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........................................................................................... Resistance training. Exercise intensity: The intensity of resistance exercise is typically prescribed in terms of one repetition maximum (1 RM). One RM is defined as the maximum amount of weight a person can lift throughout a range of motion with one repetition. Even though the performance of 1 RM appears to be a safe approach for evaluating strength102 and no significant CV events have been reported using this approach,103 for convenience and compliance reasons the use of multiple (usually five) repetitions (5 RM) is suggested. Five RM is the maximum amount of weight that can be performed five times. It has been reported that 1 RM can be accurately estimated from multiple repetitions and that 5 RM is an appropriate reflection of maximal strength.104

Exercise training zones: Resistance training using less than 20% 1 RM is generally considered aerobic endurance training. With more than 20% 1 RM, the muscular capillaries become compressed during muscle contraction resulting in a hypoxic stimulus responsible for training effects. The number of repetitions should be inversely related to the training intensity. A moderate training intensity of 3050% 1 RM with 1530 repetitions is considered muscular endurance training. Higher training intensities of 5070% 1 RM with 815 repetitions are optimal for strength gains. Training volume: Optimal strength gains occur when resistance training is performed 23 times per week. Approaches to resistance training often follow either a station or a circuit approach. In the former approach, individuals typically complete all of the sets for a given exercise per muscle group before moving to another exercise and muscle group. In the latter approach, individuals typically perform one set of a given muscle group and then rotate to another exercise and muscle group until the full set of exercises in completed per muscle group. One to three sets of 815 repetitions should be performed including flexion and extension of each muscle group. Multiple sets are superior to a single set.105

A variety of 810 resistance exercises should be prescribed to cover most of the muscular groups.88 Muscular power is best maintained when 35 min rest intervals are used instead of short rest intervals (<1 min).106 Mode of training: Resistance training can either be isometric (i.e. unchanged muscle length without joint movement) or dynamic (contraction with change in length of the muscle and movement of the joint throughout a range of motion). Isometric (static) muscle actions may induce a Valsalva manoeuvre at moderate to high loads, if it is not intentionally prevented by regular breathing, and may lead to an unnecessary fluctuation of BP. Dynamic training may include constant or variable resistance through the range of motion using either free weights or weight machines. In both of these modes, the type of contraction and the velocity of movement vary throughout the range of motion. This type of muscle activity mirrors muscle loading faced in daily activity. Muscles can contract in a concentric fashion, in which muscle shortening is exhibited during the movement, or eccentric fashion, in which a lengthening of the muscle occurs. Resistance training is an advanced application in which participants carry out a series of rapid concentric and eccentric muscle actions often at a relatively high load.

4.1.2 Classification of exercise and sports A precise classification of sports by using the different components of FITT is difficult because of the differences in the type of muscular work, the mode, and the volume and intensity of exercise. Moreover, most sports consist of an isotonic and isometric muscular

Figure 2 Sporting discipline in relation to the predominant component (skill, power, mixed, and endurance) and intensity of exercise. Intensity of exercise must be individualized after maximal exercise testing, field testing and/or after muscular strength testing (Table 2). Downloaded from academic.oup.com/eurheartj/article/42/1/17/5898937 by guest on 07 October 2026