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Hagen P, Malatesta D, Calanca L, Mazzolai L, Lanzi S. The PAD-adapted 30-20-10 during Nordic walking: A new exercise training session in patients with symptomatic peripheral artery disease. Medicine (Baltimore) 2024; 103:e38601. [PMID: 38905371 PMCID: PMC11191894 DOI: 10.1097/md.0000000000038601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 05/24/2024] [Indexed: 06/23/2024] Open
Abstract
This study aimed to investigate the feasibility of a peripheral artery disease (PAD)-adapted 30-20-10 Nordic walking session in patients with symptomatic PAD and to compare the cardiovascular response of this new training session to a traditional walking (TW) and 4 × 4 minutes Nordic walking session. This is a prospective observational study. Patients with Fontaine stage II PAD were included. Patients participated in Nordic walking sessions, which were randomly assigned as TW, 4 × 4 minute intervals, and peripheral artery disease adapted 30-20-10 exercise session (PAD-adapted 30-20-10 sessions). PAD-adapted 30-20-10 and 4 × 4 minutes sessions consisted of 4 repetitions of 4 minutes of effort followed by 3 minutes of passive recovery. PAD-adapted 30-20-10 session was characterized by 4 continuous 1-min repetitions at 3 different walking speeds [high (30 seconds), moderate (20 seconds) and low (10 seconds)]. During the 4 × 4 minutes session, patients were asked to cover the maximal distance at a constant speed. During TW session, patients were asked to walk at a speed inducing moderate-to-severe claudication pain. Heart rate, rating of perceived exertion (RPE) and claudication pain intensity using a visual analog scale were assessed. The perceived enjoyment of each session was assessed using a visual analog scale ranging from 0 (not enjoyable) to 10 (very enjoyable). Eleven patients with chronic symptomatic PAD were included (62 ± 13 years; 54% women). The mean heart rate during the time of effort was significantly higher in PAD-adapted 30-20-10 group than in 4 × 4 minutes and TW groups (127 ± 12, 122 ± 12, 114 ± 11 bpm, respectively; P ≤ .001). The mean rating of perceived exertion (16 ± 1, 15 ± 1, 13 ± 1; P ≤ .001) and claudication pain intensity (8 ± 1, 7 ± 1; 7 ± 1 mm; P ≤ .019) were significantly higher during PAD-adapted 30-20-10 sessions than during 4 × 4 minutes and TW sessions. The perceived enjoyment was similar among sessions (8.7 ± 1.6 for TW, 8.6 ± 1.7 for 4 × 4 minutes, and 8.8 ± 1.8 mm for PAD-adapted 30-20-10 sessions; P = .935). The PAD-adapted 30-20-10 session is feasible and induces higher cardiovascular stimulation and claudication pain than 4 × 4 minutes and TW procedures in patients with symptomatic PAD. Despite these different responses, a similar perceived enjoyment among the sessions has been shown. Future investigations are needed to examine the effects of this new training session in these patients.
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Affiliation(s)
- Paolo Hagen
- Institute of Sport Sciences, University of Lausanne (UNIL), Lausanne, Switzerland
| | - Davide Malatesta
- Institute of Sport Sciences, University of Lausanne (UNIL), Lausanne, Switzerland
| | - Luca Calanca
- Angiology Department, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland
| | - Lucia Mazzolai
- Angiology Department, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland
| | - Stefano Lanzi
- Angiology Department, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland
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Fitts RH, Wang X, Kwok WM, Camara AKS. Cardiomyocyte Adaptation to Exercise: K+ Channels, Contractility and Ischemic Injury. Int J Sports Med 2024. [PMID: 38648799 DOI: 10.1055/a-2296-7604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Cardiovascular disease is a leading cause of morbidity and mortality, and exercise-training (TRN) is known to reduce risk factors and protect the heart from ischemia and reperfusion injury. Though the cardioprotective effects of exercise are well-documented, underlying mechanisms are not well understood. This review highlights recent findings and focuses on cardiac factors with emphasis on K+ channel control of the action potential duration (APD), β-adrenergic and adenosine regulation of cardiomyocyte function, and mitochondrial Ca2+ regulation. TRN-induced prolongation and shortening of the APD at low and high activation rates, respectively, is discussed in the context of a reduced response of the sarcolemma delayed rectifier potassium channel (IK) and increased content and activation of the sarcolemma KATP channel. A proposed mechanism underlying the latter is presented, including the phosphatidylinositol-3kinase/protein kinase B pathway. TRN induced increases in cardiomyocyte contractility and the response to adrenergic agonists are discussed. The TRN-induced protection from reperfusion injury is highlighted by the increased content and activation of the sarcolemma KATP channel and the increased phosphorylated glycogen synthase kinase-3β, which aid in preventing mitochondrial Ca2+ overload and mitochondria-triggered apoptosis. Finally, a brief section is presented on the increased incidences of atrial fibrillation associated with age and in life-long exercisers.
