15 Strength Training and CVD_SW.ppt

15 Strength Training and CVD_SW.ppt - PA and CVD PA PA...

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Unformatted text preview: PA and CVD PA PA recommendations Effects of PA on CV fitness Treatment for Elevated Plasma Lipids Elevated BP LVH Obesity NIDDM Prevention of Hypertension NIDDM Strength Training and Cardiovascular Disease Cardiovascular Strength Training Strength Sets = How many times the exercise is Sets performed within one workout. performed Repetitions = One complete movement Repetitions of the exercise. Usually, there are several repetitions in 1 set. several Weights = How much resistance? How Weights heavy is the weight? Strength Training Strength Strength Training, CV Health and Aging and Considerations How much do I have to do? Will strength training improve my Will cardiovascular disease risk factors? cardiovascular What about other aging-related issues What that will sustain or improve my activities of daily living? of Current Guidelines Current ACSM 1990 Premises: “Programs lasting more than 60 minutes per session Programs are associated with higher dropout rates.” are “…although greater frequencies of training and although additional sets or combinations of sets and repetitions may elicit larger strength gains, the magnitude of the difference is usually small” difference Prescription: 8-10 exercises of major muscle groups 2 days per week Intensity depends on patient history and should Intensity progress slowly progress National PA Guidelines National Adults 18-64 Adults should also do muscle-strengthening activities Adults that involve all major muscle groups 2 or more days per week. or 8—12 repetitions per activity that count as 1 set 8—12 set At least 1 set of muscle-strengthening activities, but to At gain even more benefits, do 2 or 3 sets. Choose exercises that work all major muscle groups Choose (legs, hips, back, abdomen, chest, shoulders, and arms). http://www.health.gov/paguidelines/factsheetprof.aspx Training Volume Training Sets: Single or Multiple? Berger, et al (1962) – 12 weeks of ST 1 set = 22.4% strength increase, 2 sets = 21.8% set increase, 3 sets = 25.3% increase, Few studies have shown vast increases in Few strength when comparing 1 vs 3 sets. strength No studies have shown that 2 sets result in No significantly greater increases in strength compared to 1 set compared Messier and Dill (1985) – showed time to Messier complete 3 sets was 50 minutes compared to 20 minutes for 1 set to Strength Training Prescription Strength Dropout Rate Strength Gains Time Time Commitment Commitment Cardiovascular Cardiovascular Gains Gains Program Program Maintenance Maintenance Overview: Overview: Single set programs are recommended Single for the following reasons: for Similarities in strength gains Less-time consuming More cost-efficient Improve program compliance What about CVD risk factors? What Does strength training modify Does cardiovascular fitness, blood pressure, cholesterol, obesity, or diabetes status? diabetes Strength Training and CV Fitness Fitness Low CV fitness is a strong and independent Low predictor of CV disease predictor Aerobic training increases VO2max 22% in 70-79 year old men & women after 6mo 22% aerobic training (Hagberg, et al, 1989) aerobic Strength Training and CV Fitness Fitness Changes in VO2max in response to strength training have not proven to be as great proven 5% increase in VO2max after 12 weeks of ST in 60-72 year old men (Frontera, et al, 1990) 1990) Strength Training and Blood Pressure Pressure Martel, et al (1999) Baseline SBP 131± 2 mmHg Baseline DBP 79 ± 2 mmHg Post training SBP 126 ± 2mmHg Post training DBP 75 ± mmHg Strength Training and Blood Pressure Pressure Cornelissen and Fagard (2005) Cornelissen Meta-Analysis MEDLINE database search 1966-Dec. 2003 12 study groups, 341 participants 8 groups were “normotensive” Baseline BP = 107-137/72-94 3 groups hypertensive Baseline BP = 142-153/82-95 Baseline Moderate resistance