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Peripheral Heart Action Training

National Academy of Sports Medicine
National Academy of Sports Medicine
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We know that weight loss or body fat reduction is largely based on a numbers game. And “working out” is a way of controlling the numbers (less calories in, more calories out and weight loss can be achieved).

This is where peripheral heart action (PHA) training comes in! 

  • If you are a wanting to become a weight loss coach, the content in this post will teach you this really strong approach to training your clients to more effective weight loss.
  • For personal trainers this approach combines cardio and resistance training to strategically get the best of both worlds for your clients.
  • And for those just looking to lose weight and get great workout program ideas, read on!

What is Peripheral Heart Action Training?

Peripheral Heart Action Training is similar to a regular circuit training method that keeps your client moving from one exercise to another with minimal to no rest between exercises. However, with PHA training, while you are moving from one exercise to another, you are focusing on alternating upper and lower body exercises.(1)

Cardiovascular training and resistance training both have many desired benefits and we know that both should be done to achieve the best physical shape a person desires – but how can we get those “cardio” and “muscle building” clients to learn and embrace the benefits of both?

The difference between Peripheral heart action training and circuit training

In traditional circuit training techniques, clients are asked to move quickly from one body part to another in a “circuit” fashion that allows each body part enough time to recover before it is worked again.

Circuit training is similar to supersets but with a higher frequency of exercises. 

For example, NASM uses a vertical loading circuit training system that begins with working the chest, followed by working the back, shoulders, biceps, triceps, and legs. When starting with the chest, the following exercises allow the client ample time for the pectoralis muscles to recover before working them again.

However, while using a PHA system clients are performing a variation of circuit training; yet, they are simply alternating upper and lower body exercises. For example, your client would perform a chest press exercise, followed immediately by ball squat, followed again by a back exercise, immediately moving on to a leg exercise like a step-up, etc.

(See table 1 for an OPT programming example)

Table 1. Sample Programming: OPT PHA Circuits


Stabilization Circuit

Strength Circuit

Power Circuit


Ball Dumbbell Press

Flat Dumbbell Press

Medicine Ball Chest Pass


Ball Squat

Ice Skater


Single-leg Cable Row

Lat Pulldown

Woodchop Throw


Step-up to Balance

Barbell Squat

Power Step-ups


Ball Combo # 1

Seated Shoulder Press

Medicine Ball Scoop Toss


Single-leg Squat


Acute Variables

  • 1-3 sets
  • 12-20 repetitions
  • Rest 0-90 seconds
  • 3-5 sets
  • 6-12 repetitions
  • 0-60 seconds rest
  • 4-6 sets
  • 8-10 repetitions
  • 3-5 min rest

The benefits of Peripheral Heart action training

  • Overall, circuit training (in general) has been shown to increase caloric expenditure in comparison to similar traditional resistance training where a client may rest up to 90 seconds between sets.(3)
  • Enhancing an aerobic base for clients while simultaneously challenging local muscle endurance.
  • This method of training forces the blood to quickly circulate through the body, increasing caloric expenditure and theorized to decrease body fat and increase lean muscle mass.(2)

Who can perform peripheral heart action training?

Most healthy individuals can perform this type of training. Whether your client wants to lose body fat or increase muscle tone–this system of training can work for them. With increased movement comes increased caloric burn.

This form of training gives weight loss clients “more bang for their buck” and can even be used for bodybuilders or recreational exercisers looking to increase muscle size (hypertrophy). While the rest periods between exercises may be greatly reduced (or non existent) this meets the requirements for hypertrophy.

In fact, most individuals seeking hypertrophy tend to rest too long between sets and lift too heavy to train appropriately for their desired goals. Recall that several factors are required for hypertrophy (high levels of volume with minimal rest periods force cellular changes that result in an overall increase in muscle size) – volume (3-5 sets; 6-12 repetitions; 2:0:2 repetition tempo), frequency (3-6 times a week), intensity (75-85 percent of 1 RM), rest (0-60 s), and proper nutrition.

As you can see, the PHA system works well for hypertrophy clients, allowing the proper rest and volume to achieve the desired goal – while even adding in a time saving bonus!

Athletes may receive the best benefit from PHA training. While endurance athletes (like youth runners) must still engage in aerobic activity that significantly increases their maximal oxygen consumption, circuit training (which includes PHA training) increases maximal oxygen consumption 4 to 8 % (significantly less than cardiovascular conditioning programs, but important in increasing local muscular endurance).(2,3)

potential risks of peripheral heart action training

Using the PHA system may put too much physiological stress on individuals who have blood pressure deviations (high/low blood pressure) and those who may be severely de-conditioned. Individuals with special conditions, such as pregnant clients in their second or third trimester, may require more rest between exercises and, dependent on the client, may want or need to avoid PHA training.

Remember that each client is unique and while some may be able to perform PHA training, others may not be able to meet the cardiovascular and muscular demand.

A PAR-Q is invaluable in this respect. 

If individuals present with any condition listed above, proceed with caution and advise the client to seek medical advice.

As with all physical conditioning programs, clients who might be at risk should consult their physician before initiating an exercise program.

COncluding thoughts

One great way to get the most out of your program design is to combine cardiovascular work with resistance training using a method called Peripheral Heart Action (PHA) Training. 

There are several different forms of training that can benefit your clients and given each personal goal, you can become extremely creative with your programming. Be sure to incorporate a comprehensive health and fitness assessment process (which includes a preparticipation health screening and medical history), as well as a movement assessment to ensure that your client is structurally ready for the demands of your program.

For other perspectives on aerobic exercise check out these blog posts:


(1) NASM Essentials of Personal Fitness Training.

(2) Gettman LR, Ayres JJ, Pollock ML, Durstine JC, and Grantham, W. Physiologic effects on adult men of circuit training and jogging. Arch Phys Med Rehabil 1979;60:115-20.

(3) Gettman LR, Ayres JJ, Pollock ML, and Jackson, A. The effects of circuit weight training on strength, Cardiorespiratory function and body composition of adult men. Med Sci Sport Fall 1978; 10(3): 171-6.

The Author

National Academy of Sports Medicine

National Academy of Sports Medicine

Since 1987 the National Academy of Sports Medicine (NASM) has been the global leader in delivering evidence-based certifications and advanced specializations to health and fitness professionals. Our products and services are scientifically and clinically proven. They are revered and utilized by leading brands and programs around the world and have launched thousands of successful careers.


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