Renee Konidis and Robert Bertelink
During the pandemic, Renee Konidis and Robert Bertelink, Clinical Coordinators and Cardiac Rehab Supervisors at UHN's Cardiovascular Rehabilitation and Prevention Program, have been working with cardiac rehab patients over the phone to help them optimize their rehabilitation workouts from home. (Photos: Courtesy of Renee Konidis and Robert Bertelink)

It's a term some love and some dread, but one we've had to get used to either way – the at-home workout.

With the closure of gyms and training centres due to COVID-19, exercising from home has become a safe and popular alternative.

And during a time where elevated stress levels and sitting for long hours are common side effects of the pandemic, integrating physical activity into our lives remains as important as ever – both for our heart and our mind.

The Peter Munk Cardiac Centre is excited to celebrate World Heart Day on Tuesday, Sept. 29. We're asking our social media followers to show us how they get their blood pumping by sharing a fun photo of themselves engaging in any heart-healthy, physical activity and tell us a little bit about why they do it.

This could be going on a run, walking the dog, doing stretches on the couch – or, showcasing your very own at-home workout.

In preparation for World Heart Day, we're answering some commonly asked questions to master the at-home workout, courtesy of Robert Bertelink and Renee Konidis, Clinical Coordinators and Cardiac Rehab Supervisors at UHN's Cardiovascular Rehabilitation and Prevention Program.*

"Managing your stress levels, especially during difficult times like these, is critically important to staying healthy," says Robert.

Stress hormones can lead toan increase in heart rate, blood pressure, blood cholesterol and blood sugar. If these levels remain elevated for too long, it can contribute to a host of poor health outcomes, including heart disease.

"The good news?" Robert says. "Exercise is one of a number of ways to manage your stress. Not only will it will burn off some of those elevated cholesterol and sugar values, but it will help lower your blood pressure, improve your sleep, aid digestion and put you in a better mood."

Renee adds that the benefits of exercise extend to your mental health, as well as your physical.

"Staying active during a pandemic when there may be increased anxiety, depression and burnout is also important," says Renee. "Exercising can help to reduce those anxious feelings, cope with depression and manage the burnout."

Here's what Robert and Renee have to say in response to some other at-home workout questions.

When's the best time of day to workout? For those with a busy schedule, what should we keep in mind?

For the vast majority of people, it comes down to when do you have the time and motivation to do it. Personal preference is most important. For some of us, we wake up ready to take on the world and loads of energy. Take advantage of that. Get some exercise in first thing before you get busy with life and exercise gets pushed further down the list of priorities. For others, mornings are a time for coffee and waking up gradually. If it takes you a while before you even consider exertion, don't force things and set aside some time later in the day to exercise. Whatever works for you, try and make it a habit. That's really the hardest part of exercise – finding the time to do it consistently.

Where should you workout in your home?

We often tell our patients the heart is a wonderful organ, but it's not very smart. All it knows is that it needs to deliver blood to working muscles. If those muscles are in a gym, living room, or the beach – your heart doesn't care. With that thought in mind, I encourage patients to exercise in places they feel comfortable in, are easy to reach and motivating. That's going to vary for everyone. Many of our older patients workout to videos in the comfort of their living rooms. Others do better outside in the fresh air (in quieter spaces and less busy times). Gyms can be great because they're a one stop shop for all your exercise needs, but, creative people can find work arounds that are perfectly acceptable – see below.

Now that the kitchen is only a few steps away, should people eat before or after their workout?

While you certainly don't want to exercise on a full stomach, most people shouldn't exercise on an empty one either. We usually suggest our patients have a light snack if they are going to work out first thing in the morning. A slice of toast with some milk or a piece of fruit is fine. If you're exercising later in the day, after dinner let's say – give yourself at least an hour (or maybe two if you had a very heavy meal) to allow for some digestion to occur prior to working out.

If you're also living with diabetes, it's important to know your blood sugar before you exercise. Exercise will make blood sugar go down, and if you are on a certain medicine (e.g. insulin), your blood sugar could go dangerously low, under 4.0 mmol/L. If this applies to you, try to start exercise when your blood sugar is at least 5.6 mmol/L to prevent a dangerous low during exercise. Plan out your meals and snacks to make this happen.

What are some equipment substitutes you can find around your home?

For cardio, there are lots of options. Depending on your fitness level, something as simple as walking on the spot can be an excellent work out for older adults or people who are just starting a workout routine. As your fitness increases, you can progress to jogging on the spot, or skipping rope, or own body weight circuit training with push-ups, burpees or squats. For muscular fitness, the simple act of lifting something is all that's needed – your muscles won't know the difference between a 10-kilogram  dumbbell and a 10-kilogram bag of potatoes. Or, fill a bag with water bottles and lift that instead. It accomplishes the same thing.

It's important here to also put in a plug about spending too much time doing nothing. Many patients have spent hour after hour sitting in front of screens. Extended sitting is associated with negative outcomes. So even if you're not getting a work out in, at least try and get up and move around every 30 to 40 minutes to move those joints and get your wake up your metabolism.

Can you recommend any online resources to find the perfect workout, or help you create your own?

Our website has a TON of resources. WWW.CARDIACCOLLEGE.CA – from low level exercise videos (Walk –n-Talk with Rob) to instructions on how to begin a resistance training program to a full on 12-part series called THRiVE designed to help people adopt healthier lifestyle behaviours – you can't go wrong with our very own website.

*We are proud of the cardiovascular care we provide at UHN. From prevention, to acute, to rehabilitation, we offer an integrated continuum of care through the Peter Munk Cardiac Centre and Toronto Rehab. The Cardiovascular Prevention and Rehabilitation Program at UHN is located at Toronto Western Hospital's GoodLife Fitness Cardiovascular Rehabilitation Unit and Toronto Rehab's Rumsey Centre.

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