CARDIAC REHABILITATION
Measuring the functional capacity requirements of farmers to devise most effective cardiac rehabilitation program
Farmers come from sturdy stock . Physically active , they must be healthy to work their land and keep up with the daily demands of farming . Farmers also experience heart disease . Classified as industrial athletes by the American College of Sports Medicine ( ACSM ), they are now subject to updated cardiac rehabilitation and return-to-work guidelines from the ACSM . These guidelines include specificity of training encompassing muscle groups , movements , and energy systems that these patients use during occupational tasks . However , many cardiac rehab programs still rely on traditional protocol that consists primarily of aerobic exercise .
Jenny Adams , PhD , was a primary researcher in a study conducted to measure the metabolic cost of typical farming tasks and to compare two methods of calculating training intensities . Adams collaborated with several other researchers and the Kansas State Agronomy Department on the study .
Adams says the goal of the study was to design more effective cardiac rehab training that supports industrial athletes to return to work safely and confidently after experiencing a cardiac event . The aims of the study were to :
• Measure the MET level required for typical farming tasks and compare it with the 8-MET goal commonly used in traditional cardiac rehab programs
To develop the study tasks , the research team interviewed several farmers about the work they regularly do . Four task-specific stations were set up :
• Loading hay bales – 10 square bales each weighing 29 to 32 kg
• Digging fence postholes – using a clamshell-style posthole digger for three minutes or to 61 cm
• Filling seed poppers – equivalent of eight seed hoppers were each filled with 45.3 kg of grain
• Shoveling grain – a pile of grain was shoveled from the floor into a wheelbarrow
Heart rate and blood pressure were measured before and after completion of the farming tasks . Participants were fitted with a heart rate monitor chest strap and a K4 b2 metabolic system that measured carbon dioxide production , oxygen uptake , and heart rate data during testing .
To determine the training intensity that would have been calculated by the ACSM-recommended HRR method , researchers applied each participant ’ s data from each task to a predetermined equation and solved for the intensity variable .
Complete data was collected and recorded for 28 participants . During the farming tasks , the participants reached mean heart rates that were significantly higher than their RHR + 30 , suggesting that using the latter as a training target heart rate would be inadequate for preparing a farmer
MEASURING INNOVATION IN HEART AND VASCULAR CARE
“ Traditional cardiac rehab may be appropriate for patients who are primarily non active or have jobs that aren ’ t physically demanding . However , industrial athletes , including farmers , require a higher mode and intensity of cardiac rehab .”
Jenny Adams , PhD
Senior research associate , Baylor Hamilton Heart and Vascular Hospital
• Compare two methods of calculating training intensities ( RHR + 30 vs 40 % -80 % of HRR ) to determine whether either yields appropriate levels for farmers who want to return to work after a cardiac event .
Thirty-one healthy participants , men and women aged 20 to 64 years , were recruited for the study . The study was conducted at the Kansas State University Agronomy Farm in Manhattan , KS . Baylor Research Institute ’ s Institutional Review Board approved the study . return to work after a cardiac event . The participants performed the tasks at 60 to 70 percent of HRR , which is within the ACSM ’ s current recommendation of using 40 to 80 percent of HRR as a goal for exercise training intensity in cardiac rehabilitation . On the basis of the results from this study and prior studies , the researchers advocate a combined approach of aerobic exercise and supervised resistance training , using task-specific exercises , for the cardiac rehabilitation of farmers who want to return to work .
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