PA & Exercise as the "glue"

• • physical inactivity is one key preventable risk factor of cardiovascular disease (CVD) and consequently interventions designed to increase activity levels are routinely included in CPR practice
  • Accordingly, all guidelines in cardiovascular disease prevention and rehabilitation will refer to increasing physical activity
  • These recommendations often include separate targets for aerobic activity and strength training and it is important that you are able to define these and provide their rationale for inclusion
  • It is also important to note that cardiorespiratory fitness (CRF) is a strong predictor of cardiovascular events
  • One’s CRF is partly determined by genetic make-up but can be modified through structured activity (i.e. exercise) and hence the terms physical activity and exercise whilst distinct are closely related
• • structured aerobic activity aims to increase CRF
  • Every gain in CRF, expressed in METs, translates to meaning full outcomes; including reductions in all cause mortality
  • Useful fact: Every 1 MET gain is associated with an 13 - 15% reduction in all cause mortality & CVD events (Kodama et al. 2009)
• • Many authors have demonstrated, through well-conducted randomised controlled trials, that exercise training has a direct effect on the atherosclerotic process
  • These include direct anti-atherosclerotic effects by improving artery endothelial function and reducing inflammation and indirectly via modification of other risk factor components of the metabolic syndrome, by reducing risk of a coronary thrombotic occlusion (anti-thrombotic effects), by decreasing myocardial oxygen demands and increasing its vascular supply (anti-ischemic effects), and by improving cardiomyocyte electrical stability and autonomic nervous system adaptations (anti-arrhythmic effects)
  • In addition to these cardioprotective properties there are considerable health gains associated with regular physical activity
• • aerobic exercise training is an established therapeutic intervention in CPR practice
  • Strength training is also important and associated with a number of health and fitness variables, such as:
  • Improves CVD risk factor profile (insulin resistance, glucose and lipid profiles)
  • Prevents falls or modifies falls risk factors
  • In more significant cardiorespiratory diseases (COPD; CHF; PVD) it improves endurance performance
  • Energy expenditure and body composition
  • Improves psychosocial well being
• strength training compared to resistance training (NEED TO KNOW)