1. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chapter 12 Resistance-Training Strategies for Individuals with Coronary Heart Disease

2. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Coronary Heart Disease (CHD) Caused by atherosclerosis –Hardening of arteries Blood flow reduced through coronary arteries to heart muscle Typically results in chest pain and/or heart damage

3. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Managing CHD Resistance-training programs Cardiovascular exercise Proper diet Lifestyle modifications –E.g., stress management, smoking cessation

4. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Prevalence of CHD Leading cause of death for men and women in US CHD-related event occurs approximately every 29 seconds Death related to CHD occurs approximately every minute

5. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Prevalence of CHD Risk of CHD: –Men = 49 percent –Women over age 40 = 32 percent

6. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Etiology of CHD Atherosclerosis –Build up of fatty material and plaque in coronary arteries Narrowed coronary arteries cause flow of blood to heart to slow or stop

7. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Etiology of CHD Symptoms: –Chest pain –Shortness of breath –Heart attack –Others

8. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Risk Factors for CHD Family history Poor diet Lack of exercise Excess cholesterol Smoking Diabetes

9. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Cardiac Rehabilitation Comprehensive, long-term program Includes: –Medical evaluation –Prescribed exercise –Cardiac risk factor modification –Education –Counseling

10. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Cardiac Rehabilitation Designed to limit physiologic and psychological effects of cardiac illness among other benefits Incorporates latest research in exercise prescription

11. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Research Supports Resistance Training Improves mood and muscular strength Limits: –Angina –ST segment depression –Cardiovascular complications –Pulmonary complications

12. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Research Supports Resistance Training Increases muscular strength –Alleviating stress related to performing activities of daily living Improves overall quality of life Increases bone density –Countering effects of immunosuppressive therapy

13. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Research Supports Resistance Training Increases lean body mass May create more favorable blood lipid levels Increases cardiovascular conditioning Lowers blood pressure Enhances insulin uptake

14. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Program Design Considerations Requires physical and cardiopulmonary exercise test –Test results form basis of exercise program ACSM has specific guidelines

15. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Exercise Testing Considerations Can safely use 1 RM assessment on individuals with CHD Can perform maximal strength testing two to four weeks post-event RM should fall within 8 to 15 RM range to ensure assessment of strength

16. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Exercise Testing Considerations Use electrocardiogram (EKG) monitoring during RM testing to detect arrhythmias Monitor blood pressure during 1 RM assessment for hypertensive clients

17. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Exercise Testing Considerations Systolic blood pressure should not exceed 30 to 40 mm Hg –Refer to Table 12.2 Other testing methods available

18. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Program Components Exercise selection critical –Not all exercises appropriate Exercises must increase strength and lean body mass –Minimizing adverse effects Continually emphasize proper performance

19. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Program Components Exercises should mimic activities of daily living –Refer to Table 12.3 Major goal of training: –Gain muscular strength Minimum rest time of two minutes between sets

20. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Program Components Perform whole-body workouts two to three days per week Ideally perform resistance training before cardiovascular work Keep training format the same each time See sample 24-Week Program