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.