Exercise and Activity after Lung Transplant HF#6989



Exercise is important to good healing and will help you return to a more active lifestyle.  Aerobic exercise conditions the entire body.  It is continuous training and uses the large muscle groups (i.e., your arms and legs).  It helps your heart and lungs to work more efficiently. 

 

Your Hospital Exercise Program

 

While in the hospital, you will work with the Cardiopulmonary Rehab staff to find a program that is right for you.  The staff will check your heart rate, blood pressure, and oxygen saturations while you exercise.  This helps them to know how your body is responding to exercise.  It also helps them to suggest a home program that is best for you.

 

Your Home Exercise Program

 

The guidelines below are for you to follow at home.

 

What activity?	Walking on a level surface or using a stationary bike or treadmill.
How often?	4-6 times per week.
How long?	Start with ___ minutes of exercise.  Increase your walking or biking 1-2 minutes each day.  Your goal is to reach 30-45 minutes of continuous training.
How hard?	Check your heart rate or your rating of perceived exertion (RPE).  This will be explained later in this handout.

 

The Cardiopulmonary Rehab staff will work with you to receive follow-up care after you leave the hospital, at your local Pulmonary Rehab Program, to further guide you with your lifelong home exercise program.

 

How Your Body Responds to Exercise

 

Normally, you may notice you are breathing faster and your heart rate increases when you exercise.  You can also expect to sweat and to have some muscle fatigue.  

 

It’s also important to know what is NOT normal.  If you notice any of these symptoms, STOP exercising and call your local doctor.  If you feel this is an emergency, call 911 right away.

 

Severe heart pain (angina) Excessive shortness of breath or unable to talk Excessive sweating Blurred vision Frequent skipped heart beats Dizziness, light-headedness Nausea Cramping in your arms and legs

 

 

 

Knowing How Long and Hard to Exercise

 

Your heart rate and how you feel will guide how long and hard you should exercise and what activities you should do.  Here are three easy ways to check your response.

 

• The Talk Test

Choose a level of exertion that allows you to still talk while you exercise.  You should be able to talk in short sentences, but will likely not be able to sing.

 

• Your RPE (Rating of Perceived Exertion)

 

RPE tells us how hard you feel you are working.  It’s based on your muscle use, breathing, and overall feelings of effort.  In most cases, you should aim for “somewhat hard” (or 12 to 14 on the scale) during exercise.  If what you are doing gets harder than that, you need to either slow down or take a rest.

Perceived Exertion Scale         6       7   very, very light       8       9   very light       10       11   fairly light       12       13   somewhat hard       14       15   hard       16       17   very hard       18       19   very, very hard       20

 

 

• Your Heart Rate

Place your arm so that your palm is face up.  Take the second and third fingers of your other hand and place them over the blood vessel as shown below.  (Do not use your thumb.) 

 

 

 

Gently feel for the pulse.  Count your heart rate for 15 seconds.  Multiply that number times 4.  

 

_____ x 4 = _____ beats per minute

 

Take your heart rate for a few days in a row so that you know what is normal for you.  If you heart rate is below 50 or above 120 beats per minute while at rest, call your doctor. 

 

Your heart rate during exercise should not be

30 beats per minute more than it was at rest.

 

What to Wear for Exercise

 

Dress in loose-fitting, comfortable clothing.  In warmer weather, a cotton T-shirt and shorts may be enough.  In cooler weather, layer your clothing if you plan to exercise outdoors.  For instance, a windbreaker over a long sleeve shirt may work well.  Covering your nose and mouth with a scarf can also help to warm the air you breathe.

 

Avoid heavy, bulky coats or jackets.  They can increase the work it takes to move your body.  Your body heat naturally increases as you exercise.  You don’t want to become overheated by dressing too warmly.

 

Wear jogging or walking shoes.  Shoes with supportive arches reduce foot and knee soreness that can occur when you exercise for longer times.  If you have diabetes, be sure your shoes have a large enough toe box and the heels do not pinch or cause blisters. 

