Gym program

There ara patients who should be supervised by a clinic or gym for an individualised exercise program.

Warm-up phase

Ø  5-10 minutes of low-intensity aerobic activity (walking, cycling or rowing).

Ø  Aerobic exercises.

Ø  A light stretching, concentrating on the muscles and joints involved in the training

Ø  program.

Specific phase

Aerobic exercises:

Ø  4-7 times per week.

Ø  30-60 minutes of walking, cycling, or rowing at 50-90% maximum heart rate (HRmax), or 40-85% heart rate reserve (HRR).

Ø  Exercise can be continuous or intermittent (minimum of 10-minute bouts).

Resistance exercises:

Ø  Exercises should be directed to the upper and lower limbs and trunk.

Ø  6-9 different exercises, with 60-90 seconds recovery between sets.

Ø  1-4 sets per muscle group, training at 50-80% of 1RM, or 6-10RM.

Ø  Program should be incremented as patients improve to maximise training response:

1.      Increase number of repetitions, from 6 to 12

2.      Increase number of sets, from 1 to 4.

3.      Increase the load or resistance and reduce the number of repetitions and sets.

We must combine resistance exercise 2-3 times per week with these exercises, not consecutively:

Ø  Chest press

Ø  Lat pull-down

Ø  Squat or leg press

Ø  Leg extension

Ø  Shoulder press or lateral arm raise

Ø  Leg curl

Ø  Seated row

Ø  Triceps extension

Ø  Biceps curl

Ø  Core stability exercises

We may also combine resistance training with the following routines, for 3-4 days a week.

ROUTINE A	ROUTINE B
Chest press	Leg press or squat
Biceps curl	Core stability exercises
Lat pull-down	Calf raise
Triceps extension	Leg extension
Shoulder press	Leg curl
Lateral arm raise	Hip extension
Seated row

Flexibility exercises

Ø  3-4 times per week.

Ø  2-4 sets per muscle group at 15-30 seconds stretching time.

Cool-down phase

Ø  Slow walking.

Ø  Light stretching.