title: Combined high-intensity strength and aerobic training in diverse phase II cardiac rehabilitation patients.
abstract: BACKGROUND
  Developing adequate levels of muscular strength in the cardiac rehabilitation (CR) patient helps return the patient to an active lifestyle. This study evaluated the effects and safety of an 8-week high-intensity strength training (ST) program combined with a traditional aerobic-based CR program on the muscular strength of a diverse phase II CR population.
  
  
  METHODS
  Sixty-one phase II CR patients (age = 60.5 +/- 10.6 years) stratified by risk (high risk: n = 18, ejection fraction = 23.6 +/- 7.8%; intermediate risk: n = 19, ejection fraction = 40.0 +/- 4.6%; low risk: n = 24, ejection fraction = 58.0 +/- 7.7%) and gender (males = 46, females = 15) participated. One repetition maximum (1RM) testing was performed on the horizontal squat, shoulder press, leg extension, lat pulldown, and biceps curl. Patients performed two sets of each exercise 2 days per week at an intensity that started at 60% 1RM and progressed to 80% 1RM by week 4. Weeks 4 to 8 intensity was adjusted individually to maintain 8RM per set. Blood pressure and heart rate/rhythm responses to 1RM testing were monitored in high-risk patients. Muscle soreness and injury were monitored for all patients immediately after 1RM testing and on days 2 and 7.
  
  
  RESULTS
  All patient groups made significant gains (P < 0.05) in muscle strength (mean increase: lower body = 15.3%, upper body = 16.7%). No injury or significant muscle soreness occurred due to 1RM testing. No abnormal heart rate/rhythm or blood pressure responses occurred in high-risk patients.
  
  
  CONCLUSIONS
  Diverse phase II CR patients can improve their strength significantly with a combination of high-intensity strength and aerobic training.
authors.affiliation: Exercise Physiology Lab, Crawford Gym, University of Louisville, KY 40292, USA.
authors.forename: K J
authors.initials: KJ
authors.lastname: Adams
authors.forename: K L
authors.initials: KL
authors.lastname: Barnard
authors.forename: A M
authors.initials: AM
authors.lastname: Swank
authors.forename: E
authors.initials: E
authors.lastname: Mann
authors.forename: M R
authors.initials: MR
authors.lastname: Kushnick
authors.forename: D M
authors.initials: DM
authors.lastname: Denny
mesh_terms: D004562:Electrocardiography; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000502:physiology*; D012449:Safety; D012720:Severity of Illness Index; D013318:Stroke Volume; D016896:Treatment Outcome