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Affiliation(s)
- Robert H Fitts
- Biological Sciences, Marquette University, Milwaukee, United States
| | - Xinrui Wang
- Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, United States
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, United States
| | - Wai-Meng Kwok
- Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, United States
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, United States
- Anesthesiology, Medical College of Wisconsin, Milwaukee, United States
- Cancer Center, Medical College of Wisconsin, Milwaukee, United States
| | - Amadou K S Camara
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, United States
- Anesthesiology, Medical College of Wisconsin, Milwaukee, United States
- Cancer Center, Medical College of Wisconsin, Milwaukee, United States
- Physiology, Medical College of Wisconsin, Milwaukee, United States
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Lanzi S, Pousaz A, Fresa M, Besson C, Desgraz B, Gremeaux-Bader V, Mazzolai L. Short-duration aerobic high-intensity intervals versus moderate exercise training intensity in patients with peripheral artery disease: study protocol for a randomised controlled trial (the Angiof-HIIT Study). BMJ Open 2024; 14:e081883. [PMID: 38631833 PMCID: PMC11029310 DOI: 10.1136/bmjopen-2023-081883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/25/2024] [Indexed: 04/19/2024] Open
Abstract
INTRODUCTION Supervised exercise training is among the first-line therapies for patients with peripheral artery disease (PAD). Current recommendations for exercise include guidance focusing on claudication pain, programme and session duration, and frequency. However, no guidance is offered regarding exercise training intensity. This study aims to compare the effects of 12-week-long supervised walking exercise training (high-intensity interval training (HIIT) vs moderate-intensity exercise (MOD)) in patients with chronic symptomatic PAD. METHODS AND ANALYSIS This study is a monocentric, interventional, non-blinded randomised controlled trial. 60 patients (30 in each group) will be randomly allocated (by using the random permuted blocks) to 12 weeks (three times a week) of HIIT or MOD. For HIIT, exercise sessions will consist of alternating brief high-intensity (≥85% of the peak heart rate (HRpeak)) periods (≤60 s) of work with periods of passive rest. Patients will be asked to complete 1 and then 2 sets of 5-7 (progressing to 10-15×60 s) walking intervals. For the MOD group, exercise training sessions will consist of an alternation of periods of work performed at moderate intensity (≤76% HRpeak) and periods of passive rest. Interventions will be matched by training load. The primary outcome will be the maximal walking distance. Secondary outcomes will include functional performance, functional capacity, heath-related quality of life, self-perceived walking abilities, physical activity and haemodynamic parameters. ETHICS AND DISSEMINATION The Angiof-HIIT Study was approved by the Human Research Ethics Committee of the Canton de Vaud (study number: 2022-01752). Written consent is mandatory prior to enrolment and randomisation. The results will be disseminated via national and international scientific meetings, scientific peer-reviewed journals and social media. TRIAL REGISTRATION NUMBER NCT05612945.
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Affiliation(s)
- Stefano Lanzi
- Angiology Department, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Switzerland, Lausanne, Switzerland
| | - Anina Pousaz
- Angiology Department, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Switzerland, Lausanne, Switzerland
| | - Marco Fresa
- Angiology Department, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Switzerland, Lausanne, Switzerland
| | - Cyril Besson
- Department of Sports Medicine, Swiss Olympic Medical Center, CHUV, Lausanne, Switzerland
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Benoit Desgraz
- Department of Sports Medicine, Swiss Olympic Medical Center, CHUV, Lausanne, Switzerland
| | - Vincent Gremeaux-Bader
- Department of Sports Medicine, Swiss Olympic Medical Center, CHUV, Lausanne, Switzerland
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Lucia Mazzolai
- Angiology Department, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Switzerland, Lausanne, Switzerland
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Xi H, Jing M, Sun Q, Wang Y, Zhu H, Zhou J. The relationship between different exercise conditions and pericoronary inflammation as quantified by coronary CTA in coronary artery disease. Heliyon 2024; 10:e25316. [PMID: 38352755 PMCID: PMC10861983 DOI: 10.1016/j.heliyon.2024.e25316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 12/21/2023] [Accepted: 01/24/2024] [Indexed: 02/16/2024] Open
Abstract
Objectives The correlation between exercise type and intensity and coronary artery inflammation in patients with stable coronary artery disease (CAD) is unknown. Therefore, this study assessed the relationship between coronary inflammation quantified by coronary computed tomography angiography (CCTA) and exercise intensity and pattern in patients with CAD. Materials and methods Patients who underwent CCTA between 2019 and 2023 in the second hospital of Lanzhou University were retrospectively examined. We calculated the pericoronary fat attenuation index (FAI) on the right coronary artery (RCA) as a marker of coronary inflammation. We compared basic information, exercise status, and RCA-FAI values between the two groups, and described the relationship between different exercise durations and RCA-FAI using analysis of variance and restricted cubic splines. Results In total, 1222 patients were included: 774 had no CAD and 448 patients had CAD. Sex (P = 0.016; odds ratio [OR]: 0.673), high-density lipoprotein (P = 0.006; OR: 0.601), low-density lipoprotein (P = 0.001; OR. 0.762), hypertension (P = 0.000; OR: 0.762), smoking (P = 0.005; OR: 0.670), and postprandial glucose (P = 0.030; OR: 0.812), household income (P = 0.038; OR:1.117), and body mass index (P = 0.000; OR:1.084) were the risk factors for elevated RCA-FAI values in the patients with coronary artery disease group. And when the exercise modality was running and aerobics, the correlation between RCA-FAI values and exercise time showed a "U"-shaped relationship. Follow-up revealed that short periods of high-intensity exercise resulted in lower RCA-FAI values. Conclusion RCA-FAI was significantly associated with coronary artery inflammation. Although appropriate physical activity reduced the risk of pericoronary inflammation and coronary atherosclerosis, overly prolonged exercise could exacerbate the coronary inflammatory response and increase the likelihood of CAD.
