Circuit Training and the Cardiac Rehab Model
I have a class on the go in Leith which is a lot of fun to teach. It's for older people, based on a circuit training format, all easy going, low impact exercises. I trained on the REPs level 4 Cardiac Rehab programme with BACPR (brilliant course, hard slog but very worth it). As part of the exams, you need to make up a class for people who have, or have had a heart problem, like a heart attack, heart failure, angina etc. One of the recommendations is a circuit format, as it gives a range of exercises with minimal equipment, everyone works at their own pace and most people agree the circuit format is more sociable than an instructor led class.
So, the basic idea of the class is, an easy exercise, followed by a hard one, repeated through the circuit. This builds into a full workout involving all muscle groups and never letting the heart and lungs work too hard, or slow down too much. Without getting into the details, this means that even people with very low functional capacity can still exercise for a good long stint without getting exhausted.
For some of my health classes, I have people with neuro problems like MS, Parkinsons and MND as well as cardio-respiratory problems like COPD and chronic asthma. We get lots of people with diabetes as well, an increasing problem and the 'continuous but not hard going' effort is ideal for building up their capacity to exercise without getting on a blood sugar rollercoaster. Many of these people have not exercised since schooldays and have had a chronically unhealthy lifestyle. So, the simple moves and steady going pace of the class is a great introduction.
Some of the research into these sorts of exercise classes (or exercise interventions) is showing up some interesting factors-most notably the effect that it has on the 'peripherals' of the vascular system. That is the blood vessels and circulation through the arms and legs, the feet and hands. It turns out that working these muscles far away from the heart, has a beneficial effect on the heart itself. This could be because as you pull blood away from the centre of the body, it takes pressure off the heart so it pumps more easily. Also, as the blood vessels adapt to the greater blood flow, resistance is reduced, thereby reducing blood pressure and again, making it easier for the heart to pump. So even if the heart itself is very weak, or the lungs are very low in capacity, this kind of exercise can help a persons body to adapt in ways which improve the circulatory system as a whole. This in turn makes life much easier and more enjoyable.
The social side also can't be underestimated, anyone who has taken part will know you can chat if you like on the resting intervals, or between exercises. As it's all about self-regulation (AKA going at your own pace) you can slow down for a chat with an exercise partner or take a sip of water and this causes no disturbance to the class at all. Indeed, as the trainer, I constantly move around the class, gauging effort and chatting to make sure people are doing OK. This is vital in health classes of course, it's about teaching people how to exercise safely as much as anything else. Of course the endorphins and sheer joy of moving bout also help us feels good, boost confidence and this all helps us come out of our shells and give the whole experience a good shot.
As a system, the circuit training format has a lot to offer, and using it to best effect with people of low fitness level can and does work wonders.
