Respiratory Rehabilitation

Program

Ways to control
your breathing

St. Joseph’s Hospital 50 Charlton

Avenue East Hamilton Ontario L8N
4A6
This book belongs to: ________________________________

Developed by the Occupational and Physiotherapy

Department Respiratory Rehabilitation Program

Some pictures from VHI Exercise Software Respiratory Edition 1999-2005
PD 5817 (Rev 01-2015) File: peyles

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Inside this book . . .
Topic Page
Importance of Breathing Exercises:
 Breathing Training 3
 Breathing Exercises 4
 Clearing the Airways 8
Managing Shortness of Breath (S.O.B.):
 Help for Shortness of Breath - S.O.S for S.O.B. 11
 Positions to Ease S.O.B. 12
 Rate Your Exertion: The Borg Scale 13
Activities of Daily Living and Breathing Control:
 Breathing Control when You Wash and Dress 17
Let’s Talk about Exercise:
 Exercise 21
 Parts of an Exercise Program 22
 Muscles to Move By 24
 Home Exercise Tips 26
 Introduction to Tai Chi 28
Your Heart:
 Your Heart, Heart Rate and Pulse 35
 Monitoring Your Heart Rate 37
 Checking Your Heart Rate 38
 Heart Rate Table 39
 Calculating Your Working Heart Rate Range 40
 Work Sheet 41

3
Importance of Breathing Exercises

 Breathing Training 3

 Breathing Exercises 4

 Clearing the Airways 8

 Breathing Training

What does breathing training do?

 Moves stale air and carbon dioxide out of the lungs

 Moves fresh air and oxygen into the lungs
 Helps control shortness of breath at rest and with activity
 Helps remove mucous from your lungs

Pursed lip breathing (PLB)

 Breathe in slowly through your nose

and count – 1 and 2.
 Purse or pucker your lips as if you
were going to whistle.
 Breathe out gently though your pursed lips
and count slowly – 1 and 2 and 3 and 4.
 Do not force the air out of your lungs.
 There are a few ways to do this type of breathing. The physiotherapist will
help you find the best way for you.

Deep or Diaphragmatic (Belly) Breathing

 Place one hand on your abdomen just under your breastbone.

 Slowly breathe in through your nose and feel your belly rise
into your hand.
 Slowly breathe out through pursed lips and feel your belly
fall away from your hand.
 Keep your shoulders relaxed - not hunched up.
 Do this sitting or lying in a comfortable position.

Rib Breathing

 Flatten your hands on the lower part of

your rib cage.
 Breathe in through your nose and
feel your ribs move outward.
 Breathe out and feel your ribs flatten.

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 Breathing Exercises
Why do these exercises?
 To promote a proper breathing pattern
 To help you relax
 To improve your flexibility

Remember . . .
 Do these exercises EVERY day. Go at your own pace.
 Breathe out through pursed lips as you move.
 Listen to your body, do what you feel is comfortable; not every exercise is
for every body!
 Keep a proper

sitting posture:
feet flat on the floor

back supported (rolled towel if needed)

shoulders relaxed

The Exercises

1. Deep or Diaphragmatic Belly Breathing

 Place one hand on your abdomen just under your
breastbone.
 Slowly breathe in through your nose and feel
your belly rise into your hand.
 Slowly breathe out through pursed lips and feel your
belly fall away from your hand.
 Keep your shoulders relaxed - not hunched up.
 Do this sitting or lying in a comfortable position.
 Repeat 5 times.

2. Trunk Rotations
 Sit in a relaxed position.
 Cross your arms in front of you, keeping
your shoulders relaxed.
 Breathe in through your nose.
 Breathe out through your pursed lips and turn
your body to one side.
 Breathe in.
 Breathe out and return to centre.
 Repeat to the other side.
 Repeat 3 to 5 times in each direction.

4
3. Elbow Touch
 Sit in a relaxed position with your arms bent at your side.
 Breathe in through your nose.
 Breathe out through your pursed lips and bring your
elbows back, as if you were trying to make them
touch.
 Breathe in.
 Breathe out and return to start position.
 Repeat 3 to 5 times.

4. Reaching to the sky

 Sit with your arms relaxed by your side.
 Breathe in through your nose.
 Breathe out and lift one arm up, reaching to
the sky.
 Breathe in.
 Breathe out and return the arm to the start
position.
 Repeat with the other arm.
 Repeat cycle 3 to 5 times.

