Download Health Aspects of Resistance Exercise and Training

© National Strength & Conditioning Association
Volume 23, Number 6, pages 9–23
POSITION STATEMENT
National Strength and Conditioning Association Position Statement
Health Aspects of
Resistance Exercise and Training
Michael S. Conley, MD, PhD, CSCS
Department of Radiology
Indiana University Medical Center
Indianapolis, Indiana
Ralph Rozenek, PhD
Department of Kinesiology and Physical Education
California State University Long Beach
Long Beach, California
Keywords: exercise; resistance training; health
RESISTANCE TRAINING, WHICH
includes the regular use of free
weights, weight machines, body
weight, elastic bands, and other
forms of equipment to improve
muscular strength, muscular
power, and muscular endurance,
has become an increasingly popular form of physical activity. Recent recommendations have been
made regarding the use of resistance training in healthy populations (2, 43). Resistance training is
currently being advocated for use
with special populations such as
cardiac rehabilitation patients
(158) and the elderly (3). It is generally accepted that resistance
training increases muscular size,
strength, and power and is useful
for enhancing athletic performance. Benefits resulting from resistance training are strongly influenced by the large number of
training variables that can be manipulated in a program. Variations
December 2001
in load, volume, intensity, active
muscle mass, muscle contraction
type, rest interval, equipment,
technique, initial level of fitness,
training status, and program type
can all influence the magnitude
and duration of the response to
resistance exercise and ultimately
the adaptations associated with
resistance training. Taking all of
these factors into consideration,
there is an accumulating base of
scientific evidence suggesting that
a number of health-related benefits may be derived from participation in a well-designed resistance
training program. Having reviewed
the available scientific literature
on resistance training and health,
it is the position of the NSCA that:
1. Resistance training may enhance cardiovascular health
by mitigating several of the
risk factors associated with
cardiovascular disease by proStrength and Conditioning Journal
ducing such changes as
a. decreases in resting blood
pressure, particularly in
individuals with elevated
pressures;
b. decreases in exercise heart
rate, blood pressure, and
rate pressure product at a
standard workload;
c. modest improvements in
the blood lipid profile and;
d. improvements in glucose
tolerance and decreases in
hemoglobin A1c in patients with diabetes mellitus.
2. Resistance training may result
in improvements in body composition by maintaining or increasing lean body mass and
producing modest decreases
in the relative percentage of
body fat.
3. Resistance training can produce increases in bone mineral density and may help delay
9
or prevent the development of
osteoporosis by reducing the
age-associated loss of bone
mineral density.
4. Resistance training may reduce anxiety and depression
and may result in improved
self-efficacy and overall psychological well being.
5. Resistance training can reduce the risk of injury during
participation in other sports
and activities. When performed correctly and properly
supervised, it is in itself a safe
activity with low injury rates.
6. Resistance training increases
muscular strength and endurance, resulting in an increased ability to perform activities of daily living, and
reduces demands on musculoskeletal, cardiovascular, and
metabolic systems.
■ Effects on the
Cardiovascular System and
Cardiovascular Risk Factors
Heart Rate
Heart rate can increase markedly
as a result of an acute bout of resistance exercise. The magnitude
of the response may be affected by
factors such as intensity, load,
and the active muscle mass (17,
84, 85, 132, 148). Because resistance exercise is generally performed intermittently, average
heart rate values will also be largely influenced by the duration of
the rest periods between sets and
exercises. Therefore, the average
heart rate obtained during a bout
of resistance exercise may not accurately represent the extent of
the cardiovascular stress experienced, nor can it be used as an accurate estimate of exercise intensity.
Decreases in resting heart rate
and submaximal heart rate at a
given power output are well-estab10
lished adaptations to endurancetype training (59, 102). With regard to resistance training, most
cross-sectional studies report that
resistance-trained athletes have
average or below average resting
heart rates (115, 134, 135). Decreases (77, 89, 90, 146) or nonsignificant differences (124, 130,
150) have been observed in training studies. In the studies that
have shown reductions in resting
heart rate, the change is relatively
modest (approximately 3–10%).
