Cardiac Rehab Tool: Spotify Cardiac Rehabilitation Playlists: How Music Can Support a Safe, Structured Exercise Session
- James Pickett
- 6 days ago
- 8 min read
Author: Jamie Pickett, Clinical Exercise Physiologist, Health Facilitator, & Founder of My Movement Medicine.
Length: 6 minute read
Category: Cardiac Rehab Tools, Exercise, Heart Health
Starting exercise after a heart event can feel like a big step. For many people, the hardest part is not just knowing what to do, but feeling comfortable enough to get going. A good playlist can help with that. It can make a session feel more welcoming, easier to follow, and less clinical. Music is not a replacement for proper cardiac rehabilitation, but the research suggests it can be a useful support tool when it is used alongside safe, structured exercise.
Why music may help
The broader exercise literature gives the clearest starting point. A large meta-analysis of 139 studies found that music during exercise was linked with better affect, lower ratings of perceived exertion, and improved performance outcomes overall. The effects were not identical across all settings, but the general pattern was that music can make exercise feel better and sometimes feel easier, which matters when the real goal is helping people stick with activity over time.
That matters in cardiac rehabilitation because adherence is everything. Exercise-based cardiac rehabilitation is already well supported as part of secondary prevention for coronary heart disease, and music may help by improving the experience of the exercise rather than changing the underlying rehab principles. In simple terms, if a session feels smoother, more enjoyable, and more manageable, people may be more likely to keep doing it.
“One good thing about music, when it hits you, you feel no pain.” — Bob Marley
What the research says in cardiac rehabilitation
The cardiac-specific evidence is promising, but still smaller than the general exercise literature. A 2021 systematic review looking at recorded music during exercise in people with coronary heart disease concluded that there was limited evidence for potential benefits, and the authors were careful to say the findings should be interpreted cautiously because more rigorous studies are still needed.
Even so, the studies that do exist are encouraging. A 2024 randomised controlled trial found that a home-based music-paced physical activity programme after cardiac rehabilitation improved exercise capacity at 3 months and exercise self-efficacy at 6 months compared with control. That suggests music may have practical value when it is used in a purposeful, structured way rather than just added in the background.
Earlier work from the MAINTAIN feasibility study also found that tempo-synchronised personalised playlists improved adherence to physical activity in cardiovascular disease patients participating in structured exercise, compared with usual care alone. This is especially relevant for your playlists, because it supports the idea that the pacing and personal relevance of the music may matter as much as the fact that music is present at all.
A 2024 systematic review and meta-analysis of music listening interventions for physical activity in adults adds a useful wider point. It concluded that music listening may improve physical activity participation, but the certainty of evidence ranged from very low to moderate depending on the outcome. That means music looks useful, but the evidence base is still mixed in quality, so it is best presented honestly as a supportive aid rather than a guaranteed performance enhancer.
What the research suggests music may improve
Taken together, the research suggests music may help in a few main ways.
First, it may improve affect and enjoyment. If people feel better during a session, that can reduce the psychological barrier to starting again next time. The broader meta-analysis supports this clearly.
Second, it may reduce perceived exertion in some settings. That does not mean the body is doing less work. It means the exercise may feel a little more manageable, which can be useful for confidence and adherence.
Third, it may improve adherence and self-efficacy, especially when playlists are synchronised to pace or personally meaningful. This is one of the most practically useful findings for rehab settings, because long-term consistency matters more than one especially “good” session.
Fourth, there is evidence that music listening may reduce anxiety in coronary heart disease populations, although that literature is not limited to exercise sessions. That still matters, because many people returning to movement after a cardiac event feel nervous, cautious, or unsure of themselves.
“Music is the universal language of mankind.” — Henry Wadsworth Longfellow
What the research does not show clearly
The evidence is positive, but it is important not to oversell it. Music is not a treatment for heart disease, and the current literature does not show that music on its own produces major clinical improvements in all patients. The cardiac rehabilitation review specifically called the evidence limited, and the broader exercise literature does not show a strong consistent heart-rate benefit during exercise.
So the most accurate position is this: music is a low-cost, practical, enjoyable tool that may improve the exercise experience and support adherence, but it works best within a well-designed exercise programme, not instead of one.
Why playlist structure matters
This is where your playlists become more than just a list of songs. In cardiac rehabilitation, the structure of the session matters. Warm-up and cool-down are key parts of safe exercise, not optional extras. British Heart Foundation guidance says the warm-up should gradually raise heart rate and feel fairly light, ending at about 10 to 11 on the Borg scale, while the conditioning phase should feel around 11 to 14. The cool-down then helps heart rate and breathing return towards baseline steadily.
That means the order and feel of the music should support the structure of the session:
Warm-up
Gradual build, easy rhythm, steady start
Main circuit
Comfortable working tempo, consistent rhythm
Cool-down
Gradual reduction, calmer feel, smoother recovery
The playlist should mirror the session: build up, work steadily, then come back down.
Warm-up: around 110 BPM building to 120 BPM
The warm-up section begins at around 110 beats per minute and gradually builds towards 120 BPM.