5. Windmill
 Sit with arms relaxed by your side.
 Breathe in through your nose.
 Breathe out through your pursed lips and
bring your arms up over your head and try
to touch your palms together.
 Breathe in.
 Breathe out and bring your arms back to the
start position.
 Repeat 3 to 5 times.

5
6. Seated Kicks
 Sit in a relaxed position with both feet flat on the floor.
 Breathe in through your nose.
 Breathe out through your pursed lips and kick your
foot up off the floor.
 Breathe in.
 Breathe out and lower it back to the start
position.
 Repeat with the other leg.
 Repeat cycle 3 to 5 times.

7. Shoulder Shrugging
 Sit with your shoulder relaxed and your arms by your side.
 Breathe in through your nose.
 Breathe out through your mouth and lift your shoulders
up as if trying to touch your ears.
 Breathe in.
 Breathe out through your pursed lips and relax
your shoulders to the start position.
 Repeat 3 to 5 times.

Take a break if you need to!

8. Shoulder Rolls
 Sit with your shoulders relaxed and your arms by
your side.
 Breathe in through your nose and out through your
pursed lips in a slow, controlled manner.
 Roll your shoulders backwards for 3 to 5 breath cycles.
 Repeat rolling your shoulders in a forward direction
for 3 to 5 breath cycles.

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9. Foot Rocking
 Sit in a relaxed position with both feet flat on the floor.
 Breathe in through your nose and out through your
pursed lips in a slow, controlled manner.
 Rock your feet from heel to toes in a smooth pattern.
 Continue for 3 to 5 full breath cycles.

10. Neck Stretches

Sit in a relaxed position with your arms by
your side. Do these slowly and gently.
Ear to shoulder
 Breathe in through your nose.
 Breathe out and lean your head to one side
as if trying to touch your ear to your
shoulder. Keep your eyes looking forward.
 Hold the position and breathe in and out 3 times.
 Return to centre on your last breath out.
 Repeat going to the other side.

Chin to chest
 Breathe in through your nose.
 Breathe out and drop your chin down to your
chest, keeping your shoulders relaxed.
 Hold the position and breathe in and out 3 times.
 Return to centre on your last breath out.

Turning to one side

 Breathe in through your nose.
 Breathe out and turn your head to one side.
 Hold the position and breathe in and out 5 times.
 Return to centre on your last breath out.
 Repeat going in the other direction.

7
 Clearing the Airways

Coughing is the natural way to remove substances from your lungs.

Some of you may have more mucous or phlegm that causes you to cough.
Also, when you have a chest infection it is important to get the phlegm out.
This will keep the breathing tubes open and make breathing easier.

Coughing
Coughing is hard work. It can make you tired. The following steps will help
you cough better with the least amount of energy:
1. Sit up.
2. Take a slow deep breath in until your lungs are almost full.
3. Try to hold the deep breath for 2 to 3 seconds.
4. Cough 2 times with your mouth slightly open. The first cough loosens the
mucous. The second cough moves it to the back or your throat.
5. Sniff gently to take a breath in. Taking a big breath in right after coughing
may send the mucous back into your lungs.
6. Cough the mucous into a tissue. Remember to check the colour.
7. Rest.
8. Wash your hands.
9. Do this with your breathing exercises, at least in the morning, and before
you go to bed.

Your Physiotherapist (PT) may also teach you and your family
other ways to help clear your airways. There are safety
guidelines and instructions for each of them so please consult
your Physiotherapist.

This may include:

 postural drainage
 manual techniques or chest physiotherapy
 oral devices

8
 Managing Shortness of Breath

S. O. B.

 Help for Shortness of Breath - S.O.S for S.O.B. 11

 Positions to Ease S.O.B. 12

 Rate Your Exertion: The Borg Scale – 13

Monitor Your Shortness of Breath

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10
 Help for Shortness of Breath (S.O.B.)
S.O.S. for S.O.B.

When to use S.O.S. for S.O.B?

 To recover after coughing

 To recover after exercise or activity
 To help control panic and anxiety
 To help control sudden onset of shortness of breath
 To aid in relaxing the breathing muscles

S.O.S. for S.O.B.

