A new paradigm for post-cardiac event resistance exercise guidelines

Existing guidelines for resistance exercise in cardiac rehabilitation are vague and/or overly restrictive, limiting the ability of cardiac rehabilitation programs to help patients achieve their desired levels of daily activity in a timely manner after cardiac events. This study examines the illogical nature of the existing guidelines in relation to the activities of daily living patients are expected or required to carry out during the period of cardiac rehabilitation and the existing recommendations for dynamic exercise in cardiac rehabilitation. An improved method is proposed for prescribing resistance exercise in cardiac rehabilitation. A tool is presented that stratifies the risk associated with each of 13 common resistance exercises for 3 cardiac rehabilitation diagnosis groups (myocardial infarction [MI], pacemaker or implantable cardioverter defibrillator implantation, and coronary artery bypass graft surgery) that, if used in conjunction with blood pressure and heart rate measurements, will safely facilitate more efficacious resistance training in cardiac rehabilitation patients. In conclusion, changing the approach to resistance exercise in cardiac rehabilitation will accelerate patients' return to their desired levels of daily activity, improving patient satisfaction and decreasing cardiac rehabilitation program attrition. (C) 2006 Elsevier Inc. All rights reserved.