The differences in results are likely due to differences in training
variables employed in the various
studies.
Resistance training has been
shown to decrease heart rate during submaximal work (8, 50, 121,
124, 144) and during recovery
from exercise (89, 109, 145, 146).
Lower exercise heart rates as a result of resistance training have
been observed during both submaximal cycling exercise (123)
and during progressive resistance
exercise at the same absolute load
(124). It is believed that heart rate
is lowered following training by a
reduced ratio of sympathetic to
parasympathetic nervous system
activity.
The observed decreases in
heart rate following training are
thought to be compensated for by
an increase in stroke volume, allowing cardiac output to remain
more or less constant at rest or at
an absolute submaximal workload. Heart rate is among the factors that determine myocardial
oxygen demand. A decrease in
heart rate at rest or during submaximal work may result in a reduced myocardial oxygen demand.
Blood Pressure
Blood pressure may be considered
the product of cardiac output and
total peripheral resistance and is
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regulated by a complex interaction
of neural, metabolic, cardiovascular, and hormonal factors (136).
When chronically elevated as in
hypertension, it is an independent
risk factor for coronary artery disease and is associated with many
other cardiovascular disorders
(104).
Both systolic and diastolic
pressures have been shown to
acutely increase as a result of
high-force muscular contractions.
Highly elevated mean intraarterial
systolic and diastolic blood pressures on the order of 350/250
have been reported in bodybuilders performing 2 repetitions
at 95% of 1 repetition maximum
(1RM) of the leg press (99) and in
subjects performing 100% 1RM
double-leg press while executing a
Valsalva maneuver (117). However, other studies only show elevations to about 230/130 mm Hg
(148). The increased systolic and
diastolic pressures are believed to
result from increased sympathetic drive and a peripheral reflex
component originating in the active muscles as a result of occlusion to blood flow (74, 133). The
extent of the increased pressures
appears to be related to the contraction type, intensity, duration,
and amount of muscle mass engaged and breathing technique
(117, 119, 144).
Most cross-sectional studies
show no significant difference between strength athletes and control subjects for resting blood
pressure (40, 98, 138). Similarly,
most training studies show no
change or a slight decrease in subjects with normal resting blood
pressure (39, 40, 74, 150). Studies with hypertensive and mildly
hypertensive patients have shown
significant reductions in resting
blood pressure (54, 61) following
resistance training. Recent metaanalyses by Kelly (80, 81) demonDecember 2001
strated reductions at rest of approximately 4.5 mm Hg systolic
and 3.8 mm Hg diastolic blood
pressure following short-term resistance training. These results
compare favorably with the findings of another meta-analysis performed on aerobic training studies
in which reductions of 4.7 mm Hg
and 3.1 mm Hg in resting systolic
and diastolic blood pressure were
demonstrated (56). Although the
effects of resistance training on
resting blood pressure are mixed,
it appears that, when higher volume training or circuit weight
training is used, reductions in
resting blood pressure may be observed. This is significant because
modest reductions in resting diastolic blood pressure have been associated with reduced risk of
stroke and development of coronary heart disease (18, 100).
An observed beneficial adaptation to resistance training has
been an attenuated rise in blood
pressure during exercise (20, 40,
49, 50, 107, 133). A reduction in
muscular effort necessary to lift a
given weight along with a reduction in stimulation to the cardiovascular control center may contribute to the muted blood
pressure response observed following training (133). It is possible
that altered baroreceptor sensitivity may be involved in regulating
this response (152). Systolic blood
pressure is a direct determinant of
myocardial oxygen demand. A reduction in systolic blood pressure
at a standard load following training would likely reduce myocardial
oxygen demand and thus reduce
the likelihood of a severe cardiovascular event occurring during
resistance exercise or physically
demanding daily tasks requiring
heavy lifting.