 Stop and rest in a comfortable position.
 Put your head down.
 Get your shoulders down.
 Breathe in through your mouth.
 Blow out through your mouth.
 Breathe in and blow out as fast as is needed.
 Begin to blow out longer, but not forcibly. Use pursed lips if you find it
works.
 Begin to slow your breathing.
 Begin to breathe in through your nose.
 Begin diaphragmatic or deep breathing.
 Stay in position for 5 minutes or longer until your breathing returns to
a comfortable level.
 Make reassuring statements like “this will pass” and “I have gone through
this before”
 You can use a fan or open a window to help circulate the air.

Adapted from The Lung Association

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Positions to Ease S.O.B.

12
 Rate Your Exertion: The Borg Scale
Monitor Your Shortness of Breath

What is the Borg Scale?

The Borg Scale is a way to measure how much work your muscles
are doing when you are exerting in activities and exercise. It is a
number scale. This scale describes how you feel. There is no right or
wrong answer.

0 Nothing at all
0.5 Very, very slight
1 Very slight
2 Slight or light
3 Moderate
4 Somewhat severe
5 Severe or heavy
6
7 Very severe
8
9
10 Very, very, severe or maximum

Source: Borg, G. V. (1982) Psychological basis of perceived

exertion. Medicine and Science in Sports and Exercise, 14, 377-381.
American College of Sports Medicine.

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14
 Activities of Daily Living
and Breathing Control

 Breathing Control when You Wash and Dress 17

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16
 Breathing Control when You Wash and Dress

Many people with lung disease get short of breath when washing and dressing.

This is caused by the movements such as:

 reaching overhead
 rubbing and scrubbing
 twisting
 reaching your feet

Standing – The Problem

Standing to shower, wash at a sink or get dressed, adds extra demands on your
body. These movements:
 increase your heart rate
 increase the amount of oxygen your muscles need
 increase the work of breathing

Save your energy

Your Occupational Therapist will help you learn how to wash and dress.
The goal is to control your breathing to lessen:
 fatigue or feeling tired
 shortness of breath
 frustration and
 breathing recovery time

The key to this is to ensure that you are:

 breathing correctly
 breathing with movement
 taking rest breaks

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Sit down

Sitting supports your body so you can focus

on your breathing and your activities.

Helpful Hints when Sitting or Standing

 Maintain a regular flow of breathing as you move

 Never hold your breath
 Use pursed lip breathing
 Breath in before starting each movement
 Breathe out when moving out of your resting position or when doing
a strenuous movement
For example:
reaching overhead

reaching out in front of you

reaching below your waist

reaching to your feet

lifting your legs or feet

 Avoid quick jerky movements. Instead use slow, flowing movements.

This uses less energy and causes less shortness of
breath.
 Take regular rest breaths and rest breaks
throughout the task.
 Avoid rushing. Rushing will cause you to feel
more tired and short of breath.

Learning how to wash and dress will take some practice. You need to learn how
to change your routines. It may also seem like getting washed and dressed now
takes longer. However, by slowing down, breathing with movements, and taking
rests, you will be less short of breath and have more energy for other important
activities.

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 Let’s Talk about Exercise

 Exercise 21

 Parts of an Exercise Program 22

 Muscles to Move By 24

 Home Exercise Tips 26

 Introduction to Tai Chi 28

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20
 Exercise

Exercise and activity is very important. Strong muscles improve function.

Over time, exercise will reduce your level of breathlessness. This means you will
be able to do your activities of daily living easier.

Remember . . . if you do not use it, you lose it.

Keep on moving.

Psychological benefits of regular exercise and activity

 Increases your self-confidence and self-image
 Makes you feel good
 Improves concentration and memory
 Helps you relax and sleep better
 Helps control anxiety
 Helps reduce food cravings

Long-term physical benefits of regular exercise and activity

 Helps your respiratory muscles work better
 Helps you control your breathing better
 Improves the function of your heart and lungs
 Improves the flexibility of your muscles and joint range
of motion
 Maintains the health of your bones
 Enhances your co-ordination and balance
 Decreases your risk of injury and helps to manage pain
 Boosts your stamina and energy levels
 Optimizes weight control and increases lean muscle mass
 Helps in digestion
 And much more . . .

What to expect from regular exercise and activity

 Our muscles do a lot of work. At times, we may feel aches and pains
during activity and exercise. This is normal.
 To help muscles recover, take rest breaks in between exercising.