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Affiliation(s)
- Huaze Xi
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China
- Second Clinical School, Lanzhou University, Lanzhou, China
- Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China
- Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China
| | - Mengyuan Jing
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China
- Second Clinical School, Lanzhou University, Lanzhou, China
- Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China
- Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China
| | - Qiu Sun
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China
- Second Clinical School, Lanzhou University, Lanzhou, China
- Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China
- Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China
| | - Yuanyuan Wang
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China
- Second Clinical School, Lanzhou University, Lanzhou, China
- Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China
- Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China
| | - Hao Zhu
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China
- Second Clinical School, Lanzhou University, Lanzhou, China
- Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China
- Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China
| | - Junlin Zhou
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China
- Second Clinical School, Lanzhou University, Lanzhou, China
- Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China
- Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China
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Ryan J, Hebert EP, Billiot KL, Ort BN, Thomschon K, Kraemer RR. The effects of separate and simultaneous upper and lower body cycling on cardiorespiratory responses in young men. J Sports Med Phys Fitness 2024; 64:129-136. [PMID: 37902804 DOI: 10.23736/s0022-4707.23.15306-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
BACKGROUND The aim of the present study was to examine the relative cardiorespiratory and perceptual responses to upper body ergometry, lower body ergometry, and combined upper and lower body ergometry at increasing exercising intensities. METHODS Eight healthy males between 19 and 30 years of age completed three exercise sessions over seven days that included graded leg ergometry, arm ergometry, and combined arm and leg ergometry in counterbalanced fashion. During leg-only and arm-only sessions, participants exercised at workloads of 0, 32, 64, and 95 W. The combined session involved simultaneous arm and leg ergometry at 0, 32, 64, and 95 W, thus eliciting double the total power output of arm-only and leg-only sessions. RESULTS At all workloads, oxygen consumption and minute ventilation responses were greater during combined arm and leg exercise than during leg-only or arm-only exercise. However, the pattern of changes in heart rate, systolic blood pressure, rate pressure product, and rating of perceived exertion (RPE) were similar in response to arm-only and combined upper and lower body exercise, despite combined exercise involving double the workload. These cardiorespiratory and perceptual responses were significantly lower during leg-only only exercise. CONCLUSIONS The results of the study add to limited research comparing physiological and perceptual responses to upper, lower, and combined upper and lower body exercise. The findings highlight heightened cardiorespiratory and perceptual responses to upper body exercise alone or in combination with lower body exercise. Training that combines upper and lower body may create higher power output and elicit greater caloric expenditure while eliciting similar cardiovascular responses as upper body only exercise at moderate and higher intensities.
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Affiliation(s)
- Jessica Ryan
- Department of Kinesiology and Health Studies, Southeastern Louisiana University, Hammond, LA, USA
| | - Edward P Hebert
- Department of Kinesiology and Health Studies, Southeastern Louisiana University, Hammond, LA, USA -
| | - Kim L Billiot
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Brandi N Ort
- Department of Kinesiology and Health Studies, Southeastern Louisiana University, Hammond, LA, USA
| | - Kierstin Thomschon
- Department of Kinesiology and Health Studies, Southeastern Louisiana University, Hammond, LA, USA
| | - Robert R Kraemer
- Department of Kinesiology and Health Studies, Southeastern Louisiana University, Hammond, LA, USA
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Košuta D, Novaković M, Božič Mijovski M, Jug B. Acute effects of high intensity interval training versus moderate intensity continuous training on haemostasis in patients with coronary artery disease. Sci Rep 2024; 14:1963. [PMID: 38263210 PMCID: PMC10806221 DOI: 10.1038/s41598-024-52521-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 01/19/2024] [Indexed: 01/25/2024] Open
Abstract
Exercise training is associated with an acute net increase in coagulation, which may increase the risk of atherothrombosis in coronary artery disease (CAD) patients. We sought to compare the acute haemostatic effects of a bout of moderate-intensity continuous (MICT) and high-intensity interval training (HIIT) in patients with CAD. Patients after a recent myocardial infarction were randomized into a HIIT or MICT session of exercise training on a stationary bike. Blood was sampled at baseline, after the exercise bout and after a one-hour resting period. We measured overall haemostatic potential (OHP), overall coagulation potential (OCP), fibrinogen, D-dimer and von Willebrand factor (vWF) and calculated overall fibrinolytic potential (OFP). Linear mixed models for repeated measures were constructed to assess the treatment effect. A total of 117 patients were included. OCP, OHP, fibrinogen, D-dimer and vWF significantly increased after exercise and returned to baseline after a one-hour rest, OFP decreased after exercise and returned to baseline levels after a one-hour rest. Linear mixed models showed a significant difference between HIIT and MICT in fibrinogen (p 0.043) and D-dimer (p 0.042). Our study has shown that an exercise bout is associated with a transient procoagulant state in patients with CAD, with similar exercise-induced haemostatic changes for HIIT and MICT.