Although caution should be
used when prescribing resistance
exercise to patients at risk of carDecember 2001
diovascular disease, it does not
mean that it should be avoided
(36, 101). Certain steps can be
taken to minimize the blood pressure response during resistance
exercise. These include (a) emphasizing dynamic movements, (b)
using proper breathing technique
to avoid performing a Valsalva maneuver, (c) reducing or eliminating
maximal attempts during training,
(d) limiting the number of repetitions performed to or past exhaustion, (e) using moderate
amounts of resistance, and (f) emphasizing proper technique.
Rate Pressure Product
Rate pressure product (RPP) is an
estimate of myocardial work and
oxygen demand and may be estimated by the product of heart rate
and systolic blood pressure. This
measure may be particularly important as it pertains to ischemic
heart disease (IHD). Ischemic
heart disease includes several disorders that arise from an imbalance of myocardial oxygen supply
and demand. During resistance
exercise, RPP rises rapidly with
the extent of the rise being dependent on such factors as intensity
and amount of active muscle mass
involved in the movement (5, 86).
There also appears to be a progressive rise in RPP with an increasing number of sets at a given
intensity (86).
Several studies have reported
reduced RPP at rest and during
submaximal exercise in healthy
(150), elderly (121), and cardiac
patients (101) following resistance
training. Lower RPPs have also
been reported in bodybuilders
compared with sedentary control
subjects during leg ergometry (16).
The reduced RPP observed is likely the combined effects of lower
heart rate and blood pressure at a
given activity level as previously
discussed.
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A reduced rate pressure product at rest and during submaximal exercise would be considered
a positive adaptation, particularly
in individuals who have IHD. Although the RPP that produces
angina does not change following
exercise, heart rates and blood
pressures are lower at matched
absolute workloads (60). Therefore, a higher workload would be
required to attain the same RPP as
a consequence of training. The result of this adaptation is that it
would likely reduce the likelihood
of an ischemic cardiac event during physical activity.
Aerobic Power
Aerobic power, as measured by
·
maximal oxygen uptake ( VO2max),
has been classically used as an
index of cardiorespiratory fitness
but is not considered to be an independent risk factor for the development of coronary artery disease. The value obtained has been
found to be dependent on such
factors as age, gender, and genetic predisposition. The mode, intensity, duration, and frequency of
training as well as an individual’s
initial level of cardiorespiratory fitness will all influence changes in
·
VO2max.
Traditional noncircuit resistance training is not generally associated with increases in aerobic
power. However, strength athletes,
who perform little or no aerobic
endurance exercise, have been
·
shown to have higher VO2max (34,
134, 149) compared with nonathletes. Several longitudinal studies
have shown no change or minimal
·
increases (<5%) in VO2max following short-term resistance training
(35, 68, 116). When using highvolume training, consisting of
large muscle mass and multijoint
exercises, larger increases (8–10%)
·
in VO 2max have been observed
11
(150). While this increase is still
considerably lower than those observed for aerobic endurance exercise, it suggests that resistance
training can improve aerobic metabolism when high-volume training is employed (147). The
·
increased VO2max likely results
from a combination of cardiac, peripheral vascular, and skeletal
muscle adaptations that improve
oxygen delivery and utilization,
but the exact mechanism is unclear. It is possible that increases
in the proportion of lean body
mass as a result of training may
also be involved.
In studies that have employed
circuit weight training for rehabilitation of cardiac patients, larger
percentage increases in maximal
oxygen uptake have been observed, ranging from approximately 11 to 19% (53, 151). Increases in maximal oxygen uptake
of 8 and 21% as measured during
treadmill exercise and arm ergometry have also been observed in
borderline hypertensive subjects
who used a circuit weight training
program (61).
Increases in aerobic power are
beneficial in that individuals have
a greater capacity to produce energy via aerobic metabolism. At a
standard submaximal power output, there is less reliance on
anaerobic metabolism and a
greater proportion of energy is derived via aerobic mechanisms.
