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Awareness

Resistance Training: A Key Player in Cardiovascular Health, Updated Insights from the American Heart Association

2/14/2024

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In an update to its 2007 scientific statement, the American Heart Association (AHA) emphasizes the significant and multifaceted benefits of resistance training (RT) on cardiovascular health. Contrary to the misconception that RT solely enhances muscle mass and strength, the statement highlights the favorable physiological and clinical effects of this form of exercise on cardiovascular disease (CVD) and associated risk factors. The scientific statement aims to provide comprehensive insights into the impact of RT, either alone or in combination with aerobic training, on traditional and nontraditional CVD risk factors.

More is not always better

Epidemiological evidence suggests that RT is associated with a lower risk of all-cause mortality and CVD morbidity and mortality. Adults who participate in RT have ≈15% lower risk of all-cause mortality and 17% lower risk of CVD, compared with adults who report no RT. Approximately 30 to 60 minutes per week of RT is associated with the maximum risk reduction for all-cause mortality and incident CVD.
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Notice this "U" shape in the curve when examining the relationship between RT and morbidity and mortality. This curve suggests that some RT is clearly beneficial, but has the volume of RT increases past a certain point the benefits drop and it becomes harmful. The concept of a "biphasic response" is fundamental to understanding hormesis. It describes the characteristic dose-response relationship observed in hormetic processes, where a substance or stressor elicits opposite effects at low and high doses. The response can be visualized as a U-shaped or J-shaped curve, illustrating the beneficial effects at low doses and potential harm at higher doses. ​
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Learn more about hormesis

Benefits of RT on Traditional CVD Risk Factors

The AHA's scientific statement underscores the positive influence of RT on traditional CVD risk factors, including blood pressure (BP), glycemia, lipid profiles, and body composition. Numerous studies indicate that engaging in RT is associated with reduced resting BP, improved glycemic control, and favorable alterations in lipid profiles, contributing to a lower risk of all-cause mortality and CVD morbidity. Despite recommendations suggesting 2 days per week of RT, only 28% of U.S. adults adhere to this guideline, highlighting the need for increased awareness and promotion.

RT and resting blood pressure

RT has demonstrated the ability to reduce resting BP across diverse populations, with notable benefits observed in individuals with prehypertension and hypertension. The mechanisms behind these benefits include enhancements in endothelial function, vasodilatory capacity, and vascular conductance. The reductions in BP achieved through RT are comparable to those achieved with antihypertensive medications.

RT and Glycemia

RT shows promise in improving glycemia and insulin resistance, leading to a lower incidence of diabetes. The evidence suggests a nonlinear dose-response association, with up to 60 minutes per week of RT associated with the maximum risk reduction for diabetes.

RT and Lipid Profiles

While the effect on lipid profiles is modest, RT results in favorable changes in high-density lipoprotein cholesterol, total cholesterol, and triglycerides. These improvements are more pronounced in older adults and those with elevated cardiometabolic risk.

Rt, Body composition, and weight

RT positively influences body composition by increasing lean body mass and reducing body fat percentage. It is particularly effective in overweight or obese individuals, contributing to increased metabolic rate and mitigating weight gain over time.

Benefits of RT on Nontraditional CVD Risk Factors

In addition to traditional risk factors, the scientific statement highlights the potential mechanisms by which RT positively affects nontraditional CVD risk factors. These include increased cardiorespiratory fitness, improved endothelial function, and potential benefits for sleep quality, psychological health, and well-being.
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The AHA's updated scientific statement reinforces the pivotal role of resistance training in cardiovascular health, providing a comprehensive overview of its impact on both traditional and nontraditional risk factors. As the evidence supporting RT's benefits continues to grow, the statement serves as a valuable resource for clinicians and public health professionals, offering practical strategies for promoting and prescribing resistance training to enhance cardiovascular health in diverse populations.