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Affiliation(s)
- Daniel Košuta
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
- Department of Vascular Diseases, University Medical Centre Ljubljana, Zaloška Cesta 7, 1000, Ljubljana, Slovenia.
| | - Marko Novaković
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Department of Vascular Diseases, University Medical Centre Ljubljana, Zaloška Cesta 7, 1000, Ljubljana, Slovenia
| | - Mojca Božič Mijovski
- Department of Vascular Diseases, University Medical Centre Ljubljana, Zaloška Cesta 7, 1000, Ljubljana, Slovenia
- Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
| | - Borut Jug
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Department of Vascular Diseases, University Medical Centre Ljubljana, Zaloška Cesta 7, 1000, Ljubljana, Slovenia
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Bo B, Guo A, Kaila SJ, Hao Z, Zhang H, Wei J, Yao Y. Elucidating the primary mechanisms of high-intensity interval training for improved cardiac fitness in obesity. Front Physiol 2023; 14:1170324. [PMID: 37608837 PMCID: PMC10441243 DOI: 10.3389/fphys.2023.1170324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 07/31/2023] [Indexed: 08/24/2023] Open
Abstract
Obesity is a global and rising multifactorial pandemic associated with the emergence of several comorbidities that are risk factors for malignant cardiac remodeling and disease. High-intensity interval training (HIIT) has gained considerable attention due to its favorable outcomes of cardiometabolic health in individuals with overweight or obese. The primary aim of this review is to discuss the fundamental processes through which HIIT improves cardiac impairment in individuals with obesity to develop viable treatments for obesity management. In this review, a multiple database search and collection were conducted from the earliest record to January 2013 for studies included the qualitative component of HIIT intervention in humans and animals with overweight/obesity related to cardiac remodeling and fitness. We attempt to integrate the main mechanisms of HIIT in cardiac remolding improvement in obesity into an overall sequential hypothesis. This work focus on the ameliorative effects of HIIT on obesity-induced cardiac remodeling with respect to potential and pleiotropic mechanisms, including adipose distribution, energy metabolism, inflammatory response, insulin resistance, and related risk profiles in obesity. In conclusion, HIIT has been shown to reduce obesity-induced risks of cardiac remodeling, but the long-term effects of HIIT on obesity-induced cardiac injury and disease are presently unknown. Collective understanding highlights numerous specific research that are needed before the safety and effectiveness of HIIT can be confirmed and widely adopted in patient with obesity.
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Affiliation(s)
- Bing Bo
- Department of Kinesiology, School of Physical Education, Henan University, Kaifeng, China
- Sports Reform and Development Research Center, School of Physical Education, Henan University, Kaifeng, China
| | - Aijing Guo
- Department of Kinesiology, School of Physical Education, Henan University, Kaifeng, China
| | - Severa Jafeth Kaila
- Department of Kinesiology, School of Physical Education, Henan University, Kaifeng, China
| | - Zhe Hao
- Department of Kinesiology, School of Physical Education, Henan University, Kaifeng, China
| | - Huiqing Zhang
- Sports Reform and Development Research Center, School of Physical Education, Henan University, Kaifeng, China
| | - Jianshe Wei
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Kaifeng, China
| | - Yuan Yao
- Sports Reform and Development Research Center, School of Physical Education, Henan University, Kaifeng, China
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Ekkekakis P, Vallance J, Wilson PM, Ewing Garber C. Extraordinary claims in the literature on high-intensity interval training (HIIT): III. Critical analysis of four foundational arguments from an interdisciplinary lens. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 66:102399. [PMID: 37665861 DOI: 10.1016/j.psychsport.2023.102399] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 10/21/2022] [Accepted: 01/29/2023] [Indexed: 09/06/2023]
Abstract
Kinesiology aspires to be an integrated, interdisciplinary field that studies human movement from multiple perspectives. However, the main societal deliverables of the field, namely exercise prescriptions and physical activity recommendations, still reflect fragmentation, placing more emphasis on physiological outcomes than on behavioral and other considerations. Recently, researchers have called for the introduction of High-Intensity Interval Training (HIIT) to the domain of public health, based on the argument that HIIT can maximize fitness and health benefits for a fraction of the time recommended by the prevailing model of physical activity in public-health guidelines. Here, we show that an unintended side-effect of arguments underpinning the implementation of HIIT in the domain of public health might have been the exacerbation of segmentation. To highlight the value of interdisciplinarity, four foundational claims in support of HIIT are critiqued by tapping into cognate literatures: (1) the primary reason people do not exercise is lack of time, (2) HIIT is relevant to public health, (3) HIIT is being proposed as merely another option, so there is no basis for controversy, and (4) HIIT is safe and well tolerated. These claims are contradicted by credible lines of evidence. To improve the accuracy and effectiveness of its public claims, kinesiology should remain committed to the ideals of integration and interdisciplinarity.
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Affiliation(s)
| | - Jeff Vallance
- Faculty of Health Disciplines, Athabasca University, Canada
| | | | - Carol Ewing Garber
- Department of Biobehavioral Sciences, Teachers College, Columbia University, USA
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Moreira GMS, Damázio LCM, da Silva SV, Silveira AT, Mesquita IG, Silva LADS, Pereira LA, Costa ACS, Santos IAL, Campos MEP, Vaz LSC, Cardoso ZA, Gomes JVRS, Júnior PHAC, Ide LM. The Effects of Resistance Exercise on the Cardiorespiratory Tissue of Rats with Parkinson's Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2925. [PMID: 36833625 PMCID: PMC9957460 DOI: 10.3390/ijerph20042925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/28/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
Parkinson's Disease (PD) affects the cardiorespiratory system, causing an increase in the left ventricular mass in the heart and respiratory muscle weakness in relation to healthy individuals. The objective of this study was to investigate the effects of progressive resistive physical exercise on the vertical ladder on the histomorphometry of cardiac tissue and respiratory muscles in rats with PD. Seventy male Wistar rats, aged 40 days old, were divided into Parkinson's (PD) and Sham (SH) groups; they were also subdivided into groups that performed progressive resistive physical exercise on the vertical ladder Before Surgery (ExBS), After Surgery (ExAS), and Before and After Surgery (ExBAS). The physical training was carried out before and/or after PD induction. Exercise was performed five times a week for 25 min/day for four or eight weeks. PD induction was conducted via electrolytic stimulation of the Substantia nigra of the animals' brains, adopting the following stereotaxic table coordinates: -4.9; lateral medium equal to 1.7, and dorsoventral equal to 8.1. For the morphometric analysis of the heart, the following variables were calculated: relative weight and diameter and thickness of the left ventricle. The diaphragm and the myocardial, intercostal, and abdominal muscles were stained with Hematoxylin and Eosin (HE). The histomorphometric analysis was performed using the ImageJ software to assess the cross-sectional area of muscles and the number of muscle fibers. Progressive resistance exercise promoted the hypertrophy of respiratory muscles and the left ventricle in animals with PD.
