Exercise can help improve cardiovascular fitness, but how you exercise matters, particularly for people who are new to physical activity or have a higher cardiovascular risk.
Sunway Medical Centre physiotherapist Natalie Goh recommends using the FITT principle – frequency, intensity, time and type – to plan an effective and balanced exercise routine.
Frequency refers to how often you exercise, intensity to how hard you are working, time to the duration of each session, and type to the kind of cardiovascular exercise you choose.
“For adults, the general recommendation is at least 150 minutes of moderate-intensity exercise per week,” she says.
This can be spread across the week, such as 30 minutes a day, five days a week.
Alternatively, adults can opt for 75 minutes of vigorous-intensity aerobic exercise.
Strength training can also be added twice a week.
For beginners and people at higher cardiovascular risk, however, Goh advises starting at a comfortable intensity, rather than pushing too hard too soon.
“It’s always important to start it at a lower intensity first, at your comfortable level,” she says.
Simple activities such as brisk walking, cycling, stair-climbing, swimming and dancing can be options.
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As a person’s fitness improves, the intensity can gradually be increased according to their health and fitness level.
Another way to guide exercise intensity is the rate of perceived exertion (RPE) scale, which allows people to judge how hard they are working based on how they feel.
Goh says the scale is useful for monitoring exercise intensity and adjusting effort.
“The higher the rating is, means that we are exercising harder and we are feeling more exerted.”
The RPE scale ranges from one to 10, with each number indicating how hard the exercise feels:
- One: Very light activity that requires little effort.
- Two to three: Light activity that can be maintained for hours, while still allowing you to carry on a conversation.
- Four to five: Moderate intensity activity where you can still exercise for a longer period, but can comfortably hold only a short conversation.
- Six to seven: You become more short of breath and talking becomes more difficult, with only a sentence or two possible.
- Eight to nine: Vigorous activity that is very difficult to maintain, making it hard to speak more than a single word.
- Ten: Maximum effort, where you soon feel unable to continue and are too out of breath to talk.
For improving cardiovascular fitness, Goh recommends exercising at an RPE of four to five.
For people at higher cardiovascular risk, the approach is to begin at a light intensity and gradually work towards moderate intensity.
The same gradual approach is important for people who have been sedentary, are older, have an underlying medical condition or have existing heart disease.
Goh advises those starting a new exercise programme to seek professional advice from a doctor or other qualified healthcare professional first.
It is also important to pay attention to how the body responds during exercise.
She says: “Stop the exercise immediately and seek for medical help” if you experience chest pain, severe shortness of breath, palpitations or unusual dizziness.
