Critical Care Rehabilitation Exercises

Due to the prolonged period of inactivity whilst you were ill, your muscles will have lost strength and you likely feel very weak and tired.  Even the simplest tasks may feel difficult. Exercise following critical care treatment will help to improve your quality of life, as well as maximise your physical and emotional well-being.

The following exercises are aimed at improving your upper and lower limb weakness, as well as improving your general fitness.

• All exercise is good exercise. Just do what you can.

• If you struggle with any of the exercises, stop and rest for a minute. Start again when you are ready.

• If you have no weights at home, use baked bean tins or bottles of water.

• Do all the exercises gently. Take your time.

• To start with you should aim to do these exercises once a day, 2 to 3 times per week. Build this up to once a day every day, as you are able to.

Warm-up exercises

These exercises should raise your heart beat slightly. You may get slightly out of breath.

Exercise 1

1. 
   Sit comfortably in a chair, with your feet flat on the floor.
2. 
   Rotate your shoulders backwards 10 times. Relax.
3. 
   Rotate your shoulders forwards 10 times. Relax.

Exercise 2

1. 
   Sit comfortably in a chair, with your feet flat on the floor.
2. 
   Shrug your shoulders up to your ears.
3. 
   Drop them down. Repeat 10 times. Relax.

Exercise 3

• Do each exercise for 30 seconds.

1. 
   Punch your arms straight out in front on you.
2. 
   Punch your arms up to the ceiling.
3. 
   Punch out to the side, first left and then right.
4. 
   Punch down to the floor, between your knees.

Bicep exercises (arm muscles)

These exercises are aimed at improving your arm strength.

Exercise 1

• Sit comfortably in a chair, with your feet flat on the floor.

• Do this exercise for 2 minutes.

1. 
   Holding a weight in each hand, put your arms out in front of you.
2. 
   Bend your elbows and bring the weights up to your shoulders. Hold for 5 seconds. Return to your starting position.
3. 
   If you find this exercise hard, you can exercise one arm at a time.
4. 
   If you find this exercise hard, you can exercise one arm at a time.

Exercise 2

• Sit comfortably in a chair, with your feet flat on the floor.

• Repeat this exercise on both sides 10 times.

1. 
   Put one weight on the floor. Place the other weight in your right hand.
2. 
   Bending your elbow, bring the weight up to your right shoulder.
3. 
   Reach the weight up to the ceiling.
4. 
   Slowly bring it down to your shoulder.

Rowing exercises

If you have been on a ventilator, you may feel tight across your chest. These exercises aim to get the muscles across the front of your chest moving a little bit, by opening up your chest.

Exercise 1

• Sit comfortably in a chair, with your feet flat on the floor.

• Do this exercise for 2 minutes.

1. 
   Hold one weight with both hands. Place your arms out in front of you, holding onto your weight.
2. 
   Bend your elbows outwards, bringing the weight into your chest.
3. 
   Return to your starting position.

Exercise 2

• Sit comfortably in a chair, with your feet flat on the floor.

• Continue this exercise for 2 minutes.

1. 
   Hang your arms down beside your body, holding a weight in each hand.
2. 
   Keeping your arms straight, bring your arms up so they are level with your shoulders. Hold this position for 5 seconds.
3. 
   Slowly lower your arms back to your sides. Relax.
4. 
   If you find this exercise hard, you can exercise one arm at a time, first with your right arm.
5. 
   And then with your left arm.

Neck exercises

You may have had a tracheotomy tube in place during your stay on Critical Care. If so, you may find the front of your neck is quite tight. These exercises will help stretch this area.

Exercise 1

• Sit comfortably in a chair, with your feet flat on the floor.

• Slowly bring your chin down towards your chest, as far as you can.

• Hold for 5 seconds. Bring your head back to the centre.

• Let your head drop back, and look up at the ceiling. Go as far as you can.

• Hold for 5 seconds. Bring your head back to the centre.

• Slowly turn your head, looking over your right shoulder.

• Hold for 5 seconds. Bring your head back to the centre.

• Repeat on the other side.

Exercise 2

1. 
   Sit comfortably in a chair, with your feet flat on the floor.
2. 
   Slowly drop your right ear to your right shoulder, as far as you can. Keep your shoulder relaxed. Hold for 5 seconds.
3. 
   Bring your head back to the centre.
4. 
   Repeat on the left side. Hold for 5 seconds.
5. 
   Bring your head back to the centre.

Trunk exercises

The trunk is a person’s body apart from the head, arms, and legs.

The aim of these exercises is to gently stretch the muscles around your spine and rib cage. These muscles may have become tight after being on the breathing machine.

Exercise 1

• Move forward, so you are sitting on the edge of your chair. Keep your feet flat on the floor.