This results in less acute metabolic stress and potentially an increase in work time and less fatigue. However, specific training to
increase aerobic power may limit
maximal strength and power (27,
66), so careful analysis of program
goals is necessary.
Blood Lipids and Lipoproteins
Hyperlipidemia is frequently associated with coronary artery disease, atherosclerosis, diabetes
12
mellitus, and nephrotic syndrome.
It is generally accepted that aerobic endurance training improves
blood lipid and lipoprotein levels
(28), but the effect of resistance
training is more controversial. No
significant differences in blood
lipid and lipoprotein levels have
been observed between male
weight trainers and sedentary
controls (6, 7, 15, 37). However,
these studies did not control for
such factors as the type, volume,
or intensity of training, diet, or androgen use. When controlling androgen use, strength athletes have
been shown to have positive lipid
profiles (23, 72, 167, 168).
Although contradictory evidence exists, several longitudinal
studies (see reference 145) have
shown significant improvements
in blood lipid and lipoprotein levels resulting from resistance training that include reductions in total
cholesterol (3–16%) and low-density lipoprotein (5–39%) and increases in high-density lipoprotein
(14–27%). However, these results
must be interpreted cautiously
due to several methodological limitations that include inadequate
control for normal variation of
blood lipid and lipoprotein levels,
diet, and body composition (73).
More research is needed before
definitive conclusions can be
made regarding the effect of resistance training on blood lipid and
lipoprotein profiles.
Glucose Tolerance
Impaired glucose tolerance is associated with an increased risk of
many diseases that include
non–insulin-dependent diabetes
mellitus, coronary artery disease,
cataracts, stroke, intermittent
claudication, retinopathy, nephropathy, and increased risk of infection. It has been shown that contractile activity mimics the effects
of insulin in skeletal muscle by
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enhancing the translocation of
glucose channels from the cytoplasm to the cellular membrane
(63). This increases the tissue sensitivity to glucose and facilitates
its deposition. Over time, it is likely that this will reduce the degenerative effects of high circulating
glucose.
Improved glucose tolerance
and insulin sensitivity have been
shown in bodybuilders compared
with normal individuals (168).
Longitudinal studies have also
shown that resistance training improves glucose tolerance (112,
139, 140) and the improvement in
insulin sensitivity has been shown
to be greater as a result of resistance training compared with aerobic training (30). It is likely that
resistance training improves glucose tolerance by acutely increasing glucose transport into skeletal
muscle during and immediately
following an exercise bout and
chronically by increasing lean
body mass, thereby increasing the
amount of tissue available to take
up glucose from the blood. This
may allow for reduced medication
dosages for patients with certain
forms of glucose insensitivity and
offer improved control and stabilization of glucose levels. Recent
studies support this by demonstrating decreased hemoglobin
A1c (HbA1c) in diabetic patients
engaged in resistance training
programs (29, 30, 69). Thus, there
is increasing evidence to support
the use of resistance training in
the management of patients with
diabetes mellitus.
■ Effects on Energy
Expenditure and Body
Composition
The proportion of fat mass and
fat-free mass in relation to the
total body mass determines body
composition. The fat mass is composed of essential fat that is necDecember 2001
essary for normal physiological
function, while the storage fat
serves primarily as an energy reserve. Obesity, which is defined as
the storage of excess energy in the
form of body fat, has been linked
to a variety of medical disorders
that include hypertension, hyperlipidemia, heart disease, coronary
artery disease, insulin resistance,
diabetes mellitus, and osteoarthritis.
Energy Expenditure
Resistance exercise has been
found to produce modest increases in energy expenditure (4, 71,
79, 156), with the use of movements employing larger muscle
mass resulting in higher expenditures (135). Resistance exercise
also increases energy expenditure
during recovery as indicated by
increases postexercise oxygen
consumption (11, 135). Resistance training has been shown to
elevate resting metabolic rate, particularly in older individuals (12,
125, 127), and can increase average daily energy expenditure
(160).
