Independent Articles About:

1. Aerobic Fitness Benefits
2. Cardiovascular Fitness
3. Cardio Programs

Aerobic Cross Training for Weight Loss

Aerobic Cross Training for Weight Loss

Do you sometimes get bored with your aerobic exercise? Do You sometimes feel like you're not getting the results you should from your aerobic exercise? If so, then aerobic cross-training is for you.

Aerobic cross-training refers to using two to three different types of aerobic exercise during an exercise session. For example, if you plan to exercise for 60 minutes, you might start with 20 minutes of walking or jogging, followed by 20 minutes of biking, and finish with 20 minutes of rowing.

Now, please don't get the impression that you have to be in great shape to do this or that it has to be 60 minutes long. You can start with something as simple as a ten minute walk followed by ten minutes with an exercise video. This is cross-training too. You can gradually build up from there.

Here are some of the exercises you can use in your cross-training program; walking, jogging, biking, rowing, stair climbing, swimming, exercise videos, etc. Any combination of aerobic exercises will do. You simply go from one to the next with very little time between them.

Aerobic cross-training is beneficial to you in several ways:

1. It provides variety which eliminates the monotony often associated with doing the same exercise for a long period of time.

2. If your exercise sessions are less monotonous and more enjoyable, you are much more likely to exercise more often and for longer periods of time.

3. You are less prone to over-use injuries that sometimes occur from doing the same exercise movements over and over again.

4. You tone more muscles because you are using more muscles. For example, walking tones mostly the lower body muscles and rowing tones upper body muscles also. Even exercises like walking and biking that both tone lower body muscles, tone them at different angles and each tones some small muscles that the other doesn't.

5. Aerobic conditioning is very specific to the muscles being worked. For example, you can walk ten miles a day and still be somewhat breathless after climbing stairs because you haven't trained the muscles for that specific movement. Aerobic cross-training allows you to develop more comprehensive aerobic training.

6. Aerobic cross-training is effective for weight loss because your are toning and training the fat-burning systems of more of your muscles. It turns more of your muscles into 24-hour fat-burning machines! You are also more likely to exercise on a regular basis and for longer periods of time. this also promotes weight loss and fitness.

Keith Londrie II is a renowned specialist in aerobic trainning. He provides information on the subject matter at his web site at http://cardioaerobics.info/ - Visit to get your questions answered now.

Running for Beginners: The Benefits of Water Aerobic Exercise

As beginning runners (or any runners for that matter!), we often tend to stick to the one thing we know: Running.

And at Ordinary Runner (http://www.ordinaryrunner.com/) we certainly believe EVERYONE should be a runner!

However, running does give us quite a pounding on our legs! Our joints and muscles are repeatedly shocked throughout the course of a run... And the more intense the run, the more pounding they take!

Cross training a day or two a week can work wonders!

What is cross training, you ask?

It basically means that you "cross over" for a day into another aerobic exercise area, instead of only running, in order to help prevent injury. (Or to recover after an injury!)

Don't get me wrong! Running, as we've stated before, is NUMERO UNO as far as aerobic exercises go! Nothing gets your heart rate going like a good run!

But running does give you a good pounding!

So lots and lots of runners take a day or two a week and cross train.

For cross training, you want to do another activity that elevates your heart rate, but doesn't pound you quite as much as running.

This gives your muscles and joints a rest, while keeping your heart going!

Cross training has some great benefits:

1) Gives joints, bones, and muscles a much needed rest, making them fresher for your next run.

2) Still increases your heart rate, so you still get a good aerobic workout even on the days you don't run.

3) Breaks the routine. (I mean, we love running, but sometimes it's just nice to do something else!)

So, what kinds of cross training are there?

There's riding a bike... But cycling can be expensive!

There are treadmills and elliptical machines at the gym... But the gym can be expensive, too, and one of the reasons we are runners is because we like the price!

Water Running

My recommended cross training activity is water running. It does take a one-time investment in an aqua jogger shoes or gloves (around $15-20) or an aqua jogging vest or belt (a $45-55 cost), but after that, you're good to go!

Just get in the deep water at your nearest pool, and run in the water. (It takes a little getting used to, but it's really very simple. In no time, you'll be water running with the best of 'em!

The health benefit of water running is big!

When you do your water running, your heart rate still gets up there (so you get the aerobic benefit), but your muscles get a rest from the pounding for a day.

So it's a perfect cross-training activity.

And just by doing water running, you're helping yourself prevent injury!

And if you're already injured (Let's hope not! But occasionally it does happen!), water running is perfect for keeping your aerobic fitness up while your injury heals.

So, take some good advice on running for beginners! For all of you who love running and want to keep doing it for years...

... Water aerobic exercise, in the form of water running, is a great way to cross train and save your legs!

You'll be saving some of the miles in your legs for another day!