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Affiliation(s)
- Graziele Mayra Santos Moreira
- Graduate Program in Morphofunctional Sciences (PPGCM), Federal University of São João del-Rei (UFSJ), Sao Joao del Rei 36307-352, Brazil
| | - Laila Cristina Moreira Damázio
- Graduate Program in Morphofunctional Sciences (PPGCM), Federal University of São João del-Rei (UFSJ), Sao Joao del Rei 36307-352, Brazil
| | - Silvana Venâncio da Silva
- Graduate Program in Morphofunctional Sciences (PPGCM), Federal University of São João del-Rei (UFSJ), Sao Joao del Rei 36307-352, Brazil
| | - Augusto Targino Silveira
- Physiotherapy Department, Presidente Tancredo de Almeida Neves University Center (UNIPTAN/Afya), São João del Rei 36307-251, Brazil
| | - Isabella Giordano Mesquita
- Medicine and Biological Sciences Course, Dom Bosco Campus, Federal University of São João del-Rei (UFSJ), Sao Joao del Rei 36301-158, Brazil
| | - Luana Aparecida de Sousa Silva
- Medicine and Biological Sciences Course, Dom Bosco Campus, Federal University of São João del-Rei (UFSJ), Sao Joao del Rei 36301-158, Brazil
| | - Luan Alves Pereira
- Medicine and Biological Sciences Course, Dom Bosco Campus, Federal University of São João del-Rei (UFSJ), Sao Joao del Rei 36301-158, Brazil
| | - Ana Clara Silva Costa
- Medicine and Biological Sciences Course, Dom Bosco Campus, Federal University of São João del-Rei (UFSJ), Sao Joao del Rei 36301-158, Brazil
| | - Ismael Augusto Lima Santos
- Medicine and Biological Sciences Course, Dom Bosco Campus, Federal University of São João del-Rei (UFSJ), Sao Joao del Rei 36301-158, Brazil
| | - Maria Eduarda Paiva Campos
- Medicine and Biological Sciences Course, Dom Bosco Campus, Federal University of São João del-Rei (UFSJ), Sao Joao del Rei 36301-158, Brazil
| | - Luna Sara Campos Vaz
- Medicine and Biological Sciences Course, Dom Bosco Campus, Federal University of São João del-Rei (UFSJ), Sao Joao del Rei 36301-158, Brazil
| | - Zenaide Alves Cardoso
- Medicine and Biological Sciences Course, Dom Bosco Campus, Federal University of São João del-Rei (UFSJ), Sao Joao del Rei 36301-158, Brazil
| | - José Victor Ribeiro Silva Gomes
- Medicine and Biological Sciences Course, Dom Bosco Campus, Federal University of São João del-Rei (UFSJ), Sao Joao del Rei 36301-158, Brazil
| | | | - Liliam Midori Ide
- Graduate Program in Morphofunctional Sciences (PPGCM), Federal University of São João del-Rei (UFSJ), Sao Joao del Rei 36307-352, Brazil
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Franklin B, H. Eijsvogels T. A narrative review on exercise and cardiovascular disease: Physical activity thresholds for optimizing health outcomes. HEART AND MIND 2023. [DOI: 10.4103/hm.hm_1_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
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Franklin BA, Eijsvogels TM, Pandey A, Quindry J, Toth PP. Physical activity, cardiorespiratory fitness, and cardiovascular health: A clinical practice statement of the American Society for Preventive Cardiology Part II: Physical activity, cardiorespiratory fitness, minimum and goal intensities for exercise training, prescriptive methods, and special patient populations. Am J Prev Cardiol 2022; 12:100425. [PMID: 36281325 PMCID: PMC9586849 DOI: 10.1016/j.ajpc.2022.100425] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 09/05/2022] [Accepted: 10/06/2022] [Indexed: 11/11/2022] Open
Abstract
The prescription of exercise for individuals with and without cardiovascular disease (CVD) should be scientifically-based yet adapted to the patient. This scientific statement reviews the clinical and physiologic basis for the prescription of exercise, with specific reference to the volume of physical activity (PA) and level of cardiorespiratory fitness (CRF) that confer significant and optimal cardioprotective benefits. Recommendations are provided regarding the appropriate intensity, frequency, and duration of training; the concept of MET-minutes per week; critical components of the exercise session (warm-up, conditioning phase, cool-down); methodologies for establishing the training intensity, including oxygen uptake reserve (V̇O2R), target heart rate derivation and rating perceived exertion; minimum and goal intensities for exercise training; and, types of training activities, including resistance training, adjunctive lifestyle PA, marathon/triathlon training, and high-intensity interval training. In addition, we discuss the rationale for and value of exercise training programs for patients with peripheral artery disease, diabetes mellitus, and heart failure.
