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Balance exercises for cardiac rehabilitation

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This leaflet is aimed at patients with a heart condition to further improve balance. Regular balance training can bring about important benefits to our quality of life.

Falls prevention

Good balance helps to improve joint stability and control your core which can help to prevent falls. Better balance allows us to adjust to unexpected variations in uneven surfaces which can further reduce the risk of a fall. This may help boost your confidence and help avoid injury.

Reverse age-related loss of balance

A critical predictor of life expectancy is the length of time a person can stand on one leg. Balance is a complex activity which involves your brain, muscles and parts of your inner ear. If it is not something that you practice regularly, the coordination between these three systems can decline over time. However practice will help to maintain and improve this skill.

Improved posture

  • A more sedentary lifestyle has resulted in the average person having poor posture.
  • Poor posture can result in reduced upper back mobility, anterior pelvic tilt and hunched shoulders.
  • Balance exercises are important to counteract the effect of our more sedentary lifestyles.
  • By improving your balance you will also improve your posture.

Injury prevention and recovery

Balance drills following injury have been shown to speed up recovery from injury as well as preventing it.

Improved co-ordination

Lack of balance practice can lead to poor co-ordination.

Regularly practicing balance drills and achieving good balance help you adapt to any situation instinctively.

Please perform the following exercises daily to help support your balance:

Heel to toe walk forwards and backwards
A woman placing her right foot directly in front of her left foot with her toes of her left foot touching the heel of right foot.
Place your right foot directly in front of your left foot so the toes of your left foot are touching the heel of your right foot.
A woman moving her left foot in front of right foot, with toes of right foot touching the heel of the left foot.
Move your left foot in front of your right foot. Position your foot so that the toes of your right foot touch the heel of your left foot.
A woman walking forwards
Please begin by attempting five steps forward, then repeating the same again backwards and repeat two times.

Key points and progression

  • Ensure that you maintain upright posture and keep looking forwards at all times.
  • To be performed next to a surface that you are able to use for stability, such as a wall that you can hold onto if necessary.
  • Progression: increase repetitions of the exercise and as you build your confidence move further away from your support. Work towards two minutes of this exercise.
Step up
A woman standing in front of a step, feet hip width apart
Stand in front of your step, feet hip width apart.
A woman stepping up with one foot onto step
Step up with one foot onto step.
A woman standing on a step
Step up with second foot. Ensure both feet are on step.
A woman stepping off step backwards
Step back down with leading foot, followed by second leg to starting position.

Key points and progression

  • Please use the bottom step of stairs if you do not have an exercise step.
  • Try to alternate legs where possible.
  • Use handrail of stairs for support.
  • Try to keep your back straight and your abdominal muscles tight.
  • Step up five times initially with each leg. Gradually increase frequency.
Single leg hold
A woman with her hands on the back of a chair
Lift one leg up behind you and hold for ten seconds.
A woman with her hands on the back of a chair with one leg bent at a right angle behind her
Bring leg down to the ground and lift other leg up behind you. Hold for a further ten seconds .

Key points and progression

  • Begin by holding onto a chair with two hands, drop down to one hand, then try only using your fingers. Once your confidence builds, try without holding on with a support close to you.
  • Gradually extend the duration of the balance as you become more confident.
Single foot tap on three sides
A woman with her right leg out to the side and toes on the floor
Tap your right foot out to your right side then together with your other foot.
A woman with her right leg out in front of her with toes to the floor
Tap your right foot out in front then back together with your other foot.
A woman with her right leg straight out behind her with her toes to the floor
Tap your right foot behind, then back together with your other foot.

Key points and progression

  • Please use a chair for support initially. Place the chair to your left side while tapping with your right foot. Then alternate.
  • Repeat this combination of exercises five times before swapping legs and moving the chair to your right side.
  • As your confidence grows, try without holding on to a support but with a support close to you.
  • To progress, increase repetitions of exercises.
Leg extension
A woman sat on a chair with her right leg straight out in front of her and toes upwards
Sit tall towards the back of an armless chair. Keep your stomach muscles engaged and your shoulders relaxed.
A woman sat on a chair with both feet on the ground
Extend your leg out to the front and hold for two - three seconds before returning to resting position. Perform three sets of 15 repetitions on each side

Key points and progression

Try not to lean back whilst extending your leg

Progression:

  • Increase number of cycles.
  • Perform with light weights attached to ankles.
  • Perform sitting on an exercise ball.
Sideways walking
A woman standing with her hands on the back of a chair in front of her
Stand with your feet together and knees slightly bent
A woman with her right hand on the back of a chair to her right and her right leg bent at the knee
Step sideways with your right foot in a slow and controlled manner until your feet are shoulder width apart.
A woman with her hands on the back of a chair in front of her and her feet apart
Move your left foot to join your right foot until they are hip width apart. Repeat in the opposite direction.

