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.

To measure the EE among patients participating in a routine exercise session of Phase III maintenance CR/SP where a recreational activity was introduced. Methods Twelve overweight/obese male patients with coronary artery disease (62.6 ± 8.5 years) had their total EE measured during a combined aerobic [circuit workout (ACW) and recreational activity (RA)] 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-1). ACW, RA 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 RA (5.9 ± 0.8).

A combined aerobic and resistance training following standard exercise prescription practices, coupled with a RA, is an effective tool to promote exercise above moderate intensity in male coronary artery disease patients. Clinicians can adopt concepts from RA to develop CR/SP sessions.