*4.8. Resistance Training*

### 4.8.1. Rationale

Resistance training has been implemented relatively late both for healthy individuals and especially for patients with cardiovascular diseases. Firstly, in 1990 the American College of Sports Medicine recommended resistance training as an important component of fitness programs for healthy adults. Concerns

regarding the safety of resistance training (including potential complications—e.g., uncontrolled rises in blood pressure) precluded the early implementation of strength exercise components into cardiac rehabilitation. Notwithstanding the concerns mentioned above, a growing body of evidence suggests that improved muscular strength is associated with significantly better cardiometabolic risk factor profiles [74]. Consequently, improvements in the blood glucose level and insulin sensitivity have been demonstrated, and resistance training in the elderly has been shown to result in the promotion of independence and the prevention of falls [75,76]. Other favorable effects of strength exercise have been confirmed in the case of patients with muscle wasting following cardiac surgery and patients with heart failure and weakness in their peripheral muscles [77,78]. Furthermore, it has been demonstrated that resistance training has favorable effects on bone density, blood pressure, and lipid profile [79].