Key points and progression

  • Avoid dropping your hips as you step.
  • Perform ten steps from side to side.
  • To progress try with just one hand on the chair followed by fingers only. Finally try with your support nearby only and side step from one side of the room across to the other.
Crossover
A woman standing with her feet apart
Step to your right with your right foot.
A woman standing with her left leg crossed over in front of her right leg
Cross in front with your left foot.
A woman standing with her feet apart
Step out with your right foot again.
A woman standing with her right leg crossed over in front of her left leg
Cross behind with your left foot.

Key points and progression

  • Continue the crossovers for five steps, then continue with crossovers to your left-hand side.
  • Please ensure that you have a support close to you for balance.
Heel lift
A woman standing with her right hand on the back of a chair and her feet at hip width
Stand with your feet hip width apart and your toes pointing forward.
A woman standing with her hands on the back of a chair in front of her and her heels raised from the ground
Lift your heels off the floor so that you are standing on the balls of your feet. Hold the position for one - two seconds before you slowly lower your heels to the floor.

Key points and progression

  • Have a chair or wall nearby for support.
  • Keep your legs straight and try not to allow your feet to rotate.
  • Perform three sets of 30 seconds interspersed with 30 second marching intervals.
  • Maintain tall posture throughout.
Flamingo
A woman with her right hand on the back of a chair and her left knee lifted in front of her
Start with your feet shoulder width apart. Lift your left foot off the ground and raise it to the height of your other knee in front of you.
A woman with her right hand on the back of a chair and her left leg bent at the knee
Bring your left foot back down and touch the toes to the ground.
A woman with her right hand on the back of a chair and her leg at a right angle behind her
Bend from your left knee, lifting the toes out behind you. Alternate with the other leg.

Key points and progression

  • Keep your back and hips straight and head facing forward.
  • A good exercise for building balance, strengthening your core and opening up your chest and shoulders.
  • Please use a chair to start with and only attempt without a chair once you have built up your confidence.
Heel to toe hold
A woman standing with her left hand on the back of a chair and her right foot in front of her left foot
Place your right foot directly in front of your left foot so the toes of your left foot are touching the heel of your right foot. Hold using a support to hold onto for ten seconds.
A woman standing with her left foot in front of her right foot
Alternate this and place your left foot in front of your right.

Key Points and progression

  • Gradually decrease the amount that you are holding onto your support.
  • Increase the length of time in this position.
Sit to Stand
A woman sat on the edge of a chair with her feet apart on the ground and her arms stretched out with her hands by her knees
Start seated towards the front of a chair. Ensure good posture throughout.
A woman sat on the edge of a chair with her feet apart on the ground and her arms stretched out in front of her while leaning slightly forward
Without pushing off with arms, start to stand up.
A woman standing straight with her feet apart and arms by her side
Stand fully and make sure that you are balanced before you start to sit back down.
A woman lowering herself in to a chair with her arms straight out in front of her
Slowly lower yourself back to the chair and sit down. Keep your feet flat on the ground.

Key points and progression

  • Use a chair for support to begin with.
  • Perform without a support once you improve your confidence.
  • Ensure that you maintain good posture and look straight ahead whilst performing this exercise.
Heel to toe tap
A woman with her left leg out in front of her, lifting her toes off the ground
Lift up your left foot and tap your heel out in front to the ground
A woman with her left leg lifted in front of her at a right angle
Lift the heel of your left foot up and tap your toes to the ground, trying to hit the same spot on the ground.
A woman with her left leg bent at the knee and foot slightly lifted from the floor
Repeat this movement twice before repeating with the other foot.

Key points and progression

  • Use a chair for support to begin with.
  • Perform without a support once you improve your confidence.
  • Lift your foot further off the ground once you feel more balanced.
  • Be sure that you maintain good posture and look straight ahead whilst performing this exercise.

MyChart

We would encourage you to sign up for MyChart (opens in a new tab). This is the electronic patient portal at Cambridge University Hospitals that enables patients to securely access parts of their health record held within the hospital’s electronic patient record system (Epic). It is available via your home computer or mobile device

Document details

Approved

04 Jan 2024

Version number

1

Document ID

103548

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Service / Department

Cardiology

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This document was correct at the time of printing - 19-05-2024 11:00