Fat Mass
Although fats are not considered a
primary fuel source during resistance exercise, intramuscular (31)
and serum triglycerides (162) have
been shown to decrease following
an acute bout of resistance activity. Postexercise respiratory exchange ratios have been shown to
remain below preexercise values
for up to 3 hours and to be decreased during sleep in individuals engaging in resistance exercise, indicating shifts in substrate
oxidation toward the greater utilization of fats (159). An increased
oxidation of fats over time may result in decreased body fat stores.
Reductions in intraabdominal fat
stores have been observed in older
women following resistance trainDecember 2001
ing (155). Elevated visceral fat
stores, particularly in the abdominal region, have been linked to an
increase in the risk of developing
cardiovascular disease (CVD).
Thus, resistance training may
help lower the risk of cardiovascular disease by reducing visceral fat
that has been associated with increased risk of CVD.
Fat-Free Mass
Cross-sectional studies indicate
that individuals who regularly
participate in resistance training
programs, such as bodybuilders,
powerlifters, and Olympic-style
weightlifters, possess lower than
average percent body fat (145).
Fleck and Kraemer (41) have summarized 21 resistance training
studies examining changes in percent body fat. The mean duration
of these studies was 11.5 weeks
and the mean reduction in percent body fat was 2.2%. These results compare favorably with
studies involving aerobic endurance activity that show an approximate 2% decrease in body fat
for studies 15–20 weeks in duration (165).
Fat-free mass (FFM) is composed of all nonfat tissues, including muscle, bone, organ, and connective tissue. Preservation of
FFM is important for maintenance
of normal skeletal muscle function, integrity of the bone mass,
and resting metabolic rate. Skeletal muscle mass is related to muscular strength (45) and maximal
oxygen consumption and contributes to the ability to carry out
activities of daily living (53, 56).
The total amount of muscle mass
is a major factor associated with
resting metabolic rate (12, 22). Beginning in midadulthood, the FFM
declines at a rate of approximately 3 kg per decade (142). In crosssectional studies, losses of FFM on
the order of 15–30% have been reStrength and Conditioning Journal
ported when comparing young
adult males and females with
older individuals approximately
80 years of age (48).
A number of studies have
shown that resistance training is
capable of maintaining or increasing FFM in young and middleaged adult males and females (9,
14, 35, 68, 113, 160, 164). In
these studies, ranging in duration
from 8 to 20 weeks, fat-free mass
increased from approximately 1.5
to 3.0 kg.
With regard to maintenance of
FFM, the elderly are a population
where resistance training may
have particular importance. Decreases in muscle mass have been
attributed to decreases in the
number and size of muscle fibers
(51, 92, 96). Both the Type I and
Type II fibers decrease in size as a
result of the aging process, with
the decrease in the Type II fibers
being more pronounced (51, 92).
Following resistance training, increases in Type I and Type II fiber
size (13, 21, 45), muscle area (38,
45), and FFM (12) have been reported. Maintenance of muscle
mass would have an impact on
the levels of muscular strength as
well as on aerobic power and the
ability to carry out daily tasks.
Bone Mineral Density and
Osteoporosis
Osteoporosis is a disease involving
a progressive loss of bone mineral
density (BMD) that predominantly affects the elderly, especially
postmenopausal women. The loss
of BMD results in a weakening of
the tissue, predisposing it to fractures. Mechanical forces imposed
on bone are critical to the maintenance and increase of BMD. Animal and human studies suggest
that muscular activity is effective
in maintaining BMD if the forces
developed reach a minimal effective strain, which is the level re13
quired to stimulate new bone formation. Because of the high forces
that may be developed, resistance
exercises appear to be specifically
suited to prevent the loss of BMD
and development of osteoporosis.
A number of studies have
found that resistance training increases bone mineral density in a
variety of populations (94).