training Strength Training and Blood Pressure Pressure Strength Training and Blood Strength Pressure Pressure Net changes with strength training SBP = -3.2mmHg DBP = -3.5mmHg 2 of the 12 study groups showed a significant of significant decrease in SBP, 2 of the 12 study groups showed a significant decrease in DBP decrease Changes in blood pressure appear to be less in Changes the hypertensive group compared with the normotensive group normotensive Normotensive: SBP = +2.0 to -16.8mmHg, DBP = +1.4 Normotensive: to -16.5mmHg to Hypertensive: SBP = +2.0 to -3.0mmHg, DBP = 0 to Hypertensive: 2.5mmHg 2.5mmHg Strength Training and Blood Pressure Pressure Delmonico, et al. (2005) Delmonico, Systolic and diastolic Systolic BP decreased about 4mmHg after training (men and women combined (n=70) combined Could the variability in Could BP reduction be due to genetic influences? genetic Strength Training and Blood Pressure Pressure Genetic effect? WO W! WOW! WOW! Delmonico, et al. (2005) Strength Training and Blood Pressure Pressure Some studies have shown Some small decreases in SBP and DBP with ST (~4mmHg) (~4mmHg) Variations in individual Variations responses may be due to genetic differences genetic Strength Training and Cholesterol Strength In general, studies have had mixed results Limitations in studies include Lack of control group One blood sample taken before and after Studies with subjects with low risk profiles (young, Studies healthy, normal lipid levels) healthy, Lack of control for diet Strength Training and Cholesterol Strength Kokkinos, et al, (1988) 37 healthy men (19-35yrs) 10 weeks of training 37 healthy 3 groups: 1) control 2) Low-rep (4-6RM) 3) High-rep group (14-16RM) Low-Repetition Baseline Final High-Repetition Baseline Final Triglycerides Triglycerides mg/dl mg/dl 104 89 87 89 Total Chol. Total mg/dl mg/dl 150 141 148 162 HDL mg/dl 40 7 41 7 40 6 40 7 HDL2 mg/dl None of these changes were significant Strength Training and Cholesterol Kokkinos, et al (1991) Kokkinos, 16 men (35-57yrs) with abnormal lipids and 2 other risk 16 factors for CHD factors Inactive control group 20 weeks of strength training 2 blood lipid measurements at BL and Final None of these Triglycerides Triglycerides mg/dl mg/dl Baseline 193 Final 171 Total Chol. Total mg/dl mg/dl 231 210 HDL mg/dl 35 139 36 139 LDL mg/dl changes were significant! Strength Training and Strength Cholesterol Cholesterol What about women?? What Blumenthal, et al (1991) 50 healthy middle aged women (~50 yrs) 12 weeks of circuit Nautilus training No changes in total cholesterol, HDL, No LDL, VLDL, triglycerides LDL, Strength Training and Cholesterol Cholesterol Many studies investigating Many strength training and cholesterol have not been well-controlled have Studies in younger and middle Studies aged individuals have yielded mixed results mixed Studies in older individuals with Studies abnormal lipoprotein-lipid profiles have shown no significant change in lipid measures with strength training measures Review Review What is the ACSM’s recommendation for muscular What strength exercise? strength ______ days/week ______ exercises that include ______ ______ muscle groups, ______ set(s), _____intensity. ______ What is the overall expected change in BP with What muscle strengthening exercises? muscle The change in BP with strength training may be The influenced by ________. influenced Overall, there is (significant/little) evidence that Overall, muscle strength exercises influence plasma lipids. muscle Strength Training and Diabetes Diabetes Strength Training and Diabetes Diabetes Smutok, et al 1994 Men with abnormal glucose tolerance 20 weeks of AT, ST or no exercise OGTT to determine glucose metabolism OGTT changes changes Strength Training and Strength Diabetes Diabetes OGTT results: ST lowered plasma glucose levels at 60, 90, 120 min ST after glucose ingestion after ST lowered plasma insulin levels at rest (0), 90, 120 min * 90000 * Glucose AUC Insulin AUC 1500 0 0 BL Final BL