Providing overload

As the individual progresses, the exercise dose should be increased in order to achieve overload as in the aerobic component. Overload will allow an increase in muscular strength and endurance and should be carried out over time. This can be achieved by:

• increasing the resistance or weight;

• increasing the repetitions;

• increasing the sets;

• decreasing the rest period between sets or exercises.

To achieve overload, an initial increase in the number of repetitions is recommended before an increase in resistance (Fardy, et al., 1998). When the patient can safely achieve 15 repetitions, the resistance should be gradually increased. Pollock, et al. (2000) recommend that resistance is increased by 2 to 5 lbs for the upper limbs and by 5 to 10 lbs for lower limbs. This will depend on training adaptations and the individual's progress. In order to elicit an increase in strength, more resistance, with fewer repetitions, is required. In order to elicit an increase in endurance, more repetitions of a low to moderate resistance are required (ACSM, 2001).

Exercise prescription and its progression should also take into account the needs of the individual. RE programmes should accommodate the daily living and occupational requirements of participants. Emphasis should be placed on specific muscles that individuals require for their occupation and activities, e.g. upper limb strength for building trade employment. In addition, return to domestic activities after a period of inactivity should be considered. Different occupations and lifestyles may require a varying amount of either strength or endurance. This should be taken into consideration when designing RE programmes.

The benefits seen in muscle mass and strength diminish when RE is stopped (ACSM, 2001). Therefore, it is important to encourage participants to maintain exercise, both aerobic and RE, at phase III and into phase IV.

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