Heart patients urged to push exercise

My father, who underwent open-heart surgery in November 2008, was diligent about going to rehab for the first year or so after his surgery. I accompanied him once nine months after his surgery and will never forget two aspects of it.

First, wearing slacks and regular shoes, he barely broke a sweat while riding stationary bikes and doing other therapist-monitored exercises.

Second, in multiple phone conversations since, he never stopped calling it rehab.

As a believer that exercise should be a part of daily life, the latter bothered me. Rehab, at some point, needed to become routine exercise. Several times, I told him that it was probably time to stop calling it rehab and start calling it exercise. He never did.

You probably guess what happened next.

He stopped going to rehab. This year, he has not been exercising. On a visit last March, I suggested we take a walk in the neighborhood and he didn't budge. Now 78, he jumped back into his life-long routines, working part-time gigs as an instructor at Duke Divinity School and interim pastor of a country chapel in Scotland County, N.C. And he started having bad days, bad enough that on some calls he talked as if he were on death's door.

I'd ask, "Have you been exercising?"

Pausing, he'd respond, "No ... I really need to start again."

I'd say, "That's probably why you're not feeling good."

Pushing heart patients

I thought about him after reading a story in the Wall Street Journal about a study suggesting that those with heart disease push themselves with interval training.

The study, which is not without controversy, turns upside down the conventional thought of easing heart patients into exercising.

Last fall, the Norwegian University of Science and Technology team presented a 107-patient study showing a cardiac-rehab program that included supervised high-intensity treadmill workouts improved peak oxygen uptake better than a standard moderate-intensity program that burned the same number of calories.

Similarly, the newspaper article noted that the Mayo Clinic's cardiovascular health and rehabilitation program has been using high-intensity intervals in patients for about four years.

"There's been a natural progression over time of what we've thought exercise for patients with cardiovascular disease should be," Dr. Ray Squires, director of Mayo's rehab program, told the Journal. "If you go back 50 years, people were told to hardly do any exercise for weeks after a heart attack. Gradually, we learned that was wrong."

Dr. Squires says he believes Mayo is one of the only clinics in the U.S. to use intense interval training in the early stages of rehab for people who have recently left the hospital following a heart attack or cardiac surgery.

The American Heart Association doesn't have a position on high-intensity interval training for rehab.

Barry Franklin, an AHA spokesman, says that although recent research is encouraging, larger randomized, controlled studies are needed in higher-risk groups.

The high hurdle

As a runner, I've been a fan of interval training -- running short distances, such as 400-800 meters six to eight times with short rest breaks -- for years, but I could not imagine my exercise-averse father doing anything of the sort.

But as evidence is building in the perils of sitting for long periods of time, the same goes for the benefits of interval work for a multitude of reasons.

Interval training does'nt have to involve running. Any workout that involves short bursts of intense cardiovascular exercise with short rest breaks will do.

And increasingly, scientists are noting the benefits.

In 2008, Harvard Medical School's Dr. John J. Ratey noted the benefits of intervals for the brain in his book "Spark: The Revolutionary New Science of Exercise and the Brain."

"One of the key differences between moderate- and high-intensity exercise is that once you get closer to your maximum, and especially when you get into the anaerobic range, the pituitary gland in your brain unleashes human growth hormone (HGH)," Ratey writes in his book.

"HGH is the body's master craftsman burning belly fat, layering on muscle fiber and pumping up brain volume. Researchers believe it can reverse the loss of brain volume that naturally occurs as you age."

So don't wait until you are a heart patient to start adding a interval workout to your weekly routine.

Reach David Quick at dquick@postandcourier.com or 937-5516.