Exercise Your Heart Safely :: Health and Disease

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Exercise Your Heart Safely
by author Tanya Tiessen

The major killer in North America today is heart disease, even though it is preventable with proper nutrition and regular exercise. Even those who are recovering from heart disease have much to benefit from nutrition and exercise, as long as they are aware of certain considerations.

Much research has been conducted on using exercise as a rehabilitation tool for patients who have suffered from cardiac trauma or disease. An experiment conducted at the University of British Columbia (UBC) examined the effects of resistance training during early cardiac rehabilitation (phase II) on strength and body composition in 1988.

In the UBC study, 27 male cardiac patients were divided into three groups: aerobic exercise only, early-start resistance training and late-start resistance training. The duration of each type of program varied from 16 weeks to six weeks. The results showed that all three groups of cardiac exercisers had a decrease in deep abdominal fat that was not detectable through skinfold measures.

Several studies have shown a correlation between the amount of abdominal fat and various health problems. Other studies have shown that upper body fatness (from the waist up) produces a greater health risk than lower body fatness (from the waist down). A high ratio between waist and hip (waist being higher) has been shown to be correlated with a high incidence of heart attack, stroke, chest pain, breast cancer, and death.

The finding suggests that aerobic exercise alone or in combination with resistance training can have a strong effect on decreasing a patient’s dangerous deep belly fat before visible changes are noticeable. The aerobic- exercise-only group showed a loss in muscle mass, suggesting it is important to combine aerobic activity with resistance training so as not to risk losing lean active muscle mass. (Aerobic exercise uses glucose and glycogen as energy sources. When they begin to diminish you start to burn fat and that is always conbined with fluctuating amounts of lean muscle mass. The only way to conserve lean muscle mass is to participate in some type of resistance training.)

Safety and Supervision

Before a cardiac patient engages in a safe rehabilitation program there are many essential medical screening and supervision considerations.

Cardiac patients who are currently undergoing drug therapy for unstable heart conditions, as well as those who have not obtained a medical release from a successful rehabilitation regimen following their cardiovascular trauma or surgery, should not participate in a community-based fitness program. These types of cardiac patients should be engaged in a cardiac rehabilitation program with direct on-site medical supervision. Often these programs are located directly in hospitals.

The risk of dying while exercising remains far lower than dying of heart disease. The American Council of Sports Medicine developed a set of guidelines to be used to screen clients in community-based fitness programs to reduce this risk even further:

Has a doctor ever said that you have a heart condition and recommended only medically-supervised activity?
Do you have chest pain brought on by physical activity?
Have you developed chest pain in the last month?
Have you, on one or more occasions, lost consciousness or fallen over as a result of dizziness?
Do you have a bone or joint problem that could be aggravated by the proposed physical activity?
Has a doctor ever recommended medication for your blood pressure or a heart condition?
Are you aware, through your own experience or doctor’s advice, of any other physical reason that would prohibit you from exercising without medical supervision?

If the individual answers yes to any of these questions, it is recommended that he contact his health care practitioner before increasing physical activity.

If a person has been given clearance to exercise in a community setting, it is extremely important that the cardiac patient work with programming designed by their health care practitioner or an exercise physiologist who is a member of a physician-approved rehabilitation team. The exercise program must be highly specific in terms of what type of activity to engage in, the frequency, duration and intensity of exercise. It should also include special provisions regarding safety measures with exercise and disease/ drug interactions.

Getting Started

Once you have the guidelines, it’s up to you to ensure you follow them safely.

Provide the body with thorough warm-up and cool-down periods. Carefully monitor exercise intensity levels, keeping within physician-approved ranges–a heart rate monitor may be helpful.

Avoid activities that may raise thoracic, intracranial or blood pressure. These include prolonged muscular contractions, tightly gripping dumbbells, handlebars or other equipment, excessive overhead arm work, breath holding or straining.

Persons with heart disease should avoid saunas, steam baths and hot tubs, which might dehydrate or lead to hyperthermia.

Avoid exercising at high altitudes or in polluted air and take special precautions to avoid heat or cold injuries (wear proper clothing and replace fluid adequately).

If suspicious symptoms arise, cease exercising immediately and consult a physician.

Both aerobic and resistance training can be safe and effective rehabilitative activities for cardiac patients. They can provide you with the confidence to perform daily activities and renewed strength and hope for a speedy recovery.

Tanya Tiessen is a high school physical education teacher, certified aerobics instructor and personal trainer. She educates fitness professionals through lectures and workshops throughout British Columbia.

Source: alive #208, February 2000

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