Exercising at the right level means you are exercising at a level where you are getting the most benefit from the exercise while remaining safe. For many participants, this means exercising at a moderate intensity. There are several ways to determine the intensity of your activity. These include using the rating of perceived exertion (RPE) scale, the talk test, as well as taking your pulse.

Rating of Perceived Exertion Scale (RPE)

One way to monitor how hard you are exercising is to give a rating of how hard the exercise feels to you. Using the scale below, choose a number that represents your overall level of effort and fatigue during your exercise session, not just one aspect of your experience such as your breathing or sore legs. For moderate-intensity exercise, we recommend you work at a level that feels to be between levels 12-15. This may be adjusted by your physiotherapist or mentor.

The Talk Test

The talk test is a simple way to measure your exercise intensity. If you are doing moderate-intensity activity, you will be breathing faster than when you are resting but you should still be able to talk. If you can sing, you should increase the pace. If you are doing vigorous-intensity activity, you will not be able to say more than a few words without taking a breath.

Rating of Perceived Exertion (RPE) Scale
6	Nothing at all
7-8	Extremely light
8	Very light
9
10
11	Light
12
13	Somewhat hard
14
15	Hard (heavy)
16
17	Very hard
18
19	Extremely hard
20	Maximal exertion

• Place your index and middle fingers on the thumb side of your wrist just below the creases. Press lightly, and feel the beat in the artery running down that side of your wrist.
• Look at a clock or watch with a second hand or second counter. Starting with zero, count the number of beats you feel in 10 seconds.
• Multiply this number by 6 and you will have your resting pulse.
• Repeat this during or immediately after exercise, before cool-down. For many participants, the target heart rate for moderate intensity exercise is 20 to 40 beats per minute (BPM) over your resting heart rate. While participating in the cardiac rehabilitation program, you may be given a target heart rate that is more specific to you so that you can work at your optimal intensity level.

Many cardiac patients are on a type of medication that slows the heart down. This type of medication is called a beta-blocker (for example, Metoprolol, Bisoprolol, Atenolol, and Sotalol).

Number of Beats
In 10 seconds = In 1 minute
8 beats	48 beats per minute
9 beats	54 beats per minute
10 beats	60 beats per minute
11 beats	66 beats per minute
12 beats	72 beats per minute
13 beats	78 beats per minute
14 beats	84 beats per minute
15 beats	90 beats per minute
16 beats	96 beats per minute
17 beats	102 beats per minute
18 beats	108 beats per minute
19 beats	114 beats per minute
20 beats	120 beats per minute
21 beats	126 beats per minute
22 beats	132 beats per minute
23 beats	138 beats per minute
24 beats	144 beats per minute
25 beats	150 beats per minute

How to Take Your Pulse

Heart Rate Monitors

Heart rate monitors are a great option for those who have difficulty feeling their pulse or want to monitor their heart rate more closely. We recommend a monitor with a strap you wear around your chest, placing the sensor over your heart. You also wear a watch, which will continuously provide your heart rate while you exercise.

Please note a heart rate monitor may not give an accurate reading if you have an irregular heart rhythm such as atrial fibrillation.

You can find heart rate monitors at your local sports store, some department stores as well as online. Many heart rate monitors are paired with activity trackers which tell you how many steps you take in a day.

Generic heart rate charts found in most fitness clubs use a formula based on your age. Heart rate monitors and exercise equipment use a similar formula to determine your target heart or heart rate zone. If you are taking beta-blockers, you will not be able to follow any of these guidelines. Please verify with the staff of the cardiac rehabilitation program for your exercise heart rate zone.

How to Know If You Are Exercising Too Hard

Signs of Overexertion

Any of these symptoms are warning signs you are exercising too hard. Slow down and give your body more time to adapt.

• Being unable to exercise and talk at the same time.
• Prolonged fatigue 30 to 60 minutes after exercise.
• Continuous muscle or joint soreness.
• Lightheadedness.
• Nausea.
• Pounding in your head.
• Feeling faint or weak.
• A heart rate after cool-down more than 20 beats-per-minute above your resting heart rate

Abnormal Responses to Exercise

Stop exercising immediately if you experience the following symptoms.

• Discomfort in the chest, arms, upper abdomen, upper back, neck, jaw or teeth.
• Dizziness.
• Palpitations or irregular heartbeats (feeling your heart race or skip beats).

Seek medical attention if the symptoms are not relieved quickly by resting or in the case of angina, by the use of nitroglycerine as described below.

Angina is a discomfort caused by a lack of oxygen to the heart muscle. It can be felt as squeezing, pressure, heaviness, tightness or pain. It is usually brought on by activity and relieved with rest. It is often felt in the chest but can be felt in other parts of the body as mentioned above. Not every discomfort felt in these areas is angina. If you have discomfort, please discuss it with your doctor as well as your cardiac rehabilitation team.

If you get angina while exercising:

• stop and rest for five minutes.
• If the angina lasts more than five minutes, use a nitroglycerine tablet or spray. Then, wait five more minutes.
• If the pain is still there, use another nitroglycerine tablet or spray. Wait another five minutes. If the pain is still present, call 911, and take a 3rd spray of nitroglycerine.