How to involve physical activity into your life after heart attack

Movement belongs among natural physiological needs, which are connected to the existence of individual as a human being. Satisfying these needs has a positive effect on health and quality life, it belongs among the most important factors as a prevention against health disorders.

The need for physical activity is often underestimated or shifted (unlike the need to eat food) and doing other things instead. The lack of movement activity and sedentary lifestyle is a typical sign of today’s (otherwise ,,healthy”) society. If the person then suffers from some illness, physical activity is among the first things cut out from the daily life, because there is an assumption that sport is only for healthy individuals, but it’s quite the opposite.

Physical activity has to be accommodated to the condition of the exercising person (age, gender, condition, health condition, burden intensity, etc…). In the following text we will focus on the basic principles and recommendations for individual exercising for people after heart attack.


Ideal physical activity is determined by the called FITT (frequency, intensity, time, type).

  • Frequency - at least 3-5 times a week
  • Intensity - measuring pulse frequency and blood pressure before, during and after the exercise. Limitation should be increased pulse frequency on about 20-30 beats per minute, and increased blood pressure for about 30 mmHg. From the start it is ideal if you are under supervision of professional medical personnel. Later you can use sporttester with a chest belt. During optimal intensity burden you should be able to speak normally, if you are able to sing the intensity is low, and if you can’t say a word the intensity is too high.
  • Time/type - we recommend endurance types of activities (this is understood as activity lasting at least 40 minutes and more), which support fat burning and have positive effect on the levels of the blood lipids and lowering the blood pressure.


The training should be consisted of warming up phase, aerobic training, strength training and relaxation.

  • Warming up phase (10-15 minutes) makes the transition from inactivity to activity easier, it also improves the blood supply of the muscles. Incorporate simple exercises with or without exercising tools (gym ball, overball). Part of this phase is also stretching of the muscles you will put pressure on during training.
  • Main part of the training is the aerobic phase (25-40 minutes), which is usually taking place on stationary bikes (in ambulant facilities and spa), or exercising in form of circle trainings, which incorporates exercising the muscles of legs, arms and trunk, and you can combine it by using gym machines. Sports such as cycling, jogging, walking, nordic walking are usually good choice, and you can easily gradually increase the intensity by these sports.

For a long time strength training was not recommended to be incorporated because of the fear of increased blood pressure and possible negative remodeling effect it can have on the left chamber of the heart. But many studies have proved the positives (prevention against muscle atrophy) and safety of the exercise. Rational argument is also the fact that you need a certain degree of strength during daily activities. But we recommend you to start with the strength training after 4 weeks of aerobic training and test the reaction of blood pressure on the isometric pressure by a handgrip test. Physiotherapist can help you set the initial intensity of the workout by the 1-RM (one repetition maximum) method.

  • The purpose of the relaxing phase (10-15 minutes) is a to return back to the circulatory ration you had before the training and thus relax. It is therefore ideal to incorporate stretching, slower walking or any relaxing techniques.


With your own management and choice of activity you should keep the four Ps of training:

  • Regularity - perform the physical activity regularly, ideally daily, use the common daily activities such as walking to work, walking up the stairs, walking your dog.
  • Progress - start with easier exercises and gradually add more (first add more repetitions, later add intensity and pressure)
  • Adequacy - avoid overloading which doesn’t bring you joy but rather pain in the musculoskeletal system and aversion to the activity.
  • Diverse physical activity - it is a presumption for developing all the basic movement abilities (speed, power, endurance and finesse).

Attention: before your start, don’t forget to consult your training with a specialised medical personnel about your acute condition and other possible illnesses and health conditions. Ask about which activity would be ideal for your individual needs and abilities.

Instructions on how to do the exercises are very important, such as correction of the sitting posture and standing posture, and removing the muscle imbalances.

We wish you many success in every aspect, because… ,,Let him who would move the world move himself first.” - Socrates

 FYZIOklinika physiotherapy Ltd., Prague, Czech Republic

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