Stress Awareness Month takes place annually throughout the whole of April. Since 1992, this event has been dedicated to raising awareness of the causes and cures for stress in our modern world.
According to the American Heart Association, ongoing stress not only takes an emotional and psychological toll but can also lead to physical symptoms such as:
- Headaches
- Upset stomach
- Tense and aching muscles
- Insomnia
- Low energy
Chronic stress has also been linked to increased cardiovascular events. The Mayo Clinic emphasizes that periods of excessive and pervasive stress play a major role in stress-induced heart failure by elevating stress hormone levels, particularly cortisol.
The Role of Occupational Therapy in Stress and Cardiac Health
Since stress has been linked to cardiac issues, Occupational Therapists play two critical roles:
- Prevention through education – Teaching stress management techniques to reduce stress-related health complications.
- Rehabilitation support – Assisting patients recovering from cardiac events as they progress through cardiac rehabilitation programs.
A key part of cardiac rehab involves understanding MET levels to help patients regain independence in their activities of daily living (ADLs). Knowing which activities expend specific METs and whether certain ADLs should be performed sitting or standing is essential for safe and effective practice.
Having a MET level guide that categorizes activities based on energy expenditure simplifies intervention planning and ensures that patients progress safely.
What Are MET Levels?
A MET (Metabolic Equivalent of Task) is a unit that measures the energy expenditure of various activities. It is defined as the amount of oxygen the body uses per kilogram of body weight per minute of activity.
By understanding MET levels, individuals can determine which activities they can safely perform based on their current energy capacity.
For example, someone who can walk on level ground at 4 mph (approximately 4 METs) may also be able to:
- Stock shelves
- Do plumbing work
- Perform general housework
- Bowl or golf with a pull cart
- Climb stairs
The following MET level chart categorizes activities into exercise, recreational, occupational, and daily living tasks to help guide intervention planning in cardiac rehabilitation.
MET Level Guide
| METs | Exercise | Recreational | Occupational | Activities of Daily Living |
|---|---|---|---|---|
| 1.5-2.0 METs | Strolling 1-1.5 mph, 1 mile in 40- 60min | Knitting, playing cards, sewing, watching TV | Desk work, driving auto/truck, sitting doing light assembly, typing, using hand tools, writing | Brushing hair/teeth, light housework, making bed, partial bath, polishing furniture, washing clothes |
| 2.0-3.0 METs | Walking 2.0-2.5 mph, 1 mile in 24- 30min Cycling outdoors 5mph | Horseback riding (walk), Light golf (power cart), Playing musical instrument, Shuffleboard, Woodworking | Bartending, Crane operation, Standing doing light or medium assembly, TV/auto/car repair, Working heavy lever | Cooking, Driving car, Ironing, riding lawn mower, Scrubbing floor, walls, cars, windows, Showering, Sweeping, Tub bath |
| 3.0-4.0 METs | Walking 3.0-4.0 mph, 1 mile in 15- 20min Cycling outdoors 5.5 mph | Billiards, Bowling, Canoeing, Croquet, Fly fishing, Golf (pulling cart), Shopping, Volleyball (non-competitive) | Baling hay, Driving heavy truck, heavy machine assembly, Janitorial work, Light welding, Operating large levers, Plastering, Plumbing, Stocking shelves | Cleaning windows, Climbing stairs (slowly), General House work, Kneeling, Light work, Packing/unpacking, Power lawn mowing (light), Sexual intercourse, Stocking shelves, Vacuuming |
| 4.0-5.0 METs | Walking 3.5-4.0 mph, 1 mile in 15-17 min, Cycling 8 mph, Calisthenics, Swimming (20 yd/min) | Ballet, Dancing, Gardening (hoeing, weeding, digging), Golf (carrying clubs), Table tennis, Tennis (doubles), Volleyball | Building interior of house, Carrying trays/dishes, Farm work (sporadic), House painting, Lifting, carrying objects (20-40 lb), Light carpentry, Mechanic work | Raking leaves, Shoveling light loads |
| 5.0-6.0 METs | Walking 4.0-4.5 mph, 1 mile in 13-15 min, Biking 10 mph | Canoeing (4 mph), Gardening (digging), Skating (ice/roller), Social/square dancing, Softball/baseball (non-game), Stream fishing | Handyman work (moving, shoveling), Heavy Carpentry, Putting in sidewalk | Raking leaves, Shoveling light loads |
| 6.0-7.0 METs | Walking/jogging 4.0-5.0 mph, 1 mile in 12-13 min, Biking 11 mph, Swimming (breaststroke) | Backpacking (light), Badminton, Hiking, Hunting, Horseback riding (trot), Skiing (cross-country 2.5 mph), Skiing (light downhill), Square dancing, Tennis (singles) | Exterior home building, Lifting, carrying objects (45-64 lb), Shoveling (10/min 9 lb), Splitting wood | Lawn mowing (push mower), Snow shoveling (light snow) |
| 7.0-8.0 METs | Walking 5 mph, 1 mile in 12 min, Biking (outdoors) 12 mph, Swimming (backstroke) 40 yd/min | Badminton (competitive), Basketball (non-game), Canoeing (5 mph), Golf (carrying bag), Horseback (gallop), Skiing (downhill vigorous) | Ascending stairs with 17 lb load, Lifting, carrying (65-84 lb), Moving heavy furniture, Sawing | |
| 8.0-9.0 METs | Jog/run 5.5 mph, Biking (outdoors) 13 mph, Swimming (breaststroke) 40 yd/min, Rowing machine, Rope jumping (60-80 skips/min) | Basketball (non-game), Handball / Squash / Racquetball, Mountain climbing, Soccer (non-team), Touch football, Tour skiing | Lifting, carrying (85-100 lb), Moving heavy furniture (moving van work), Shoveling (14 lb scoops, 10 scoops/min), Using heavy tools | |
| 9.0-10.0 METs | Jog/run 6 mph, 1 mile in 10 min | Football (competitive), Sledding/tobogganing | Heavy labor, Lumberjack, Shoveling (16 lb scoops) | Ascending stairs carrying 54 lb |
How Pass the OT Simplifies Learning MET Levels
In Pass the OT’s web course, we simplify learning MET levels by providing structured examples of how activities progress across different phases of cardiac rehabilitation.
By categorizing MET levels with clear activity examples, students and practitioners can:
- Quickly reference safe activity levels
- Grade activities based on rehabilitation stages
- Improve clinical decision-making in cardiac rehab
Here is a preview of our MET levels worksheet, which helps guide intervention planning and patient education.
FAQ
What is Stress Awareness Month and why is it important?
Stress Awareness Month is observed in April every year since 1992 to raise awareness about the causes and cures of stress. It highlights the impact of stress on mental and physical health, including its association with cardiovascular issues.
How does stress affect physical health according to the article?
The article mentions that ongoing stress can lead to physical symptoms like headaches, stomach issues, muscle tension, insomnia, and increased risk of cardiovascular events due to elevated stress hormones like cortisol.
What role do Occupational Therapists play in managing stress-related cardiac issues?
Occupational Therapists have a preventive role by educating and teaching stress management techniques. They also assist patients in progressing through cardiac rehabilitation by understanding MET levels.
What is a MET level and why is it important in cardiac rehab?
A MET (Metabolic Equivalent of Task) is a measure of work level used to calculate calories and fitness level. It’s essential in cardiac rehab to help patients safely perform activities based on their MET capacity.
Where can I find more resources for learning about MET levels?
The ‘Pass the OT’ web course provides simplified learning by offering examples of MET levels and stages of activities used during different phases of cardiac rehabilitation.