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 Parts of an Exercise Program

There are 3 types of Exercise:

1. Stretching:
 Improves flexibility
 Lowers the risk of injury
 Keeps muscles and joints loose and agile
When you stretch . . .
 Stretch slowly until you feel a gentle pull.
 Co-ordinate your breathing with your movements.
 Hold each stretch for 10 to15 seconds or longer if you can.

2. Strength Training:
 Refers to slow repetitive movements with certain muscles.
These are often done using weights or resistance.
 Important to help you do tasks of daily living safer and easier.
 Standing up from a chair or climbing stairs also improves
leg strength.

3. Cardiorespiratory or Aerobic Training:

 Continuous movement using large muscle groups like walking,
cycling or treadmill.
 Increasing your heart and respiratory rate during aerobic
activity improves conditioning.
 You need organized aerobic exercise to improve fitness.
Walking from your bedroom to the living room is not enough.

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Warm Up:

It is important to warm up 5 minutes before all

exercises to:
 Warm up muscles and body temperature
 Increase heart rate and breathing rate slowly
 Lower the risk of injury
 Slowly increase your speed on the exercise
equipment or when you are walking to ease into it

Cool Down:
It is important to cool down for 5 minutes
before stopping.

Cooling down:
 prevents dizziness, sore muscles and blood pooling
 helps you regain control of your breathing and
heart rate
 slowly decrease your intensity on exercise equipment before coming to
a complete stop

Warm Up and Cool Down:

Breathing exercises and slow-paced walking are

ways to warm-up and cool down.

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 Muscles to Move By

Muscles in the Front:

Necks Muscles: Facial Muscles:

 Help with breathing.  Use for pursed lip
 Need to stretch and breathing and smiling.
relax.
Shoulder Muscles:
Chest Muscles:  Move upper arms.
 Help with breathing,  Need to be strong.
moving shoulders.
 Need to stretch. Bicep Muscles:
 Bend elbows for
Abdominal Muscles: lifting and overhead
 Help with breathing, tasks.
coughing and posture.

Hip Muscles:
 Need to be strong for
walking and moving.

Thigh Muscles:
 Need to be strong for
walking and stair
climbing.
Shin Muscles:
 Need to be strong
for walking.

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 Muscles in the back:

Shoulder and Neck Muscles:

 Help with breathing.
 Need to stretch and relax.

Shoulder Muscles:
 Move upper arms.
 Need to be strong.
Back Muscles:
 Help with posture. Tricep Muscles:
 Straighten elbows.
 Used for overhead
motions.
 Need to be strong.

Hip Muscles:
 Help for walking,
climbing stairs, and
getting up from chair.
Inner Thigh Muscles:
 Help with walking.
 Need to be strong. Back Thigh Muscles:
 Bend knees.
 Help with climbing stairs.
 Need to be strong.
Calf Muscles:
 Bend the ankles for
walking.
Achilles Tendons:
 Help with walking and
going up on toes.
 Need to stretch and
strengthen

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 Home Exercise Tips

It is important to maintain your exercise and activity levels. Your

Physiotherapist will give you a home exercise program and schedule to follow.
 Make exercise a regular part of your day.
 Set up an exercise space in your home with your equipment.
 Try to follow your schedule to keep on track.
 Give yourself time. It takes a few weeks to get into a routine.
 Avoid feeling discouraged. Remember, practice makes perfect.
 Balance rest with activity.

Your activity program may include:

 Daily breathing exercises
 Walking
 Going up and down stairs
 Riding a stationary bicycle
 Using a treadmill
 Doing arm and leg strengthening exercises

Other places to do your exercise routine:

 Community Centre or Senior Centre
 Fitness or Wellness Centre
 YMCA or YWCA
 Shopping Mall walking

Keep an exercise record:

 Use the exercise sheets given to you by

your Physiotherapist.

 This record helps you see your progress and keep on

track.

 Write your reason for not exercising such as increased shortness of

breath, feeling unwell or high humidity.

26
When you do NOT feel well:

 Do not exercise. You should still do your breathing

exercises.

 Contact your doctor as advised on your individual Action Plan.

27
 Introduction to Tai Chi

What is Tai Chi?

 Tai Chi is a form of exercise that combines deep concentration, slow
coordinated movements and controlled breathing.
 The slow, circular motions of Tai Chi routines gently stretch muscles,
massage internal organs, assist in blood circulation and release tension in
your body. It is a full, gentle and relaxing workout with many benefits.

