What Would a General Rehabilitation Program Look Like?
As written in part I of this article, it was highlighted that studies examining the therapeutic value of exercise of people with various cancers during primary cancer treatment suggest that exercise is safe and feasible.1 By reducing symptoms and improving strength and endurance through appropriate exercise, you can counter the effects of the disease and medication interventions, subsequently helping to improve physical functioning and mood disturbances and, hence, the overall quality of life. A tailored program under the direction of a licensed physical therapist could be very beneficial for these reasons. However, if going to see a physical therapist isn’t an option for you, but you still don’t want to miss out on the benefits exercise can provide you, what would a general rehabilitation program look like?
General guidelines for people with cancer include a progressive program for 15-30 minutes daily for 3-5 days per week at:
1.) 60-80% of your maximum (max) heart rate, or
2.) A rate of perceived exertion (RPE) of 11-141.
To figure out your estimated max heart rate, subtract your age from 220. You can then multiply that number by 0.6 (to give you 60% of your max heart rate) and 0.8 (to give you 80% of your max heart rate).
An example heart rate range
Let’s take a 50-year-old individual as an example:
220 – 50 (age) = 170 beats per minute (bpm) — This would be the predicted max heart rate in beats per minute (bpm).
Then take 170bpm (max heart rate) x 0.6 (60%) = 102bpm; and 170bpm x 0.8 (80%) = 136bpm
This would give this 50-year-old individual a heart rate range of 102bpm to 136bpm (60% to 80% of their max heart rate) to stay within during their exercise routine.
What if I don’t like math?
If you don’t have a heart rate monitor, don’t want to get one, don’t like math, or are currently on a beta blocker medication*, you can use the RPE scale instead. RPE is a scale of how much exertion you feel you are putting forth. It is from 6 (at complete rest) to 20 (at maximal effort). You should aim for an effort between 11-14.
It is also worthwhile to note that even if you are unable to tolerate 30 minutes of exercise at a time, it is still beneficial to do even just 10-minute exercise sessions 2-3 times a day.
The components of fitness
Additionally, a general program would want to target the 5 components of fitness: 1.) cardiovascular endurance, 2.) muscular strength, 3.) muscular endurance, 4.) flexibility, and 5.) body composition. Let’s delve into specifics for each of these.
Cardiovascular endurance relates to the efficiency of your heart and lungs to uptake oxygen, diffuse it into your blood, pump your blood throughout your body to deliver the oxygen to the tissue cells in exchange for waste products such as carbon dioxide, and rid of the waste products back into the lungs to be exhaled. Ways to work on your cardiovascular endurance include walking, biking, dancing, or anything that will increase your heart rate up to 80% of your maximum heart rate that you can maintain for 10-30 minutes.
Muscular strength relates to how much force your muscles can produce. This correlates to the size of your muscles, as well as the neuromuscular adaptations of your muscles, which means how many nerves are recruited to innervate your muscles to elicit more motor units to contract. Ways to work on your muscular strength include using resistance to work the major muscles of your arms, legs, and core. Resistance can be cans of beans from your pantry, dumbbells, resistance bands, or even your own body weight.
Muscular endurance relates to how efficiently your body can utilize energy and rid of waste products so that your muscles can continue to work without burning (lactic acid buildup) and fatigue. Ways to work on your muscular endurance include increasing the repetitions you do during a set of an exercise.
Flexibility relates to the length and elasticity of your muscles, which is important for unrestricted movement and proper postural alignment. Ways to work on your flexibility includes gentle stretching of major muscles in your arms, legs, neck, and trunk.
Body composition relates to what kinds of tissues make up your body, specifically your body fat percentage. Too much or too little body fat can greatly impact your overall health. A well-balanced diet and daily activity will help achieve and/or maintain an ideal body fat percentage.
While exercise and physical activity may not treat cancer directly, it can be used to combat the symptoms and side effects of cancer and conventional cancer treatments. It is important to ask your doctor if exercise is okay for you before beginning.
*Beta blocker, or beta antagonist, medications are prescribed for angina pectoris (chest pain), hypertension (high blood pressure), arrhythmias, tremors, migraines, anxiety, or open-angle glaucoma. These medications alter heart rate, so caution is required when exercising.2
- Goodman, Catherine Cavallaro., and Kenda S. Fuller. Pathology: Implications for the Physical Therapist. Third ed., Saunders, 2009.
- Sueki, Derrick, and Jacklyn Brechter. Orthopedic Rehabilitation Clinical Advisor Text and E-Book Package. Mosby Inc, 2009.