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Affiliation(s)
- Barry A. Franklin
- Preventive Cardiology and Cardiac Rehabilitation, Beaumont Health, Royal Oak, MI, USA
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Thijs M.H. Eijsvogels
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ambarish Pandey
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, USA
| | - John Quindry
- Integrative Physiology and Athletic Training, University of Montana, Missoula, MT, USA
- International Heart Institute – St. Patrick's Hospital, Providence Medical Center, Missoula, MT, USA
| | - Peter P. Toth
- CGH Medical Center, Sterling, IL, USA
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Effect of Exercise on Carotid Artery Intima-Media Thickness in Adults: A Systematic Review and Meta-Analysis. J Phys Act Health 2022; 19:855-867. [PMID: 36257606 DOI: 10.1123/jpah.2022-0372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/22/2022] [Accepted: 09/01/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Carotid intima-media thickness (cIMT) is a validated surrogate marker of atherosclerosis that is independently associated with the risk for cardiovascular disease. Recent studies on the effect of exercise on cIMT have yielded conflicting results. METHODS Studies that were available up until October 30, 2021 from the PubMed, Cochrane Library, Embase, and Web of Science databases were included in the analysis. Subgroup analyses were performed to determine the effects of the type, intensity, and duration of exercise on cIMT. RESULTS This review included 26 studies with 1370 participants. Compared with control participants, those who engaged in exercise showed a decline in cIMT (weighted mean difference [WMD] -0.02; 95% confidence interval [CI], -0.03 to -0.01; I2 = 90.1%). Participants who engaged in aerobic (WMD -0.02; 95% CI, -0.04 to -0.01; I2 = 52.7%) or resistance (WMD -0.01; 95% CI, -0.02 to -0.00; I2 = 38.5%) exercise showed lower cIMT compared with control participants. An exercise duration of >6 months was associated with a 0.02 mm reduction in cIMT. In participants with low cIMT at baseline (<0.7 mm), exercise alone was not associated with a change in cIMT (WMD -0.01; 95% CI, -0.03 to 0.00; I2 = 93.9%). CONCLUSIONS Exercise was associated with reduced cIMT in adults. Aerobic exercise is associated with a greater decline in cIMT than other forms of exercise. Large, multicenter, randomized controlled trials are required to establish optimal exercise protocols for improving the pathological process of atherosclerosis.
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Kristiansen J, Sjúrðarson T, Grove EL, Rasmussen J, Kristensen SD, Hvas AM, Mohr M. Feasibility and impact of whole-body high-intensity interval training in patients with stable coronary artery disease: a randomised controlled trial. Sci Rep 2022; 12:17295. [PMID: 36241898 PMCID: PMC9568554 DOI: 10.1038/s41598-022-21655-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 09/29/2022] [Indexed: 01/10/2023] Open
Abstract
Exercise training reduces cardiovascular mortality and improves quality of life in CAD patients. We investigated the feasibility and impact of 12 weeks of low-volume high-intensity interval training (HIIT) in CAD-patients. Patients with stable CAD were randomized 1:1 to supervised HIIT or standard care. HIIT sessions were completed three times weekly for 12 weeks on a rowing ergometer. Before and after the 12-week intervention, patients completed a physiological evaluation of cardiorespiratory performance and quality of life questionnaires. Mixed model analysis was used to evaluate differences between and within groups. A total of 142 patients (67 ± 9 years, nHIIT = 64, nStandard care = 78) completed the trial. Training adherence was 97% (range 86-100%). Six patients dropped out because of non-fatal adverse events. Weekly training duration was 54 min with an average power output of 138 W. HIIT increased peak oxygen uptake by 2.5 mL/kg/min (95% CI 2.1-3.0), whereas no change was observed in standard care (0.2 mL/kg/min, 95% CI - 0.2-0.6, P < 0.001). In addition, HIIT improved markers of quality of life, including physical functioning, limitations due to physical illness, general health and vitality (P < 0.05). Twelve weeks of low-volume whole-body HIIT increased cardiorespiratory capacity and improved quality of life in patients with stable CAD compared to standard care. In addition, our study demonstrates that the applied vigorous training regime is feasible for this patient group.Clinical trial registration: www.clinicaltrials.gov . Identification number: NCT04268992.