Final Strength Training and Strength Diabetes Diabetes Smutok, et al 1994 ST improved glucose metabolism 8 subjects with impaired glucose subjects tolerance all normalized their glucose tolerance with strength training tolerance Results were the same for ST and ET Strength Training and Strength Diabetes Diabetes Cauza, et al 2005 All patients were 50-70 years old 22 (11 men, 11 women) type II diabetes 22 patients for strength training patients 17 (9 men, 8 women) type II diabetes 17 patients for endurance training patients 4 months of training ET: 60% VO2max, 15 min to 30 min 3x/wk ST: 1 set 10-15 reps (to fatigue) up to 2 sets ST: 10-15 reps 10-15 Strength Training and Diabetes Cauza, et al, 2005 Diabetes Strength Training and Diabetes Diabetes Although not all Although studies show an improvement in glucose metabolism with ST, most show a benefit in those with either normal or impaired glucose metabolism. metabolism. Strength Training and Obesity Strength Effects of diet + exercise on Effects body composition body Lose both fat and lean body mass with weight loss. If same weight loss as with diet only, some evidence for tendency to greater fat and less lean body mass loss compared to diet only. Strength Training and Obesity Strength Strength training supplements endurance Strength exercise in calorie burning exercise Good for Thermic Effect of Activity (TEA)!!!! RMR (resting metabolic rate) decreases RMR with age due to a decline in fat-free mass (FFM) (FFM) Strength Training and Obesity Strength Pratley, et al, 1994 Pratley, Measured RMR and body composition in Measured 13 men 50-65 years old 13 16 weeks of heavy ST Body weight did not change but fat% went Body from 25.6 ± 1.5% to 23.7 ± 1.7% (P < 0.001) 0.001) FFM increased 60.6 ± 2.2kg to 62.2 ± 2.1 FFM kg (P < 0.01). RMR increased 7.7% RMR Strength Training and Obesity Strength There is evidence that there may be There gender differences in ST and RMR changes… changes… Lemmer, et al, 2001 Younger (20-30 years) and older (65-75 Younger years) men and women years) 24 weeks of ST Strength Training and Obesity Strength Lemmer, et al, 2001 RMR changes with ST: Whole group increased RMR 7% Same increase (7%) for both young and Same older groups older Men increased RMR by 9% Men Women (young and older) showed no Women significant increase in RMR significant Strength Training and Obesity Strength ST supplements the ST calories expended due to activity due ST may decrease ST body fat % body RMR is increased RMR with ST due to an increase in FFM increase BUT there may be BUT gender differences! gender Sounds good…anything else? Sounds ST may help to attenuate other age-related ST changes that can affect daily living changes Loss in muscle strength, mass, & quality Loss (Sarcopenia) (Sarcopenia) Decreased strength and stability Can lead to increased falls and injuries with age Bone Loss (Osteoporosis) Increases/maintenance of bone mineral density is Increases/maintenance similar for endurance training and strength training similar Osteoarthritis May help to decrease joint pain and stiffness No evidence that ST improves flexibility Overview (Hurley and Roth, 2000) (Hurley Disease / Risk factor Effects of Effects strength training strength CHD VO2max VO lipoprotein-lipids lipoprotein-lipids Hypertension ↔ or ↑ or muscle strength muscle ↑↑↑ ↔ muscle mass muscle ↑↑ ↔ or ↓ or muscle power muscle ↑ muscle quality muscle ↑ glucose intolerance glucose ↔ or ↓ or insulin resistance insulin ↓ men, ↔ women men, Obesity RMR RMR Effects of Effects strength training strength Sarcopenia Diabetes total body fat total Disease / Risk factor Osteoporosis bone mineral den bone risk of falls risk ↓ Loss of flexibility ↑ men, ↔ women Osteoarthritis men, ↑ or ↔ or ↓ ↔ or ↑ or ↓ Strength Training Prescription Strength Dropout Rate Strength Gains Time Time Commitment Commitment Cardiovascular Cardiovascular Gains Gains Program Program Maintenance Maintenance ...
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