References

Paluch, Amanda E, et al. “Resistance Exercise Training in Individuals with and without Cardiovascular Disease: 2023 Update: A Scientific Statement from the American Heart Association.” Circulation, 7 Dec. 2023, https://doi.org/10.1161/cir.0000000000001189. Accessed 11 Dec. 2023.

Momma H, Kawakami R, Honda T, Sawada SS. Muscle-strengthening activities are associated with lower risk and mortality in major non-communicable diseases: a systematic review and meta-analysis of cohort studies. Br J Sports Med. 2022 Jul;56(13):755-763. doi: 10.1136/bjsports-2021-105061. Epub 2022 Feb 28. PMID: 35228201; PMCID: PMC9209691.
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Multifidi

5/8/2019

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Picture
Posterior views, right illustration highlighting origins and insertions. (Image by R. Dorn)
mul-tif​-i-di

Action
Unilaterally:
  • Rotate the vertebral column to the opposite side

Bilaterally:
  • Extend the vertebral column

Origin
  • Sacrum and transverse processes of lumbar through cervical vertebrae

Insertion
  • Spinous processes of lumbar vertebrae through second cervical vertebrae (span two to four vertebrae)

Nerve
  • Spinal
Location: Deep to erectors, lateral to spine
BLMs: Spinous and transverse processes
Action: "Extend and/or rotate your spine"
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Longissimus

5/8/2019

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Picture
Posterior views, right illustration showing branches of longissimus. (Image by R. Dorn)
lon-jis-i-mus

Action
Unilaterally:
  • Laterally flex the vertebral column to the same side

Bilaterally:
  • Extend the vertebral column

Origin
  • Common tendon (thoracis)
  • Transverse processes of upper five thoracic vertebrae (cervicis and capitis)

Insertion
  • Lower nine ribs and transverse processes of thoracic vertebrae (thoracis)
  • Transverse processes of cervical vertebrae (cervicis)
  • Mastoid process of temporal bone ​(capitis)

Nerve
  • Spinal
Location: Lateral to spinalis fibers
BLMs: Spinous processes of all vertebrae
Action: "Extend your spine"
0 Comments

Functional Range Conditioning

5/2/2019

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Developed by world-renowned musculoskeletal expert Dr. Andreo Spina, Functional Range Conditioning (FRC) is a comprehensive joint training system based in scientific principals and research.

There are 3 main goals when training using FRC system and all are closely interrelated, and acquired simultaneously:
  1. Mobility Development:
    Mobility refers to the amount of active, usable motion that one possesses. The more mobile a person is, the more they are able to maximize their movement potential safely, efficiently, and effectively.
  2. Joint Strength:
    While improving mobility and movement potential, the FRC system also acts to ‘bullet proof’ (or safe-guard) your joints so that movement can be executed safely.
  3. Body Control:
    Training with FRC improves the function of your nervous system. This leads to a reduction of pain and injury, joint health and longevity, as well as an increased ability to move freely and easily.
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Intertransversarii

4/24/2019

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Picture
Posterior views of vertebral column, cervical and lumbar sections highlighted. (Image by R. Dorn)
in-ter-trans-verse​-er-i

Action
Unilaterally:
  • Laterally flex the vertebral column to the same side

Bilaterally:
  • Extend the vertebral column

Origin
Cervical:
  • Spanning the transverse processes of vertebrae C-2 to C-7

Lumbar:
  • Spanning the transverse processes of vertebrae L-1 to L-5

Insertion
Cervical:
  • Spanning the transverse processes of vertebrae C-2 to C-7

Lumbar:
  • Spanning the transverse processes of vertebrae L-1 to L-5

Nerve
  • Spinal
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Interspinalis

4/24/2019

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Picture
Posterior views of vertebral column, cervical and lumbar sections highlighted. (Image by R. Dorn)
in-ter-spi-na-lis