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Affiliation(s)
- Jacobina Kristiansen
- Department of Medicine, National Hospital of the Faroe Islands, Tórshavn, Faroe Islands ,grid.154185.c0000 0004 0512 597XDepartment of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark ,grid.154185.c0000 0004 0512 597XDepartment of Cardiology, Aarhus University Hospital, Aarhus, Denmark ,grid.7048.b0000 0001 1956 2722Faculty of Health, Aarhus University, Aarhus, Denmark ,grid.449708.60000 0004 0608 1526Faculty of Health, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Tórur Sjúrðarson
- grid.449708.60000 0004 0608 1526Faculty of Health, University of the Faroe Islands, Tórshavn, Faroe Islands ,grid.5254.60000 0001 0674 042XDepartment of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Erik Lerkevang Grove
- grid.154185.c0000 0004 0512 597XDepartment of Cardiology, Aarhus University Hospital, Aarhus, Denmark ,grid.7048.b0000 0001 1956 2722Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Jan Rasmussen
- Department of Medicine, National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
| | - Steen Dalby Kristensen
- grid.154185.c0000 0004 0512 597XDepartment of Cardiology, Aarhus University Hospital, Aarhus, Denmark ,grid.7048.b0000 0001 1956 2722Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Anne-Mette Hvas
- grid.154185.c0000 0004 0512 597XDepartment of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark ,grid.7048.b0000 0001 1956 2722Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Magni Mohr
- grid.449708.60000 0004 0608 1526Faculty of Health, University of the Faroe Islands, Tórshavn, Faroe Islands ,grid.10825.3e0000 0001 0728 0170Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, 5230 Odense M, Denmark
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Okur I, Aksoy CC, Yaman F, Sen T. Which high-intensity interval training program is more effective in patients with coronary artery disease? Int J Rehabil Res 2022; 45:168-175. [PMID: 35191412 DOI: 10.1097/mrr.0000000000000524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aim of the study is to examine high-intensity interval training (HIIT) programs and a moderate-intensity continuous training (MICT) program, which are frequently used in cardiac rehabilitation programs in terms of their effects on the functional capacity and quality of life of patients with coronary artery disease (CAD). The study included 20 patients with CAD (mean age, 60.95 ± 5.08 years) who had undergone revascularization surgery. The participants were randomized into HIIT-short, HIIT-long, and MICT groups. All the groups participated in a 24-session exercise-based cardiac rehabilitation program. The participants' exercise capacity was evaluated using the maximal exercise test and estimated VO2max values, functional capacity using the 6-min walk test (6MWT), and quality of life using the Short Form-36 survey and MacNew Heart Disease Health-related Quality of Life (MacNew) questionnaire. It was determined that the estimated VO2max values statistically significantly improved after treatment (P < 0.05), and both HIIT groups were superior to the MICT group (P < 0.05). Only the HIIT groups achieved the minimal clinically important difference in the 6MWT distance. After treatment, only the MICT group had a statistically significant improvement in quality of life. There was no statistically significant difference between the groups in relation to the improvement in the 6MWT distance and quality of life (P > 0.05). The results of our study showed that both HIIT programs were superior to MICT in improving the maximal exercise capacity of patients with CAD, and the three programs had a similar effect on quality of life.
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Affiliation(s)
- Ismail Okur
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Kutahya Health Sciences University
| | - Cihan Caner Aksoy
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Kutahya Health Sciences University
| | - Fatima Yaman
- Department of Physical Therapy and Rehabilitation, Faculty of Medicine, Kutahya Health Sciences University
| | - Taner Sen
- Department of Cardiology, Faculty of Medicine, Kutahya Health Sciences University, Kutahya, Turkey
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Smith M, Orchard J, La Gerche A, Gallagher R, Fitzpatrick J. Fit, Female or Fifty–Is Cardiac Rehabilitation “Fit” for Purpose for All? A Systematic Review and Meta-Analysis With Meta-Regression. Front Cardiovasc Med 2022; 9:764882. [PMID: 35425816 PMCID: PMC9001939 DOI: 10.3389/fcvm.2022.764882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 03/07/2022] [Indexed: 11/13/2022] Open
Abstract
AimsCardiac rehabilitation (CR) is an evidence-based intervention promoting risk factor modification following coronary artery disease events but the relative benefits for patient subgroups is not clear. This review synthesizes the available evidence on the effectiveness of modern CR programs and determines outcomes for age, sex and prior level of fitness.MethodsMEDLINE, CINAHL, and EMBASE were examined for RCT and cohort studies involving exercise prescription or phase II or III CR following Myocardial Infarction (MI), Percutaneous Coronary Intervention (PCI) and cardiac surgery from January 2010 to February 2021. Outcomes assessed included peakVO2max, 6-min walk test and Metabolic Equivalent of Task. Meta-regression was used to determine CR impact for change in fitness and age and sex influences.ResultsThe mean age of study participants was 59.5 years and 82.7% were male. Females, younger people and those of average or above cardiorespiratory fitness were substantially under-represented in data and attendance, with 13% of study groups with a mean age <55 years. At entry, 73% were below average for fitness vs. age-matched normative values. Fitness improved across all groups following CR with no evidence of sex or age independently affecting outcomes.ConclusionsModest improvements in fitness in all groups were shown, but the benefits of CR can be far greater. A modern, innovative approach to CR will likely lead to more substantial benefits. This may require a “Precision Medicine” model which tailors exercise prescription to different populations to ensure all CR participant's needs are met. This will ensure that CR is more flexible and accessible for all.
