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www.nuh.nhs.uk
The benefits of exercise for
haematology patients
Information for patients
Physiotherapy Department
If you require a full list of references for this leaflet please email
[email protected] or phone 0115 924 9924
ext. 67184.
This document can be provided in different languages and
formats. For more information please contact:
The Trust endeavours to ensure that the information given here
is accurate and impartial.
Physiotherapy Department
Nottingham University Hospitals
Hucknall Road, Nottingham
Tel: 0115 969 1169 ext. 55292
Greg Stretton, Physiotherapy Department © January 2015. All rights reserved.
Nottingham University Hospitals NHS Trust. Review January 2017.
Ref: 1272/v2/0115/AM.
Public information
Aim of the leaflet
Notes
This leaflet is aimed at haematology patients who may have had
treatment including a bone marrow transplant, or for relatives
who want to know more about the benefits of exercise for
haematology patients.
It aims to provide information on why to exercise, how to do so
safely, and how to incorporate exercise into daily life.
The leaflet also includes space for you to record your exercise
activity.
Why should you exercise?
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To increase energy
To reduce fatigue
To strengthen your bones and muscles
To enhance your immune system
To improve your balance and coordination
To improve your mental alertness
To increase your confidence
To maintain your independence
Exercise reduces blood pressure
Weight control
Blood sugar control
To reduce the risk of developing other diseases such as
heart disease, stroke and osteoporosis
Exercise releases ‘endorphins’ which are the body’s natural
form of pain relief. They also give a feeling of well-being.
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Diary of exercise
WEEK 7
Day
AM
Activity
Afternoon
PM
Monday
Tuesday
Why is exercise important for haematology
patients?
After being in hospital and having treatment, you will probably
find that you get tired quickly. You may have stiff joints and sore
muscles from being in bed, and as a result of being less mobile
you may have a lower exercise tolerance.
Wednesday
You may also have lost weight while in hospital. This will include
a combination of fat and muscle, and to regain muscle weight
you will need to exercise.
Thursday
How much exercise should I do?
How much exercise you’re able to do will depend on:
Friday
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WEEK 8
Day
AM
Activity
Afternoon
Monday
How long you were in hospital
What condition you were diagnosed with
If you’ve had a transplant, what type you received
Your strength and mobility prior to diagnosis.
PM
You should gradually increase the amount of exercise that you
do. Pushing yourself too hard, too quickly will tire you out and
may discourage you.
You may tire very easily to begin with as your muscles are not
used to having to work hard. You should aim to do some form of
exercise three to five times a week.
Tuesday
Wednesday
You should be able to talk or maintain a conversation while
exercising. If you are short of breath when you talk, you are
exercising too hard and need to reduce the intensity.
Thursday
Friday
14
3
The Borg scale
Diary of exercise
The Borg scale of perceived exertion is used to ensure that you
are exercising at the right intensity. The scale is graded from 6
to 20 as shown below.
You should use the scale to rate how hard you feel you are
exerting yourself when doing your exercises.
WEEK 5
Day
AM
Activity
Afternoon
PM
AM
Activity
Afternoon
PM
Monday
Tuesday
When exercising you should be working at a level which gives
you a rating of between 12 and 15.
Wednesday
Thursday
6 No exertion at all
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 Maximal exertion
Friday
WEEK 6
Day
Monday
Tuesday
Wednesday
Thursday
Friday
4
13
Diary of exercise
WEEK 3
Day
What does exercise involve?
AM
Activity
Afternoon
PM
Monday
During the warm up your body should be prepared for exercise.
It will take up to 15 minutes of suitable low impact aerobic
exercise and stretches to warm up your body for exercise.
Tuesday
A cool down is needed after your main exercise session to bring
your heart rate back down, and prevent any aches or stiffness
after exercising. This should last for a minimum of five to 10
minutes.
Wednesday
Thursday
Friday
WEEK 4
Day
1) A warm up (5-15 minutes)
2) A main session (10-60 minutes)
3) A cool down (5-10 minutes)
AM
Activity
Afternoon
Monday
PM
Examples of activities for a main exercise session:
• Brisk walking
• Swimming
• Cycling
• Step ups
• Circuits (like rehab)
• Sit-Stand
• Squats
• Push ups
• Weights.
Tuesday
Wednesday
Thursday
Friday
12
5
The Importance of warming up
The following beneficial changes take place in the body
during a warm up session:
Increased body and muscle temperature
This means there is far less risk of overstretching a muscle and
causing injury during exercise.
Blood vessels dilate
This reduces the resistance to blood flow and lowers stress on
the heart.
Increased blood temperature
The temperature of blood increases as it travels through the
muscles. As blood temperature rises, the binding of oxygen to
hemoglobin in your red blood cells weakens. This makes the
oxygen more readily available to working muscles, which may
improve endurance.
Improved range of motion
The range of motion around a joint is increased.
Hormonal changes
Your body increases its production of various hormones
responsible for regulating energy production. During warm-up
this balance of hormones makes more carbohydrates and fatty
acids available for energy production.
Diary of exercise
WEEK 1
Day
AM
Activity
Afternoon
PM
AM
Activity
Afternoon
PM
Monday
Tuesday
Wednesday
Thursday
Friday
WEEK 2
Day
Monday
Tuesday
Wednesday
Thursday
Friday
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Mental preparation
Walking as exercise
Walking is an excellent way to build up your stamina and fitness.
Set aside some time each day for walking if you can.
The pace should be brisk: challenging but sustainable. You will
feel breathless and warm. You should be able to talk or maintain
a conversation while exercising.
If you can walk comfortably at a fast pace without tiring, try
incorporating hills or steps into your route to make it harder.
The warm-up is also a good time to mentally prepare by clearing
the mind, increasing focus, reviewing skills and strategy.
Positive imagery can also help you relax and build
concentration.
Warm up exercises to include
Gentle mobility exercises:
• Shoulder and hip rotation
Heart rate increasing exercises:
• Marching, walking, side steps
Stretches:
• Calves, quads, hamstrings - see below:
Examples of stretches:
Hold for 10-20 seconds
10
7
The cool down
How much energy is needed?
The cool down should include the same exercises as the warm
up, but gradually reducing the pace.
A ‘MET’ is a measurement of the amount of energy that is used
during a given activity. The list below shows how many METS
different activities use on a scale of 1 MET (easy) to 10 METS
(very hard) :
For example you could walk on the spot, slowing the walking
down gradually, and finishing off with some gentle stretches.
Hold these stretches for 10-20 seconds each.
More demanding sessions may require a more extensive cool
down.
The gentle aerobic activity helps to get rid of any metabolic
waste products which may have accumulated during the
exercise session. During a cool down, the heart rate is gradually
lowered to its resting level.
The inclusion of stretching exercises within the cool down period
not only helps to gradually lower the activity level of the body at
the end of the session, it may also prevent stiffness the following
day.
Exercises:
Cycling
Dancing
2-3
5-6
8-9
2-3
3-3.5
3.5-4
5-6
8-9
9-10
4-9
Functional activity:
Bed making
Washing dishes
Cooking (standing)
Dressing
Vacuuming
General housework
Sex
Mowing the lawn
(Un)loading washing machine
Stairs
Carrying heavy groceries
Digging the garden
2-6
2-3
2-3
2-3
3-3.5
3-4
3-5
4-5
4-5
4-7
5-7
6-7
Walking
Swimming
(5mph)
(10mph)
(13mph)
(2mph)
(3mph)
(3.5mph)
(4mph)
(breaststroke)
(front crawl)
Functional activities can be as beneficial as exercising.
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