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Chapter 12

Chapter 12. Resistance-Training Strategies for Individuals with Coronary Heart Disease. 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.

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Chapter 12

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  1. Chapter 12 Resistance-Training Strategies for Individuals with Coronary Heart Disease

  2. 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. Managing CHD • Resistance-training programs • Cardiovascular exercise • Proper diet • Lifestyle modifications • E.g., stress management, smoking cessation

  4. 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. Prevalence of CHD • Risk of CHD: • Men = 49 percent • Women over age 40 = 32 percent

  6. 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. Etiology of CHD • Symptoms: • Chest pain • Shortness of breath • Heart attack • Others

  8. Risk Factors for CHD • Family history • Poor diet • Lack of exercise • Excess cholesterol • Smoking • Diabetes

  9. Cardiac Rehabilitation • Comprehensive, long-term program • Includes: • Medical evaluation • Prescribed exercise • Cardiac risk factor modification • Education • Counseling

  10. Cardiac Rehabilitation • Designed to limit physiologic and psychological effects of cardiac illness among other benefits • Incorporates latest research in exercise prescription

  11. Research Supports Resistance Training • Improves mood and muscular strength • Limits: • Angina • ST segment depression • Cardiovascular complications • Pulmonary complications

  12. 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. 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. Program Design Considerations • Requires physical and cardiopulmonary exercise test • Test results form basis of exercise program • ACSM has specific guidelines

  15. 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. Exercise Testing Considerations • Use electrocardiogram (EKG) monitoring during RM testing to detect arrhythmias • Monitor blood pressure during 1 RM assessment for hypertensive clients

  17. Exercise Testing Considerations • Systolic blood pressure should not exceed 30 to 40 mm Hg • Refer to Table 12.2 • Other testing methods available

  18. 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. 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. 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

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