1. 
   Sit straight, and cross your arms over your chest.
2. 
   Slowly rotate your trunk, turning to the right. Follow with your head. Hold for 5 seconds.
3. 
   Return to the centre.
4. 
   Repeat on the left side.
5. 
   Return to the centre.

Exercise 2

1. 
   Sit comfortably in a chair, with your feet flat on the floor.
2. 
   Slowly reach your left arm down your side towards the floor. Try to nearly reach the floor. Hold for 5 seconds.
3. 
   Return to the centre.
4. 
   Repeat on the right side.
5. 
   Return to the centre.

Leg exercises

These exercises are aimed at improving your leg strength.

Exercise 1

1. 
   Stand up, and hold on to a surface with both hands, for example the back of a chair or a Zimmer frame.
2. 
   Start marching, lifting your knees as high as you can.
3. 
   Continue this exercise for 2 minutes.

Exercise 2

1. 
   Stand up, and hold on to a surface with both hands, for example the back of a chair or a Zimmer frame.
2. 
   Slowly bend your knees and squat down, go as far as you can. Make sure you keep your back straight during this exercise. Do not lean forwards or backwards.
3. 
   Return to a standing position. Continue this exercise for 2 minutes.

Exercise 3

• If you find it hard to exercise both feet together, exercise them one at a time.

• Continue this exercise for 2 minutes.

1. 
   Stand up, and hold on to a surface with both hands, for example the back of a chair or a Zimmer frame.
2. 
   Go up onto your toes. Hold for 5 seconds.
3. 
   Return your feet to the ground.

Pelvis and hip exercises

These exercises are aimed at improving the strength of your muscles round your hip and pelvis area.

Exercise 1

• If you struggle with this exercise, rest your toes on the floor.

• Continue this exercise for 2 minutes.

1. 
   Stand up, keeping your back straight. Turn sideways, and hold onto the surface with one hand.
2. 
   Keeping your right leg straight, bring it out to the side. Hold for 5 seconds.
3. 
   Bring your leg back to the centre.
4. 
   Repeat on the other side.
5. 
   Bring your leg back to the centre.

Exercise 2

• If you struggle with this exercise, rest your toes on the floor.

• Continue this exercise for 2 minutes.

1. 
   Stand up, keeping your back straight. Hold on to a surface with both hands.
2. 
   Keeping your leg straight, bring your leg out behind you. Hold for 5 seconds.
3. 
   Bring your leg back to the centre.
4. 
   Repeat on the other side.
5. 
   Bring your leg back to the centre.

Exercise 3

• If you struggle with this exercise, place some cushions on your seat to make yourself higher.

• If you really struggle, use your arms to support yourself when standing.

• Continue this exercise for 2 minutes.

• Let your arms drop down by your side, and relax.

• Sit comfortably in a chair, with your feet flat on the floor.

1. 
   Move forward, so you are sitting on the edge of your chair. Sit straight, and cross your arms over your chest.
2. 
   Lean forward.
3. 
   Come up to standing.
4. 
   Slowly return to sitting.

Cool-down exercises and stretches

We now need to bring your heart rate down by doing some cool-down exercises and stretches.

Exercise 1

1. 
   Sit comfortably in a chair, with your feet flat on the floor.
2. 
   Rotate your shoulders backwards 10 times. Relax.
3. 
   Rotate your shoulders forwards 10 times. Relax.

Exercise 2

1. 
   Shrug your shoulders up to your ears. Hold for 5 seconds. Keeping your shoulders up, let your arms drop loosely down by your side.
2. 
   Drop your shoulders and shake your arms out. Repeat 3 times.

Exercise 3

1. 
   Stretch your arm out across your chest.
2. 
   Add a little pressure on your elbow, and feel the stretch in your shoulder. Hold for 5 seconds.
3. 
   Drop your arm down and repeat on the other side.
4. 
   Repeat on both sides 3 times.

Exercise 4

1. 
   Place your left hand on your left shoulder, and raise your elbow.
2. 
   Push your elbow back, and stretch your triceps muscle. This is the muscle in the back of your upper arm. Hold for 5 seconds. Relax.
3. 
   Place your right hand on your right shoulder, and raise your elbow.
4. 
   Push your elbow back, and stretch your triceps muscle. Hold for 5 seconds. Relax.

Exercise 5

1. 
   Stretch your left leg out in front of you.
2. 
   Stretch your left hand towards your left toes, feeling a stretch in your hamstring muscle. This is the muscle in the back of your thigh. Hold for 5 seconds. Relax.
3. 
   Stretch your right leg out in front of you.
4. 
   Stretch your right hand towards your right toes, feeling a stretch in your hamstring muscle. Hold for 5 seconds. Relax.

Contact details

If you have any concerns or questions about these exercises or your rehabilitation, please contact the Critical Care Rehabilitation Team.

• Critical Care Rehabilitation Team
  Telephone: 07771 378331 (text or call)
  Open 9am to 4pm, Monday to Friday