Strength athletes have been
shown to have higher BMD than
controls (19, 78). Longitudinal resistance training studies have
shown increases in BMD in both
adult (26, 97, 141) and elderly
subjects (82, 110, 166), although
others have shown no change (14,
64, 70, 106). Most evidence suggests that the increases in BMD
are specific to the type of exercises
performed and limbs/joints involved in the movement (57, 78).
For example, to increase BMD of
the femur, it is necessary to include resistance exercises that
specifically load the muscles that
have their origin or insertion on
the femur. Resistance training
may have the effect of stimulating
bone formation while inhibiting
bone resorption during the early
phases of a training program (47).
Based on available evidence, it appears that both endurance-type
activity and resistance training
help to maintain or increase BMD,
with resistance training possibly
having a greater overall effect.
■ Psychological Status
Anxiety and depression are very
common psychiatric disorders
(20–30% lifetime prevalence) (83,
131) that significantly compromise quality of life. They are considered risk factors for other diseases such as coronary artery
disease, peptic ulcer disease,
asthma, headaches, and rheumatoid arthritis (44). Although controversy exists (24), it is the general consensus that exercise is
14
associated with reduced state and
trait anxiety (91) and reduced depression (144). Most of the work
leading to these consensus statements focused on the effects of
aerobic exercise on anxiety and
depression. Comparatively, little
research has been done with resistance exercise and training.
However, the research that has
been done suggests that resistance training produces similar
improvements in anxiety and depression (118, 137, 157) and may
improve self-efficacy and enhance
psychological well-being, particularly in populations such as patients with heart disease and the
elderly (33, 105, 122).
■ Risk of Injury
Resistance exercises, when performed properly, are extremely
safe, with very low rates of injury
compared with most other sports
and recreational activities (75,
129). Traditional resistance training, including both machine and
free weights, has been shown to
have an injury rate of 0.0035 per
100 participation hours (58). Powerlifting, which typically involves
lifting heavy weight and a low
number of repetitions, has also
been shown to have very low injury rates—0.0027 per 100 hours
(58). This compares favorably with
other common activities such as
soccer (6.20 per 100 hours), track
and field (0.57 per 100 hours),
football (0.10 per 100 hours), basketball (0.03 per 100 hours), and
gymnastics (0.044 per 100 hours).
Resistance exercise was also not
associated with an increased risk
of serious injury (58). It should be
noted that weightlifting and associated exercises, which emphasize
explosive free-weight movements,
have been shown to have lower injury rates than traditional resistance exercises—0.0017 per 100
hours versus 0.0035 per 100
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hours (58). Thus, when properly
supervised, free-weight or explosive exercises need not be contraindicated because of increased
risk of injury.
The performance of maximal
attempts (1RM) has been discouraged by some who believe that
they are associated with an increased risk of injury. However,
this has never been shown experimentally and most anecdotal evidence suggests that injuries during maximal attempts are
extremely rare. It is still usually
advisable to avoid maximal attempts in prepubescent or elderly
subjects because of immature or
compromised musculoskeletal
systems. In general, the following
guidelines should be followed to
minimize the risk of injury during
resistance exercise: (a) adequate
warm-up should be performed
prior to each exercise bout, (b)
proper technique should always
be used for each exercise, (c) all
training should be supervised by
qualified personnel, (d) spotters
should be used appropriately for
each exercise, (e) a minimal number of repetitions should be performed after the onset of fatigue,
(f) all equipment should be in
proper working order, and (g) the
training facility should have ample
space for all exercise participants.
Regular participation in a resistance training program has
been shown to reduce the rate and
seriousness of injury during participation in other sports and activities (25, 52, 62, 88, 95). This is
likely due to strengthening of the
components of the musculoskeletal system, including ligaments,
tendons, and cartilage (93, 143,
153, 154). It has also been shown
that elderly subjects, who are at
an increased risk of injury resulting from falls, benefit from increased muscle mass, strength,
postural stability, and functional
December 2001
mobility following resistance
training (38, 76). These positive
adaptations appear to reduce the
number of falls and injuries experienced in the elderly (65, 128).