Kely Braswell has been a runner for 27 years. He's not the fastest... just an Ordinary Runner. But he stays in shape, and he knows a lot about running! Beginning runners can look at http://www.ordinaryrunner.com/goarticles/wateraerobic, simple advice on running for beginners and mere mortals!

You Don't Have to Strain for Cardio Fitness Gains

Copyright 2005 Daily News Central

Quantity may beat quality when it comes to exercise and heart health. Adults who engage in mild exercise -- such as walking briskly for 12 miles or exercising moderately for 125-200 minutes over the course of a week -- can improve their aerobic fitness significantly and reduce their risk of cardiovascular disease, according to a study published in Chest.

"The classic exercise regimen has a component of intensity up to 80 percent of someone's maximum for health benefits," says lead author Brian D. Duscha of Duke University Medical Center in North Carolina.

"Our study demonstrates that you can exercise at an intensity much less than that and still achieve fitness benefits," he notes.

"People find exercise 'hard' and few people want to exercise at an intensity higher than they have to. Walking briskly for 12 miles a week per week is realistic and does not require anyone to incorporate a hardcore training regimen. Increasing your mileage or intensity will give you even greater health benefits," Duscha says.

Improved Oxygen Consumption

A Duke Medical Center research team examined the effects of different exercise training regimens on 133 patients aged 40 to 65 years. All were sedentary, overweight nonsmokers who had abnormal levels of fat in their blood.

The participants were divided into four exercise groups:

- high-amount/high-intensity (HAHI), the equivalent of jogging 20 miles per week at 65 to 80 percent peak Vo2 (maximum oxygen consumption);

- low-amount/high-intensity (LAHI), the equivalent of jogging/walking up an inclined treadmill approximately 12 miles per week at 65 to 80 percent peak Vo2;

- low-amount/moderate intensity (LAMI), the equivalent of walking approximately 12 miles per week at 40 to 55 percent peak Vo2; and

- a control group of nonexercising patients.

All patients underwent cardiopulmonary exercise testing twice at baseline and after seven to nine months of exercise training.

All exercise groups significantly improved their absolute and relative peak oxygen consumption and time to exhaustion (TTE) compared to baselines scores.

Increasing Intensity May Help Too

Although the HAHI group showed the greatest improvements in peak Vo2 overall, increasing exercise intensity from 40 to 55 percent to 65 to 80 percent (at a controlled amount of 12 miles/week) did not significantly improve peak oxygen consumption. However, increasing the amount of exercise did produce improvements.

An increase in exercise amount also demonstrated a graded increase in TTE between groups, although data were not statistically significant.

"Although our results did point toward amount being more important, it is very likely fitness levels can be improved by increasing either amount or intensity," says Duscha.

"This is illustrated by the tiered effect the exercise dose had on fitness improvements across our groups. We believe with more people in the study, increasing intensity would also have been significant," he explains.

Losing Weight Not Essential

Body mass index (BMI) was reduced in the LAHI and HAHI, groups but remained unchanged in the LAMI group. All exercise groups lost an average of 2.87 pounds after exercise. Baseline characteristics of age, BMI, weight, peak and relative Vo2, and TTE were not different between the groups.

"A second very important message is that subjects enjoyed fitness benefits in the absence of weight loss. Many people exercise with the purpose of losing weight. When they do not lose weight, they do not think the exercise is benefiting them and they stop exercising," notes Duscha.

"The truth is, you can improve your cardiovascular fitness and reduce your risk for heart disease by exercising without losing weight. Even if individuals do not lose weight, it is likely that they will lose body fat and increase lean muscle mass while reducing other risk factors," he points out.

12 Miles a Week

Adherence to exercise requires motivation and making exercise a priority, the researchers stress. They advise those who are beginning an exercise regimen to start slowly, choose an enjoyable activity, and make exercise a social activity. Individuals with medical problems should consult a physician before starting an exercise program.

"If you distill our results down, the public health message is: You only need to walk briskly for 12 miles per week or for approximately 125 to 200 minutes per week to improve your health. This sheds more light on the question, 'What is the minimum amount of exercise I need to do to get a health benefit?'" says Duscha.

"Regular exercise is an important part of a well-balanced lifestyle," adds Paul A. Kvale, MD, FCCP, President of the American College of Chest Physicians. "Physicians and other healthcare providers should encourage their patients to engage in regular exercise in order to obtain pulmonary and cardiovascular benefits."

Rita Jenkins is a health journalist for Daily News Central, an online publication that delivers breaking news and reliable health information to consumers, healthcare providers and industry professionals: http://www.dailynewscentral.com

Is Your Cardiovascular Program meeting Goals?

In today's highly competitive health care market with cardiovascular services comprising as much as 40% of acute care revenues, it makes sense to take a critical look at that service line to see where it stands and where it is going.