 

Activities You Can Expect to Do

 

The first month after surgery	1-3 months after surgery
Light housework, crafts Dining out, shopping Stair climbing Putting a golf ball	Biking indoors Gardening Dancing Chipping with a golf club

 

Activity Guidelines

 

The chest incisions take 2 – 3 months to heal completely.  To protect the incisions while they heal, you will need to restrict your lifting and arm work.

 

• Do not lift over 10 pounds for 3 weeks.
• Do not lift over 30 pounds for 3 months (i.e., young children, an armload of wood, water softener bags, garage door, groceries, etc.)
• Do not drive or bike outdoors for one month.
• Avoid vigorous push-pull arm movements (i.e., vacuuming, raking, hoeing, lawn mowing.)
• Avoid any arm motion that causes pain in the incisions.

 

Stair Climbing

 

Climbing stairs can be strenuous activity.  While healing, you may need to climb stairs at a slower rate.  At first, be sure to pace yourself to one stair every 2 seconds.  As you heal, you can slowly increase your rate.

 

Arm Exercises

 

Your lifting and arm work is limited for 2-3 months while the chest incisions heal.  During this time, the muscles of your chest and upper limbs need to stay mobile and flexible.  The exercises below allow you to stretch your muscles without putting too much pressure on your wound.  They also help you to maintain range of motion and avoid losing muscle tone in your chest, shoulders, and arms.

 

Plan to do these exercises daily for 4-6 weeks after surgery.  Start by doing 5 of each daily.  Slowly progress to doing 10 of each per day.  While you exercise, remember to breathe.  Do not hold your breath. 

 

The Chest Stretch

• Start with your arms in front of your chest.  Hold the towel shoulder width apart.
• Slowly raise your arms to the point just before your feel discomfort.
• Slowly bend your elbows while bringing the towel into your chest.
• Straighten your elbows and return to your starting point.
• Repeat.  As you heal, your arms should go farther toward the ceiling to begin with.  Eventually you may be able to start with the towel above your head and lower it behind your head.

 

Arm Circles

• Place your hands on your shoulders.
• Move your arms clockwise as if you are drawing circles with your elbows.  Start with little circles.  Make the circles bigger and bigger.
• Repeat in the opposite direction.

 

Sexual Activity

 

Once home, you may engage in sexual activity as you feel able and have the desire.  The peak effort with sex is equal to climbing stairs at a moderate pace.  That would likely be “somewhat hard” on the exertion scale.  During sex, heart rate may peak at 120 beats per minute and remains at that rate for only a short time. 

 

As you are healing, you will need to protect your incision.  Trying positions that place less stress on your upper body will work best.

 

Some heart medicines can affect your sexual drive and ability.  If you have questions or concerns about this, please talk with your doctor or heart care team.

 

 

Cold weather – Avoid exercising outdoors when the temperature or wind chill factor is below 0 degrees.  The body and heart have to work harder to walk against wind and snow.  Learn to pace yourself and avoid sudden bursts of effort.  You may need to work and rest at intervals to maintain this rating.  Your exercise should never feel harder than “somewhat hard.” 

 

Shoveling – After 3 months, you may be able to shovel light snow again.  Before doing so, warm up and do gentle stretches.  Pace yourself.  You may safely shovel if your effort is controlled at the “somewhat hard” level.    Again, mix work and rest every 2-3 minutes to avoid over doing it. 

 

While shoveling, remember to:

• Avoid holding your breath.
• Shovel fresh snow rather than wet, packed snow.
• Push instead of lifting.  It’s easier on the back and spine.  “Push shovels” are sold for this purpose.
• Avoid picking up too much snow at once.  Use a smaller shovel or only fill it ¼ to ½ full.
• Bend your legs and not your back.  Keep the small of your back straight.  This avoids placing extra stress on your spine.

 

Your Pulmonary Rehabilitation Program

 

Follow-up care is very important to your recovery.  You can receive this follow-up care through the UWHC Cardiopulmonary Rehabilitation Program or through a program nearer your home. 

 

Your local Pulmonary Rehab program: _______________________

 

Phone number: _______________________________________

 

UW Hospital Cardiopulmonary Rehab                             (608) 263-6630

UW Research Park Cardiopulmonary Rehab                    (608) 263-7420

 

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 02/09/2010

Copyright © 02/09/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6989

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