoms from arrhythmia and may reduce arrhythmia burden. The type of exercise you can do depends on your arrhythmia, but there will be an exercise that suits everyone. One should be cautious as certain physical activity can not only relieve symptoms or reduce the incidence of arrhythmia but can aggravate and make it worse. Many patients with arrhythmia will be on blood thinning anticoagulants. In such cases it's important to consider the implications of high impact/intensity sports. PHYSICAL ACTIVITY AND ARRHYTHMIA 

IS IT SAFE TO EXERCISE IF I HAVE A PACEMAKER OR ICD? Exercise is safe with a pacemaker, in If recently fitted certain precautions Most people with an ICD can exercise Keep your device card with you. Avoid contact sports. fact most people who have required a pacemaker find they are able to exercise more than before their device was fitted. should be taken. safely. 

Seek expert advice. Smoking cessation. Pulmonary Rehabilitation. Strengthen your heart and cardiovascular system. Asthma/COPD: OTHER CHRONIC HEALTH CONDITIONS Reduce your risk of having a stroke. Level of exercise dependent of how a stroke has affected you. Stroke/TIA: 

ARTHRITIS/ OSTEOPOROSIS Delays the progression of osteoporosis and prevent the risk of osteoarthritis. Reduce the risk of falling and improve Reduce pain and stiffness. mobility. CHRONIC PAIN CONDITIONS Reduce the cycle of more pain and loss of function. Focus on areas of the body to exercise where you don’t have pain. DIABETES Exercise can help control glucose levels and better manage your disease. Inactivity is a major risk factor for the development of type 2 diabetes. OBESITY Exercise proven to lower the risk of For those overweight being physically active brings significant reductions in risk of mortality and morbidity. Significant risk of developing chronic obesity and maintain a healthy weight. illness by being overweight. 

SUMMARY Physical activity is important for physical and psychosocial health. The benefits gained by leading an active lifestyle are huge, and not only prevent or reduce incidence of disease, but can improve the symptoms of an underlying condition. There are very few barriers to having an exercise or activity programme as part of a healthy lifestyle. It is always advisable to speak to a health professional or exercise specialist before beginning an exercise programme if you have an underlying health condition and are not sure what's best. Listen to your body. 

IS PHYSICAL ACTIVITY A 'MAGIC BULLET' FOR CARDIOVASCULAR DISEASE? 

ANY QUESTIONS?