Physician-supervised exercise programs in rehabilitation of patients with coronary heart disease. Council on Scientific Affairs

JAMA ◽  
1981 ◽  
Vol 245 (14) ◽  
pp. 1463-1466 ◽  
2019 ◽  
Vol 27 (16) ◽  
pp. 1691-1698
Author(s):  
Maxime Boidin ◽  
Lukas-Daniel Trachsel ◽  
Anil Nigam ◽  
Martin Juneau ◽  
Jonathan Tremblay ◽  
...  

Background We aimed to compare: (1) two different periodized aerobic training protocols (linear (LP) versus non-linear (NLP)) on the cardiopulmonary exercise response in patients with coronary heart disease; (2) the proportion of responders between both training protocols. Design A randomized controlled trial. Methods A total of 39 coronary heart disease patients completed either LP ( n = 20, 65 ± 10 years) or NLP ( n = 19, 66 ± 5 years). All patients completed a cardiopulmonary exercise testing with gas exchange measurements. Patients underwent a 12-week supervised exercise program including an isoenergetic aerobic periodized training and a similar resistance training program, 3 times/week. Weekly energy expenditure was constantly increased in the LP group for the aerobic training, while it was deeply increased and intercepted with a recovery week each fourth week in the NLP group. Peak oxygen uptake (peak V̇O2), oxygen uptake efficiency slope, ventilatory efficiency slope (V̇E/V̇CO2 slope), V̇O2 at the first (VT1) and second (VT2) ventilatory thresholds, and oxygen pulse (O2 pulse) were measured. Responders were determined according the median value of the Δpeak V̇O2 (mL.min−1.kg−1). Results We found similar improvement for peak V̇O2 (LP: +8.1%, NLP: +5.3%, interaction: p = 0.37; time: p < 0.001) and for oxygen uptake efficiency slope, VT1, VT2 and O2 pulse in both groups (interaction: p > 0.05; time: p < 0.05) with a greater effect size in the LP group. The proportion of non-, low and high responders was similar between groups ( p = 0.29). Conclusion In contrast to the athletes, more variation (NLP) does not seem necessary for greater cardiopulmonary adaptations in coronary heart disease patients.


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