Sherman is a 65-year-old, sedentary male with Heart Failure (HF). He weighs 200 lb, is 5'8" tall. He has a cardiac output of 4.0 L/min and his left ventricular ejection fraction (LVEF) is 40%. He is referred to you by his cardiologist who would like him to begin exercising in your cardiac rehabilitation facility. Discuss how heart failure affects Sherman's physiology and the compensatory mechanisms to maintain circulation. How will this limit his ability to exercise?
As his clinician you need to design an 8-week exercise program for Sherman. Before you develop an exercise program, you evaluate his VO2max, which is 20 mL/kg/min. Specify the optimal training program including intensity and duration that would yield the greatest improvement in his cardiovascular function and explain why. Outline Sherman's expected cardiovascular (central and peripheral) and pulmonary adaptations to exercise. How would you evaluate his cardiopulmonary performance before and after the 8-week exercise program to determine if the program was successful?