Action
  • Extend the vertebral column

Origin
Cervical:
  • Spanning the spinous processes of C-2 to T-3

Lumbar:
  • Spanning the spinous processes to T-12 to L-5

Insertion
Cervical:
  • Spanning the spinous processes of C-2 to T-3

Lumbar:
  • Spanning the spinous processes to T-12 to L-5

Nerve
  • Spinal
0 Comments

Internal Oblique

4/24/2019

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Picture
Lateral and anterior view. *Linea alba (Image by R. Dorn)
o-bleek

Action
Unilaterally:
  • Laterally flex the vertebral column to the same side
  • Rotate vertebral column to the same side

Bilaterally:
  • Flex the vertebral column
  • Compress abdominal contents

Origin
  • Lateral inguinal ligament, iliac crest and thoracolumbar fascia

Insertion
  • Internal surface of lower three ribs, abdominal aponeurosis to linea alba

Nerve
  • T7, 8, T9-12, L1, iliohypogastric and ilioinguinal, ventral rami
0 Comments

Internal Intercostals

4/24/2019

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Picture
Anterior view of rib cage. (Image by R. Dorn)
kos​-tal

Action
  • Draw the ribs inferiorly (decreasing the space of the thoracic cavity) to assist with ​exhalation

Origin
  • Inferior border of the rib above

Insertion
  • Superior border of the rib below

Nerve
  • Thoracic
Location: Spaces between the ribs
BLMs: Body of the ribs
Action: "Exhale"
0 Comments

Iliocostalis

4/10/2019

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Picture
Posterior views, right illustration showing branches of iliocostalis. (Image by R. Dorn)
il-ee-o-kos-ta-lis

Action
Unilaterally:
  • Laterally flex the vertebral column to the same side

Bilaterally:
  • Extend the vertebral column

Origin
  • Common tendon (lumborum)
  • Posterior surface of ribs 1-12 (thoracis and cervicis)

Insertion
  • Transverse processes of lumbar vertebrae 1-3 and posterior surface of ribs 6-12 (lumborum)
  • Posterior surface of ribs 1-6 (thoracis)
  • Transverse processes of lower cervicals (cervicis)

Nerve
  • Spinal
Location: Lateral to longissimus fibers
BLMs: Spinous processes of all vertebrae
Action: "Extend your spine" or "raise your feet slightly"
0 Comments

External Oblique

4/10/2019

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Picture
Lateral views. (Image by R. Dorn)
o-bleek

Action
Unilaterally:
  • Laterally flex the vertebral column to the same side
  • Rotate vertebral column to the opposite side

Bilaterally:
  • Flex the vertebral column
  • Compress abdominal contents

Origin
  • External surfaces of fifth to twelfth ribs

Insertion
  • Anterior part of the iliac crest, abdominal aponeurosis to linea alba

Nerve
  • (T5, 6), T7-11, T12
Location: Lateral surface of abdomen
BLMs: Iliac crest, bottom edge of ribs
Action: "Rotate your trunk to the opposite side"
0 Comments

external intercostals

4/3/2019

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Picture
Anterior view of rib cage. (Image by R. Dorn)
kos​-tal

Action
  • Draw the ribs superiorly (increasing the space of the thoracic cavity) to assist with ​inhalation

Origin
  • Inferior border of the rib above

Insertion
  • Superior border of the rib below

Nerve
  • Thoracic
Location: Spaces between the ribs
BLMs: Body of the ribs
Action: "Inhale"
0 Comments

erector Spinae group

4/3/2019

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Picture
Posterior view. (Image by R. Dorn)
(Spinalis, Longissimus, Iliocostalis)

Action
Unilaterally:
  • Laterally flex the vertebral column to the same side

Bilaterally:
  • Extend the vertebral column

Origin
  • Common tendon (thoracolumbar aponeurosis) that attaches to the posterior surface of sacrum, iliac crest, spinous processes of the lumbar and last two thoracic vertebrae

Insertion
  • Various attachments at the posterior ribs, spinous and transverse processes of thoracic and cervical vertebrae and mastoid process of temporal bone