All acute care hospitals provide some level of cardiac services, ranging from non-invasive diagnostics to full invasive and surgical cardiac care. Yet very few program administrators take the time to thoroughly assess how their programs stack up.

Successful cardiovascular programs demand ongoing attention to the effectiveness of all the factors that influence results. These include organizational structure, data systems and information management, quality assessment and performance improvement, operational efficiencies, personnel utilization and management, finance (cost and revenue), and program marketing.

The CV services administrator must appreciate and understand where the business comes from and where it goes. Other issues are equally important. What does it cost to run the business and who can run it? What will it take to grow the business and in what direction should it grow?

The best way to address these questions is to periodically perform an internal program self-assessment.

Begin with a review of the organizational structure for all services related to the provision of cardiovascular care. In a service line model this is easy, as all cardiovascular service areas report either directly or indirectly to a CV administrator or director.

This allows for information regarding each individual service to be reviewed not only in the context of the individual service, but also within the scope of the overall cardiovascular program. Surprisingly, very few hospitals take a true service line approach, in which all information related to the service line flows to a central point for review and decisions.

Service silos can be barriers to success

If the present structure does not allow for service issues, volumes, costs and patient outcome data from individual departments to be reviewed by a CV Administrator in context with the other cardiac services provided, the hospital essentially is providing multiple cardiac services in isolation from every other cardiac service. These service silos make it difficult to distinguish what issues are having an impact on the institution's services, where the real problems are coming from, what the program's strengths are, and what interrelationships exist between services.

Many cardiovascular services overlap. Take, for example, a patient with an abnormal treadmill stress test who is referred for a cardiac catheterization. In turn, a patient with abnormal cardiac catheterization is referred for coronary artery bypass graft (CABG) surgery. Upon discharge, a patient who has had CABG surgery is referred to cardiac rehabilitation. Thus, it is critical to be able to monitor cardiac services as a whole as well as individually.

Data systems and information management

Take a close look at how your hospital currently collects data, manages data and reports results for CV services. Data management is critical to a successful CV services program so that overall volumes, costs, revenues and outcomes can be reviewed and acted upon.

Data collection and management can be performed in many ways, ranging from the use of manual data extraction and compilation processes to integrated automated data management systems that incorporate financial and clinical data. Although the use of a computerized data management system will be more efficient, it can also be expensive. The level of sophistication of the data management system is not as important as the types of data collected and reported and how they are used to review overall program operations and outcomes.

Software to collect American College of Cardiology (ACC) and Society of Thoracic Surgeon (STS) data is of great value in terms of the data elements collected and how that data can be used internally to review patient outcomes and individual physician practices.

Data from all areas of the cardiac service line should be reviewed in an integrated fashion. A committee should be established to review the service line data, make recommendations, and initiate actions for change. This committee is usually a part of the hospital's quality improvement/process improvement program and should be multidisciplinary.

Quality assessment, performance improvement Quality assessment (QA) and performance improvement (PI) in the cardiovascular program is closely related to and interdependent with data and information management. Appropriately evaluation of the CV program requires an administrator to know what indicators regarding volumes, finance, and patient care outcomes are being monitored once the data is collected. The administrator must then ask a series of follow-up questions:

• How is the information analyzed and, most importantly, how is the information used to promote change? • Is there an established process in the CV program to give performance feedback to the staff and physicians? •When problems are identified, what is the methodology for root-cause analysis? • How is a plan for change implemented? • Once change has been implemented, how is reevaluation completed?

In summary, it is imperative to identify key indicators, monitor them closely and act quickly on areas of concern.

An administrator can also skillfully apply trending techniques to the data when a negative pattern is identified, which can be very helpful in motivating staff and physicians to take proactive measures to solve problems. Physician "report cards" that identify individual physician practice patterns such as length of stay, cost per case and clinical outcomes are also useful. A medical advisory committee is a valuable way to identify and manage physician performance issues.

Although personnel performing each service may monitor indicators for QA/PI, the data from all service areas should be integrated to reflect overall program performance and identify opportunities for interdepartmental process improvement. Be sure to make use of national data benchmarks from organizations such as ACC, STS and NRMI (National Registry of Myocardial Infarctions) to compare your program data with outside performance references.

Don't overlook the importance of assessing participant satisfaction (patient, physician and staff) in your CV program. Periodic surveys of these groups provide valuable information regarding the strengths and weaknesses of the CV program from each participant's perspective. Patient concerns may focus on the ease of access, quality of care and personal service. The physician may be more concerned with how quickly and easily patients can be scheduled, accommodation of the physician's schedule for CVOR or cardiac catheterization lab time and availability of the latest equipment and technology. The clinical staff may be concerned about salary and benefits, staff-to-patient ratios and work schedule flexibility.

