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Does walking/exercise improve ejection fraction?

Medically reviewed by Carmen Fookes, BPharm. Last updated on Oct 27, 2021.

Official answer


Exercise including walking can improve ejection fraction if it is done 3 to 5 times per week for at least 20 to 40 minutes per session at a moderate-intensity pace, but it must be built up gradually. With time, exercise can also help improve the strength and efficiency of the rest of your body, reduce hospitalizations, help maintain weight, and boost your quality of life.

There was a significant improvement in LVEF (from 46.9% to 61.5%) in coronary artery disease patients who completed 12 weeks of structured exercise training within 1 month of discharge. The exercise program consisted of 5–10 min warm-up (breathing exercise, stretching exercise, and walking on a treadmill) followed by graded aerobic training and 5–10 min cool down. Graded aerobic training was mainly treadmill walk three to five times per week, with an intensity of 40–70% for 20–40 min.

What can exercise do for ejection fraction?

People with heart failure should exercise, and a good exercise program can:

  • Strengthen the heart
  • Improve circulation, which helps the body better use oxygen
  • Reduce heart failure symptoms such as shortness of breath and fatigue
  • Lower blood pressure
  • Improve cholesterol levels.

What is ejection fraction?

Ejection fraction is a way doctors can measure a person’s degree of heart failure. If somebody is said to have an ejection fraction (EF) of 38%, that means that their heart can only pump 38% of its blood to their body (normal is 55-70%).

What exercise is recommended to improve ejection fraction or heart failure?

Exercise is recommended for people with heart failure, but it is important to slowly ease into it, particularly if you have recently been in hospital for a heart-related condition.

Do not jump into high-intensity physical activity routines immediately or over-exert yourself. Some of your heart failure symptoms, such as swelling in the legs, shortness of breath, wheezing, or fatigue may make exercising challenging initially but being stationary or inactive will just make the symptoms worse.

Start slowly with some of the following activities:

  • Light stretching or light yoga
  • Walking on a flat surface or around your home
  • Walking a dog around your block
  • Pilates or a gentle exercise class at the gym
  • Swimming or water walking
  • Gentle biking on a flat road.

Pick something you enjoy and build up your routine gradually. Even two extra steps per day is progress because slow and steady wins the race when it comes to exercise and heart failure. Always discuss your physical activity plans with your doctor before starting because, as with any major change, there are risks that should only be assessed by an expert familiar with your circumstances. Your doctor may be also able to point you in the direction of a good cardiac rehabilitation program and give you pointers about exercises to try and which to avoid. The good news is that cardiac rehabilitation is usually covered by health insurance plans for many patients who suffer from heart failure.

When should I stop exercising if I have heart failure?

Warning signs to take heed of while you are exercising include:

  • Extreme shortness of breath, weakness, dizziness, or lightheadedness while exercising
  • Irregular or very fast heartbeat
  • Feeling pressure or pain in the chest, arms, neck, jaw, or shoulders

If these symptoms happen, slow down, stop, and call for medical attention if they don’t go away.

  • 5 Tips for Exercise with Heart Failure. Penn Medicine. July 20, 2015.'s%20important%20to%20remember%20that,the%20rest%20of%20your%20body.
  • Haddadzadeh MH, Maiya AG, Padmakumar R, Shad B, Mirbolouk F. Effect of exercise-based cardiac rehabilitation on ejection fraction in coronary artery disease patients: a randomized controlled trial. Heart Views. 2011;12(2):51-57. doi:10.4103/1995-705X.86013
  • Kim M J. Demystifying Heart Failure: Exercise is A-OK. Scope. Stanford Medicine. September 5, 2019

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