Energy expenditure during an exercise training session for cardiac patients

Increasing energy expenditure (EE) in cardiac patients remains a challenge. Exercise approaches in cardiac rehabilitation/secondary prevention programs (CR/SP) have consistently resulted in minimal weight loss, due in part to the low exercise-related EE. The purpose of this study was to measure the EE among patients participating in a routine exercise session of Phase III maintenance CR/SP, where a recreational activity was introduced. Twelve overweight/obese male patients with coronary artery disease (aged 62.6 +/- 8.5 years) had their total EE measured during a combined aerobic (circuit workout (ACW) and recreational activity) and resistance training (RT) session using a portable gas analyzer. Subjects were instructed to exercise at 60%-70% of heart rate reserve. Activity EE was calculated from total EE and resting EE. The duration of the session was 75.3 +/- 1.5 min, of which 59.7 +/- 8.8 min were above moderate intensity (3-6 METs). Activity EE was 309 +/- 76 kcal, concurring to a total EE of 457 +/- 80 kcal (3.9 +/- 0.8 METs-h). ACW, recreational activity, and RT fulfilled 34.4% +/- 6.4%, 25.0% +/- 5.3%, and 14.2% +/- 2.7% of the activity EE, respectively. Absolute intensities (METs) were significantly different between the RT (3.9 +/- 1.0) and the ACW (6.9 +/- 1.8) and recreational activity (5.9 +/- 0.8). In conclusion, a combined aerobic and resistance training following standard exercise prescription practices, coupled with a recreational activity, is an effective tool to promote exercise above moderate intensity in male coronary artery disease patients. Clinicians can adopt concepts from recreational activity to develop CR/SP sessions.