Operational efficiencies

Programs must be reviewed periodically for core program factors. Consider your responses to the following basic considerations:

• How easy is it to schedule a test or procedure? • What is the backlog or waiting time to get a patient on the schedule for a test/procedure? • How difficult or easy is it for patients to get to the facility, park their cars and get into the testing area? • What is the patient flow between CV areas? What is the proximity of services to each other? What can be done in service areas to improve work flow for the staff? • Are there opportunities to remodel or relocate services to complement the program and provide for physical plant changes and other space needs? • Can scheduling be centralized to simplify the process for patients and physician offices? • Can registration be decentralized to allow patients to proceed directly to the testing area without having to first visit a registration area? • Are there communications systems in place to provide consistent and timely delivery of needed patient information from one service area to another? • What are the operating hours of each CV service and do they meet the needs of the patients? Do they meet the needs of the physicians?

Review these operational issues to determine if the program is meeting present needs and to anticipate any operational changes to meet future needs. Successful CV program services are easily accessible (for both patients and physicians), and are well organized, consistent and timely.

Personnel utilization and management

Health care personnel shortages almost everywhere in the nation dictate that special attention be given to reviewing how services are staffed. Is there adequate staff? Is there qualified staff? Is there the right mix of staff for the care that needs to be accomplished?

Examine the services provided and determine the number and types of health care personnel appropriate to provide the service. The scope of care provided by ancillary, technical and professional staff has changed dramatically over the last five to seven years. Some services previously provided by professional RN staff are now carried out by technical personnel. Ancillary staff now perform services previously provided by technical personnel. Revise your mix of personnel in each department to optimize use of staff.

Cross-training staff members also can help maximize use of personnel, so that staff from a less-busy department can help a busy service. This allows for flexibility in critical staffing situations. Be sure to pay sufficient attention to education, training and ongoing competencies of personnel when considering cross-training or when revising or adding to existing responsibilities.

Review staff turnover rates related to specific departments and determine why staff leaves. Departures may be related to the working environment (workload, physical plant, management expectations, work schedules) or strong demand for these people in the job market. With increasing competition for experienced health care providers, staff are being lured to new employment opportunities by higher salaries, bonuses, matching vacations and flexible schedules.

Financial considerations

As with any business endeavor, financial considerations are a priority.

Pay close attention to CV service operational budgets by examining budget variances and their causes. Technological advances related to CV care have been arriving fast and furiously. However, not all technologies are reimbursed or yet proven cost-effective. A tertiary care center often has an opportunity to capitalize on new technologies and draw market share by adding a new technology very quickly after its introduction and winning referrals from facilities that do not yet offer the service.

New, costly technology may prove too expensive for a smaller community-based program to provide without adequate reimbursement. When considering use of new technologies, evaluate all the critical factors related to cost and return on investment, including capital outlay, reimbursement, potential for positive outcomes, expected volume and use, and potential to draw market share. The CV program's technology committee can review specific criteria for considering the use of a new technology.

Vendor contracts

All vendor agreements should be examined periodically to determine if the conditions of a contract require revisions to reflect changes in practice and use patterns. This same group should provide input and assist in planning for capital purchases or equipment replacements and upgrades.

Essential elements of successful CV service line programs are ongoing review of reimbursement levels, coding and billing procedures. All areas must periodically review regulations and HCFA requirements for changes in reimbursement, new or revised procedure codes and updates to APC codes.

Administrative departments must work closely with physicians to ensure that appropriate documentation supports the coding. Managers must also continually provide additions and deletions to the charge description master for billable items so that charges for new disposable supplies are not lost.

Although many hospital financial systems lack the ability to provide true cost accounting on each case, there are methods to determine average cost per case, cost per procedure and cost per service. Each CV service area should be able to identify and periodically examine those costs to determine any changes and their impact on the operational budget. It is the role of department managers to investigate methodologies to hold steady or decrease their costs per case.

Program marketing

CV services can amount to a significant portion of the hospital's revenues, and therefore it is important to actively market the hospital's full range of CV services both to consumers and to the physicians who refer or have the potential to refer patients to the program.

Successful CV programs are aware of their market share and actively engage strategies to not only maintain, but also grow that market share. The CV program strategic plan should act as a template for directing marketing activities to both consumers and physicians. Dollars must be allocated to this in either individual department budgets or in an overall CV program budget. The CV director must examine what marketing activities have occurred, their effectiveness and determine where next to direct those marketing dollars.

Marsha's cardiovascular experience has included clinician, critical care educator, cardiac clinical nurse specialist and manager. Marsha received her R.N. Diploma from The Washington Hospital School of Nursing and her undergraduate degree from the Pennsylvania State University. She has a Masters Degree in Nursing with a Cardiovascular Clinical Specialty from the University of Pittsburgh