Getting ready . . .
Your physiotherapist will teach you how to do the Tai Chi movements safely.
You will learn to do these movements sitting first. When you are ready for a
harder workout, you can do Tai Chi standing.

Helpful hints:
 When you are sitting, sit up straight, with your head, neck and spine
aligned. This promotes relaxation and helps lessen the stress on your
back. Place one foot in front and the other foot slightly behind and angled
outward.

 All movements are done slowly. Slow movements help

create an awareness of every muscle and joint in your
body. This also increases the number of muscles you use.
Move at your own comfortable pace.

 Remember, not all movements are good for everybody. Do what feels
right. If you have too much discomfort, take a rest break or stop the
motion.

 Make sure your elbows are never fully straight. Always keep your joints
slightly bent to help the energy flow gently through your body.

28
 Tai Chi – The Program

Your physiotherapist will teach you how to breathe. Remember to breathe out
through pursed lips.

Warm Up
 Deep breathing: Internal warm up that relaxes the body and
promotes movement of breathing muscles.
 Ballerina stretch: Warms up the shoulders and arms.

 Gentle rotation of body with arms swinging: Warms up the chest and
stretches the breathing muscles.

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 Tai Chi Routine
Forward Wave
In this exercise, your arms lift smoothly up and down like a wave.
“Wave” your arms up to shoulder level.

 
Start with your hands on your knees

 
As you lift your arms up

 
As you lower your arms down

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Side-to-Side Wave
 Start with your hands on your knees.
 Lift your arms up gently. Move your arms to one side in a wave-like
motion turning your torso at the same time.
 Return your “wave” to the centre and do the same on the other side.

Front-to-Back Wave
 Begin with both hands in the middle with your palms facing each other
but not touching as shown in the picture below.
 Swing hands away and push them down and back.
 Return hands to the centre changing positions.
 Repeat 5 to 10 times slowly.

31
Pushing Hands
 Push your hands to one side as you extend your arms out to one side.
 Bring both hands back to a resting position.
 Then do this on the other side.
 Repeat 5 to 10 times.

Cool Down - Cross Finish Movement

 Raise both hands in front of your palms facing each other.
 Push hands back and down.
 Return to centre with your wrists crossed in front of your body.
 Repeat 5 to 10 times.

32
 Your Heart

 Your Heart, Heart Rate and Pulse 35

 Monitoring Your Heart Rate 37

 Checking Your Heart Rate 38

 Heart Rate Table 39

 Calculating Your Working Heart Rate Range 40

 Work Sheet 41
 Notes 43

33
34
 Your Heart, Heart Rate and Pulse
Your heart:
Your heart is a muscle. It works like a pump to deliver blood that contains
oxygen to all of the parts of your body. As the cells in your body use
oxygen they produce carbon dioxide. The blood then brings this back to
your lungs to breathe out.
As your heart works it contracts to push the blood
around and then relaxes. This is called your heart beat.
As your heart contracts and relaxes you can feel your
pulse and count the heart beats. This is called your
heart rate.

There is a place on your wrist that you can feel your

pulse and count your heart beats. This is described on page 27.
Your physiotherapist will show you how to take your pulse and count your
heart rate.

Why is it is important to check my heart rate when I exercise?

Here are some reasons why:

Safety

 Your heart rate helps you monitor the intensity of your workout to
make sure you are not working too hard.

 If your heart rate is above your working heart rate range, you should
slow down and use fewer arm movements.

Effectiveness

 If your heart rate shows that you are not working hard enough,
you can increase the intensity of your workout.

 To make sure you are doing your aerobic workout hard enough, you
need to stay in your working heart rate range for 15 to 30 minutes a
day.

 This can be done throughout the day. Here is an example of a 20

minute program: walk 10 minutes in the morning then do 5 minutes
of biking and 5 minutes of stairs throughout the rest of the day.

35
Benefits

 You will find that each week you will be able to exercise at a higher
level of intensity and have the same or lower heart rate.
 This is the way your heart tells you it is getting
stronger and more efficient. Positive results help
you keep exercising.

36
 Monitoring Your Heart Rate

There are 3 heart rates you will monitor:

1. Resting Heart Rate:

This is the rate of your heart after you have been sitting quietly for at least
5 minutes. A lower resting rate can mean that your heart is fit. Some
medications can also make your heart rate faster or slower.

Your Resting Heart Rate should be between 60 to 100 beats each minute.

Take your Resting Heart Rate before starting to exercise.

