When to start resistance exercise

There is some dispute as to when coronary heart disease patients should commence an RE programme. There is general consensus that patients should complete a period of aerobic exercise prior to initiating resistance training. The ACSM (2001) and SIGN (2002) recommend a period of four to six weeks' aerobic acclimatisation. This period allows for patients' haemodynamic responses to exercise to be assessed and for any complications to be ruled out before progression to RE. Additionally, the patient can use this time to become familiar with self-monitoring and to establish the correct training intensity.

The ACSM (2001) suggest that patients post-MI and CABG should wait for four to six weeks post-event before commencing RE. For patients following percutaneus transluminal coronary angioplasty (PTCA) a shorter period of one to two weeks may be adequate (ACSM, 2001).

Prior to commencing upper limb resistance training CABG patients should have their wound and sternal area assessed, to ensure adequate healing and stability (Pollock, et al., 2000). Caution is advised for patients who demonstrate symptoms of chest clicking or discomfort, as this can signify problems with healing. There is some evidence that an exercise programme should avoid any exercises that place strain on the sternal area for three months post-operation (Pollock, et al., 2000). This will vary considerably between individuals, due to differences in pain tolerance and wound healing.

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