This part should feel controlled and reassuring. It suits marching on the spot, heel digs, side steps, shoulder rolls, arm patterns, and mobility work. The aim is not to start hard. The aim is to help the body and mind settle into movement. A gradual musical build supports that shift from rest to exercise.
BPM: 111
BPM: 115
Main circuit: around 120 to 130 BPM
The main section usually sits around 120 to 130 BPM.
This range tends to work well for low-impact cardio, seated or standing circuit work, repeated resistance moves, and simple aerobic patterns. In research terms, faster music often has stronger effects on performance and psychophysical responses than slower music, but in rehab the aim is not to drive intensity up. It is to support a steady, appropriate working pace that still feels manageable.
BPM: 120
BPM: 121
Cool-down: around 120 BPM lowering to 100 BPM
The cool-down begins around 120 BPM and gradually lowers towards 100 BPM.
This taper matters. The body needs time to come down properly, and the music can help signal that change. Early cool-down tracks can still support gentle movement, while later tracks should feel calmer and less driving so the session can finish with easier breathing, mobility work, and stretches.
BPM: 104
BPM: 106
How we use Spotify Jam in live online sessions
During live online sessions, Spotify Jam can help create a more shared group experience. Spotify’s own guidance says remote joining requires Premium, and participants can listen together on their own devices while contributing to the shared queue. In practice, that means the group can follow the same soundtrack together rather than everyone listening separately.
That is useful in online exercise because it helps the warm-up, main section, and cool-down feel more joined up. It also adds a social element, which can help online sessions feel more connected and less isolated. The music is still there to support the session, not to pressure anyone, but it can make the overall class feel more cohesive.
“I think music in itself is healing. It’s an explosive expression of humanity.” — Billy Joel.
Music should support the session, not control it
Even with a well-designed playlist, the body comes first. The songs are there to guide the feel of the session, not to create a pace that everyone must match exactly. People should still work to their own level, use the Borg scale or talk test where appropriate, and follow advice from their cardiac rehab team or exercise professional.
If a song feels too quick, the movement can be slowed down, shortened, or adapted. Safe and steady is always better than trying to keep up.
Relevant studies
Terry PC, Karageorghis CI, Curran ML, et al. (2020). Effects of music in exercise and sport: A meta-analytic review. Psychology Bulletin / Psychological Bulletin. Broad exercise and sport meta-analysis showing benefits for affect, perceived exertion, and performance.
Chair SY, Chau JPC, et al. (2021). A systematic review of effects of recorded music listening during exercise on physical activity adherence and health outcomes in patients with coronary heart disease. Cardiology Journal / related indexed journal. Concluded there is limited but promising evidence in CHD populations.
Chair SY, Liu T, et al. (2024). Effectiveness of a home-based music-paced physical activity programme on exercise-related outcomes after cardiac rehabilitation: a randomized controlled trial. Found improved exercise capacity and self-efficacy.
Alter DA, O’Sullivan M, Oh PI, et al. (2015). Synchronized personalized music audio-playlists to improve adherence to physical activity among patients participating in a structured exercise program: a proof-of-principle feasibility study. Found improved adherence with tempo-synchronised personalised playlists in cardiovascular disease patients in rehab.
Clark IN, Taylor NF, Peiris CL. (2024). Music listening interventions for physical activity: a systematic review and meta-analysis of randomised controlled trials. Broader adult physical activity review showing possible benefits, with mixed certainty of evidence.
Ballmann CG. (2021). The Influence of Music Preference on Exercise Responses and Performance: A Review. Useful review on why preferred music may matter for motivation, dissociation, and affective responses.
Song requests welcome
These playlists are designed to support the My Movement Medicine community and make sessions feel safe, steady and enjoyable.
If there is a song that helps you move well, improves your mood, or would fit nicely into a warm-up, circuit or cool-down, you are welcome to submit a suggestion.
Listen or Follow on Spotify
You can explore the playlists on the My Movement Medicine Spotify profile here:
How to use these playlists safely
Use the playlists as a guide to session flow, not as a target you must keep up with.
Always work to the level that is right for you. That may mean adjusting the size of the movement, slowing the pace, taking rests, or sitting for part of the session. In cardiac rehab, safe and consistent is always better than fast and forced.
Stop exercising and seek advice if you develop chest pain, dizziness, unusual shortness of breath, palpitations that feel abnormal, or if you feel unwell. In an emergency, call 999.
Cardiac Rehab & Prevention: How My Movement Medicine can help
If you want support with getting moving in a healthy, and sustainable way, here are a few simple options.
Phase 4 cardiac rehab C.I.C. group sessions (in-person and online): safe pacing, clear progressions, in a supportive environment
Confidence with intensity: learn to use heart rate, the talk test and Borg RPE so exercise feels safe and doable
Trying a new activity? Approach it the right way with some support from our Activity Specific Guides:
This health guide was written by Jamie Pickett, Clinical Exercise Physiologist, Health Facilitator, & Founder of My Movement Medicine.
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