2. Working Heart Rate:

Your Working Heart Rate is the rate you should try to reach when you
exercise. This helps your heart, lungs and body get the most benefit from
your workout. The Working Heart Rate may also be called your Target Heart
Rate.
 Your Working Heart Rate is a good way to pace yourself when you
exercise.
 Adjust your workout to stay in the middle of your working range:
 If your heart rate is too high, slow down and do less
arm movements.
 If your heart rate is too low, go a little faster.
 You can read more about finding your Working Heart Rate range
starting on page 40. The physiotherapist or physiotherapist assistant
also helps you do this.
 Some people may have heart rates that do not fall within the training
ranges due to other health conditions or medications. Your
physiotherapist will plan your exercise program with you.

3. Recovery Heart Rate:

This is the heart rate you take as you cool down and 5 minutes
after stopping exercise.
 It is important to get back to your resting heart rate.
 As your fitness improves, your heart rate will return to resting levels
faster.
37
 Checking Your Heart Rate

Checking your pulse

To check your heart rate you take your pulse.

There are 2 places to check your pulse:
 on one side of the neck called the carotid
 on a wrist called the radial

Carotid pulse:
 A carotid artery on each side of the neck supplies
blood to the head and neck.
 You can feel the carotid pulse by using your first
(index) and second (middle) fingertips.
 Gently press these 2 fingers on one side of the
neck beside your Adam’s apple.
 Your physiotherapist will show you where and how
to do this safely.

Radial pulse:
The radial pulse is over the radial artery inside the wrist. It is below the base
of the thumb when your palm is up.
 Bend your elbow with your arm at
your side, the palm of your hand
up. Rest your hand on your lap.
 Using your first and second
fingertips, gently feel for the radial
pulse.
 Your physiotherapist will show you where and how to do this safely.

Count your radial pulse for:

 1 full minute (60 seconds) or
 15 seconds, then multiply this number by 4. Check the chart on the
next page.

Remember . . .
 Never use your thumb to take a pulse. Your thumb has a
pulse.

38
 Heart Rate Table
Number of heart beats Number of heart beats in
in 15 seconds 1 minute
15 60
16 64
17 68
18 72
19 76
20 80
21 84
22 88
23 92
24 96
25 100
26 104
27 108
28 112
29 116
30 120
31 124
32 128
33 132
34 136
35 140

39
 Calculating Your Working Heart Rate Range

For moderate intensity, your Working Heart Rate should be 60% to 80% of
your maximum heart rate.

We will use the following short forms to calculate your Working Heart Rate
and your Maximum Heart Rate:
 Beats per minute = bpm
 Heart Rate = HR
 Working Heart Rate = Working HR
 Maximum Heart Rate = Maximum HR

An estimate of your Working Heart Rate can be calculated by

subtracting your age from 220.

For example, if you are 55 years old:

Step 1 220 – 55 = 165 bpm

Your Maximum Heart Rate is 165 bpm

Step 2 60% level: 165 x 0.60 = 99 bpm

Step 3 80% level: 165 x 0.80 = 132 bpm

Therefore your Working Heart Rate range is 99 to 132 bpm.

Calculating your Working Heart Rate Range

 There are working sheets on the next 2 pages to help

you calculate your Working Heart Rate if you would
like to try it yourself.

Your physiotherapist or physiotherapist assistant can help

you do this or check your calculations.

40
 Work Sheet
Step 1
220 - ___________ = ___________

Your age Maximum Heart Rate

Step 2

60% level = _____________ X 0.60 = ____________

Maximum Heart Lower Working

Rate Heart Rate
Step 3

80% level = _____________ X 0.80 = ____________

Maximum Heart Higher Working

Rate Heart Rate

Your Working Heart Rate range is:

_______________ to _______________ bpm

or

_______________ to _______________ 15 seconds

(refer to the Heart Rate table on page 28)

41
 Work Sheet
Step 1
220 - ___________ = ___________

Your age Maximum Heart Rate

Step 2

60% level = _____________ X 0.60 = ____________

Maximum Heart Lower Working

Rate Heart Rate
Step 3

80% level = _____________ X 0.80 = ____________

Maximum Heart Higher Working

Rate Heart Rate

Your Working Heart Rate range is:

_______________ to _______________ bpm

or

_______________ to _______________ 15 seconds

(refer to the Heart Rate table on page 28)

42
Notes

43