Nerve
  • Spinal
Location: Alongside the spine
BLMs: Spinous processes of all vertebrae
Action: "Extend your spine" or "raise your feet slightly"
0 Comments

quadratus femoris

3/6/2019

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Picture
Posterior views of right hip. (Image by R. Dorn)
kwod-rait-us fe-mo-ris

Action
  • Laterally rotate the hip (coxal joint)

Origin
  • Lateral border of ischial tuberosity

Insertion
  • Intertrochanteric crest, between the greater and lesser trochanters

Nerve
  • Sacral plexus L4, 5, S1, (2)
Location: Deep to gluteus maximus
BLMs: Greater trochanter, ischial tuberosity
Action: "Laterally rotate your hip"
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piriformis

3/6/2019

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Picture
Posterior and anterior views of right hip. (Image by R. Dorn)
​
pir-i-form​-is

Action
  • Laterally rotate the hip (coxal joint)
  • Abduct the hip when the hip is flexed

Origin
  • Anterior surface of sacrum

Insertion
  • Superior aspect of greater trochanter

Nerve
  • Sacral plexus L(5), S1, 2
Location: Deep in gluteus maximus
BLMs: Sacrum, greater trochanter
Action: "Laterally rotate your hip"
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Pectineus

3/6/2019

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Picture
Anterior and posterior views of right hip and thigh. (Image by R. Dorn)
pek-tin​-e-us

Action
  • Adduct the hip (coxal joint)
  • Medially rotate the hip (coxal joint)
  • Assist to flex the hip (coxal joint)

Origin
  • Superior ramus of pubis

Insertion
  • Pectineal line of femur

Nerve
  • Femoral and Obturator L2, 3, 4
Adductor group
Location: Superficial and deep, medial thigh
BLMs: Pubic tubercle, rami and ischial tuberosity
Action: "Squeeze your thighs together"
0 Comments

obturator internus

3/6/2019

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Picture
Posterior and anterior views of right hip. (Image by R. Dorn)
ob-tu-ra-tor in-tur​-nus

Action
  • Laterally rotate the hip (coxal joint)

Origin
  • Obturator membrane and inferior surface of obturator foramen

Insertion
  • Medial surface of greater trochanter

Nerve
  • Sacral plexus L5, S1, ​2
0 Comments

Obturator Externus

3/6/2019

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Picture
Anterior and posterior views of right hip. (Image by R. Dorn)
ob-tu-ra-tor ex-tur​-nus

Action
  • Laterally rotate the hip (coxal joint)

Origin
  • Rami of pubis and ischium, obturator membrane

Insertion
  • Trochanteric fossa of femur

Nerve
  • Obturator L3, ​4
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iliacus

3/6/2019

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Picture
Anterior views of spine and right hip. (Image by R. Dorn)
i-lee-a-cus

Action
With the origin fixed:

  • Flex the hip (coxal joint)
  • May laterally rotate the hip (coxal joint)
With the insertion fixed:
  • Flex the trunk toward the thigh
  • Tilt the pelvis anteriorly

Origin
  • Iliac fossa

Insertion
  • Lesser trochanter

Nerve
  • Femoral L(1), 2, 3, 4
Location: Deep in abdomen
BLMs: Iliac fossa and crest
Action: "Bring your knee toward your chest" or "flex your hip"
0 Comments

Gracilis

3/6/2019

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Picture
Anterior views of right hip and thigh, anterior view of right tibiofemoral joint. (Image by R. Dorn)
gra-cil-is

Action
  • Adduct the hip (coxal joint)
  • Medially rotate the hip (coxal joint)
  • Flex the knee (tibiofemoral joint)
  • Medially rotate the flexed knee (T/F joint)

