Exercise training should be planned individually for each patient based on the current physical capacity achieved during the exercise test, ergospirometry test or a six-minute walk test. In order the physical training to be effective, the physician determines the individual range of the training heart rate for each patient based on the exercise tests. Initially, patients exercise under physician’s and physiotherapist’s supervision and guidance. Afterwards they can exercise on their own at home or outdoors.
Endurance aerobic training. Endurance aerobic training (Nordic walking training, walking, cycling). Nordic walking is a safe, widely available and effective form of endurance training. When learning the technique, one needs to remember to keep the walking poles close to their body with relaxed and loose shoulders. The pole’s end should aim backwards diagonally, at an angle of about 60 degrees. The right pole should hit the ground when the left foot is on the ground. At this moment the grip on the handle should tighten and subsequently loosen with the shifting of the pole towards the rear. It’s important to move arms and legs alternately, rotating the upper body and pelvis to maintain the proper body balance, and interlacing walking periods with respiratory and strength exercises.
Respiratory training. The patient can perform the respiratory training on his own using a “Inspiratory muscle trainer” or the device called “Three balls”
Resistance and strength training. Resistance and strength training can be aided by “Thera Band” tape. Patients choose a few exercises and perform several (5-15) repetitions. With the improvement of the physical condition they may later increase the length and number or sets. The patient needs to keep the correct posture, slightly stretching the tape during the initial phase of the movement. Throughout the course of the exercise the motion needs to be slow and steady, with the patient minding the right resistance direction and breathing. Each exercise must be performed on both sides. Examples of exercises are shown in the figures.
During the resistance training the patient can also use wrists and ankle weights. The exercises should engage individual muscle groups an should always be performed with the correct posture and the proper breath coordination.
A healthy diet is based primarily on fresh vegetables and fruits, ideally originated from organic farming industry.
“Healthy diet and physical exercise pyramid” presents the rules of composing a healthy diet and recommends physical exercises which are its basis. The quantity and frequency of the consumption of the food represented in the highest tiers should be limited. When composing an everyday menu, one needs to remember to include a 3/1 ratio of vegetables and fruit, which are the most important food group in the pyramid. The next tier depicts cereal products. Whole wheat bread, rich in healthy fiber, is the right choice, similarly to pasta. An everyday menu should also include groats and bran. The next tier contains milk and dairy products: cheese, yoghurt, kefir, cream and butter. Next-to-last tier represents protein-rich products. Sea fish rich in omega-3 acids are recommended. However, meat consumption (especially red meat) should be limited to few times a month. Animal fats should be avoided or swapped for their vegetarian counterparts. The top of the pyramid comprises oils and various kinds of nuts and almonds. They are healthy but also very caloric, so moderation is advised.
It is very important to drink sufficient amount of liquids throughout the day, especially water. Green tea and different herbal teas are also a good idea.
The amount of consumed sugar and salt should be reduced and supplemented by herbs and spices, which enhance flavor and contain healthy ingredients. All ready-made spice mixes containing preservatives should be avoided.
Heart failure patients remain under constant supervision of cardiac care. We can’t forget about other preventive medical examinations designed to diagnose diseases which do not show clear symptoms yet. That’s why we strongly encourage women and men to have periodical gynecological, breast, and urology check-ups.
Oral health affects the heart. We recommend periodical dental examinations. Untreated tooth decay, gums’ infections and inflammation increase the risk of cardiovascular system diseases.
Preventive flu and pneumococcus vaccinations are recommended by the European and Polish Society of Cardiology.
Patients can cope with symptoms of stress, depression and anxiety using proper meditation and relaxation techniques. If those do not help improve the mental state, seeing a psychologist is advised.
Sleep quality and duration is also important for mental wellbeing. Falling asleep before midnight and getting at least 7 hours of sleep is recommended.
An important aspect of quality of life is the sexual sphere. Cardiovascular diseases as well as some medications can affect the intimate life. In case of problems in this area, it is worth asking for advices to a sexologist and/or a cardiologist.
Despite their illness, patients should not abandon their social activities.