■ Functional Capacity
Normal daily functioning will likely require an individual to perform
activities such as stair climbing,
lifting, and carrying heavy objects.
Even an activity such as walking
requires some level of muscular
strength and endurance. In the elderly, a close correlation exists between muscular strength and
walking speed (38). It has also
been shown that the maintenance
of strength throughout life may reduce the prevalence of functional
limitations (10) and that strength
and muscle cross-sectional area
better predict exercise capacity in
patients with cardiac disease than
hemodynamic measures or peak
aerobic power (161). Recent studies in the debilitated elderly (111)
and stroke patients (163) have
demonstrated that resistance
training is effective in improving
functional capacity as demonstrated by improvements in
strength, chair stand time, balance, and motor performance.
Combinations of dynamic and
static contractions are involved in
most activities of daily living, with
each type of contraction producing a unique physiological response. With resistance training,
maximal strength and power levels increase. As a consequence,
absolute loads represent a lower
percentage of maximal effort, thus
reducing the relative exercise intensity.
Increased endurance as a result of resistance training has
been observed in such activities as
squatting to exhaustion (108,
148), incremental cycling and
treadmill running to exhaustion
(67, 68, 120, 150), and cycling at
December 2001
constant and relative power outputs (67, 103, 108). Reductions in
blood lactate concentrations at an
absolute load (124) and elevations
in the lactate threshold (103) have
also been observed following resistance training. In elderly populations (1), improvements in leg
strength, walking endurance, and
spontaneous activity were observed in individuals participating
in resistance training programs (1,
32). More recently, Hagerman et
al. (55) have found significant increases in treadmill performance
and maximal oxygen uptake in a
group of resistance-trained elderly
men. It is apparent that improvements in muscular strength provide a greater reserve and reduce
demands on the musculoskeletal,
cardiovascular, and metabolic systems, making typical tasks relatively less stressful.
■ Practical Considerations
It is widely recognized that the
performance adaptations resulting from resistance training are in
accord with the principle of specificity of training, i.e., the greatest
improvements in performance are
observed in activities similar to the
ones performed during the training. This has been shown to exist
for training mode, movement pattern, muscle contraction type
(e.g., isometric, concentric, eccentric), velocity, and joint angle (see
reference 41). It also appears that
health-related adaptations result
from stimulus-specific changes
elicited by the manipulation of
program variables. For example,
the health benefits related to cardiovascular disease risk factors
appear to be linked to training volume. While some benefit may be
seen with low-volume training,
most evidence suggests that
greater improvements occur with
higher volume training. Therefore,
multiple sets of large muscle mass
Strength and Conditioning Journal
exercises should be used with
moderate to high repetitions when
changes in cardiovascular disease
risk factors are desired. In contrast with the cardiovascular
adaptations, increased bone mineral density appears to be linked
to exercise intensity and movement pattern. To increase bone
mineral density, it appears necessary to perform exercises with a
relatively high load that stimulates
specific parts of the skeleton such
as the hip or vertebrae. This may
best be done by exercises that load
the axial skeleton such as the
squat. The recognition that different health-related changes are associated with specific program
variables will allow for the design
of more efficient and beneficial resistance training programs. This
may also help explain the seemingly contradictory evidence seen
in several areas of the scientific literature because of the considerable variation in the types of regimens used in research. ▲
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Conley
Rozenek
Michael S. Conley, MD, PhD,
CSCS, is currently a resident in the
Department of Radiology at the Indiana University Medical Center in
Indianapolis, IN. He received an
MD from Indiana University School
of Medicine and a PhD in Exercise
Physiology from the University of
Georgia.
Ralph Rozenek, PhD, is a professor in the Department of Kinesiology and Physical Education at California State University, Long
Beach. He has been involved in research investigating the effects of
resistance exercise and training for
the past fifteen years.
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