Origin
  • Inferior ramus of pubis

Insertion
  • Proximal, medial shaft of tibia at pes anserinus tendon

Nerve
  • Obturator L2, 3, 4
Adductor group
Location: Superficial and deep, medial thigh
BLMs: Pubic tubercle, rami and ischial tuberosity
Action: "Squeeze your thighs together"
0 Comments

sartorius

2/15/2019

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Picture
Anterior/medial and anterior views of right and thigh. (Image by R. Dorn)
sar-tor-ee-us

Action
  • Flex the hip (coxal joint)
  • Laterally rotate the hip (coxal joint)
  • Abduct the hip (coxal joint)
  • Flex the knee (tibiofemoral joint)
  • Medially rotate the flexed knee (T/F joint)

Origin
  • Anterior superior iliac spine (ASIS)

Insertion
  • Proximal, medial shaft of the tibia at pes anserinus tendon

Nerve
  • Femoral L2, 3​, (4)
Location: Superficial, slender
BLMs: ASIS, pes anserinus region
Action: "Bring your knee toward the ceiling" or "flex your hip"
0 Comments

GAMELLUS Superior

2/15/2019

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Picture
Posterior and anterior views of right hip. (Image by R. Dorn)
​jem-el​-us

Action
  • Laterally rotate the hip (coxal joint)

Origin
  • Ischial spine

Insertion
  • Medial surface of greater trochanter

Nerve
  • Sacral plexus L5, S1, 2
0 Comments

Gamellus Inferior

2/15/2019

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Picture
Posterior and anterior views of right hip. (Image by R. Dorn)
jem-el​-us

Action
  • Laterally rotate the hip (coxal joint)

Origin
  • Ischial tuberosity

Insertion
  • Medial surface of greater trochanter

Nerve
  • Sacral plexus L4, 5, S1, (2)
0 Comments

Psoas Minor

2/1/2019

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Picture
Anterior views of spine and right hip. *Umbilicus. (Image by R. Dorn)
so-as

Action
  • Assist to create lordotic curvature in the lumbar spine
  • Tilt the pelvis posteriorly

Origin
  • Body and transverse process of first lumbar vertebra

Insertion
  • Superior ramus of pubis

Nerve
  • Lumbar plexus L1, 2
0 Comments

Psoas Major

2/1/2019

0 Comments

 
Picture
Anterior views of spine and right hip. *Umbilicus. (Image by R. Dorn)
so-as

Action
With the origin fixed:
  • Flex the hip (coxal joint)
  • May laterally rotate the hip (coxal joint)
With the insertion fixed:
  • Flex the trunk toward the thigh
  • Tilt the pelvis anteriorly
Unilaterally:
  • Assist the laterally flex the lumbar spine

    Origin
    • Bodies and transverse processes of lumbar vertebrae

    Insertion
    • Lesser trochanter

    Nerve
    • Lumbar plexus L1, 2, 3​, 4
    Location: Deep in abdomen, lateral to navel
    BLMs: Bodies of lumbar vertebrae
    Action: "Bring your knee toward your chest" or "flex your hip"
    0 Comments

    Biceps Femoris

    1/29/2019

    0 Comments

     
    Picture
    Posterior views of right hip and thigh, left illustration showing long head, right illustration showing short head. (Image by R. Dorn)
    bi-seps fe-mor-is

    Action
    • Flex the knee (tibiofemoral joint)
    • Laterally rotate the flexed knee (T/F joint)
    Long head:
    • Extend the hip (coxal joint)
    • Assist the laterally rotate the hip (coxal joint)
    • Tilt the pelvis posteriorly

    Origin
    Long head:
    • Ischial tuberosity
    Short head:
    • Lateral hip of linea aspera

    Insertion
    • Head of the fibula

    Nerve
    Long head:
    • Sciatic (tibial branch) L5, S1, 2, 3
    Short head:
    • Sciatic (peroneal branch) L5, S1, 2
    Hamstrings as a group
    Location: Superficial, posterior thigh
    BLMs: Ischial tuberosity, tendons of posterior knee
    Action: "Bend your knee" or "extend your hip"
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