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Affiliation(s)
- Martin Smith
- Australasian College of Sport and Exercise Physicians, Melbourne, VIC, Australia
- *Correspondence: Martin Smith
| | - Jessica Orchard
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute and The University of Sydney, Sydney, NSW, Australia
| | - Andre La Gerche
- Clinical Research Department, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Robyn Gallagher
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Jane Fitzpatrick
- Department of Physiotherapy, Centre for Health, Exercise and Sports Medicine, Melbourne School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Carlton, VIC, Australia
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Zhao S, Liu S, Wen Y, Qi Q, Huang P. Analysis of the Effect of External Counterpulsation Combined With High-Intensity Aerobic Exercise on Cardiopulmonary Function and Adverse Cardiovascular Events in Patients With Coronary Heart Disease After PCI. Front Surg 2022; 9:851113. [PMID: 35310429 PMCID: PMC8927644 DOI: 10.3389/fsurg.2022.851113] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 01/31/2022] [Indexed: 12/04/2022] Open
Abstract
Purpose To explore the intervention effect of external counterpulsation (ECP) combined with high-intensity aerobic exercise (HIAT) on patients with coronary heart disease (CHD) after PCI. Methods 124 patients with stable CHD after PCI admitted to our hospital from June 2018 to June 2021 were selected, and all patients were divided into control group and observation group using the random number table method. The control group received conventional treatment, The observation group received ECP combined with HIAT based on the control group. The cardiorespiratory function indexes, exercise endurance indexes, incidence of major cardiovascular adverse events (MACE), Barthel index of the two groups were observed. Results After intervention, METs max, VO2max, VO2max/kg, VO2max/HR, and PP, ED, AT, and Barthel score in both groups were significantly higher than before intervention, and patients in the observation group were significantly higher than those in the control group (P < 0.05). The incidence of MACE in the observation group (3.23%) was lower than in the control group (12.90%) (P < 0.05). Conclusion ECP combined with HIAT can improve the cardiopulmonary function of patients with CHD after PCI, and improve exercise endurance, reduce the incidence of MACE, improve patients' ability of daily living.
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Affiliation(s)
- Shiming Zhao
- Department of Cardiology, Wuhan Hankou Hospital, Wuhan, China
| | - Shaowen Liu
- Department of Cardiology, Wuhan Hankou Hospital, Wuhan, China
| | - Yuan Wen
- Department of Cardiology, Wuhan Hankou Hospital, Wuhan, China
| | - Qiuhuan Qi
- Department of Cardiology, Wuhan Hankou Hospital, Wuhan, China
| | - Peng Huang
- Intensive Care Unit, Emergency Medical Department, Wuhan Hankou Hospital, WuHan, China
- *Correspondence: Peng Huang
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Quindry JC, McNamara M, Oser C, Fogle C. Cardiac Rehabilitation and Resting Blood Pressure: MONTANA OUTCOMES PROJECT CARDIAC REHABILITATION REGISTRY FINDINGS. J Cardiopulm Rehabil Prev 2022; 42:E23-E31. [PMID: 34508034 DOI: 10.1097/hcr.0000000000000638] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Exercise-based cardiac rehabilitation (CR) is essential for treating cardiovascular disease, and modifying risk factor modification, including hypertension. Because the causes of hypertension and benefits of CR are faceted, we examined the influence of phase II CR on resting blood pressure (BP). METHODS Outcomes straddle the release of the updated BP guidelines, and study emphases included CR session number, sex, race/ethnicity, insurance provider, and referring diagnosis. RESULTS Patient files of 31 885 individuals uploaded to the Montana Outcomes Project registry indicated that lowered systolic and diastolic BP were further improved after the release of the revised BP guidelines. The CR session number was proportional to improvements in diastolic BP. Blood pressure improved independent of sex, although female patients exhibited lower diastolic BP before and after CR. Race/ethnicity analyses indicated that Asian and White patients experienced drops in systolic and diastolic BP, while diastolic BP was improved in Hispanic patients. Neither American Indian nor Black patients exhibited statistically altered BP. Medicare, Veterans Administration, and privately insured patients had lowered systolic and diastolic BP, while Medicaid patients had lower diastolic BP, and the uninsured had lower systolic BP. Blood pressure outcomes were generally improved independent of the primary referring diagnosis, while those with peripheral artery disease showed no improvements. CONCLUSIONS Findings demonstrate that phase II CR is highly effective in the control of BP, although improvements are not equally distributed to all individuals according to differences in sex, race/ethnicity, and access to insurance-funded health care.
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Affiliation(s)
- John C Quindry
- School of Integrative Physiology and Athletic Training, College of Health, University of Montana, Missoula (Dr Quindry); International Heart Institute, St Patrick Hospital, Missoula, Montana (Dr Quindry); and Cardiovascular Health Program, Montana Department of Public Health and Human Services, Helena, Montana (Mr McNamara and Mss Oser and Fogle)
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18
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Hansen D, Abreu A, Ambrosetti M, Cornelissen V, Gevaert A, Kemps H, Laukkanen JA, Pedretti R, Simonenko M, Wilhelm M, Davos CH, Doehner W, Iliou MC, Kränkel N, Völler H, Piepoli M. Exercise intensity assessment and prescription in cardiovascular rehabilitation and beyond: why and how: a position statement from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology. Eur J Prev Cardiol 2022; 29:230-245. [PMID: 34077542 DOI: 10.1093/eurjpc/zwab007] [Citation(s) in RCA: 105] [Impact Index Per Article: 52.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/02/2021] [Accepted: 01/08/2021] [Indexed: 12/12/2022]
Abstract
A proper determination of the exercise intensity is important for the rehabilitation of patients with cardiovascular disease (CVD) since it affects the effectiveness and medical safety of exercise training. In 2013, the European Association of Preventive Cardiology (EAPC), together with the American Association of Cardiovascular and Pulmonary Rehabilitation and the Canadian Association of Cardiac Rehabilitation, published a position statement on aerobic exercise intensity assessment and prescription in cardiovascular rehabilitation (CR). Since this publication, many subsequent papers were published concerning the determination of the exercise intensity in CR, in which some controversies were revealed and some of the commonly applied concepts were further refined. Moreover, how to determine the exercise intensity during resistance training was not covered in this position paper. In light of these new findings, an update on how to determine the exercise intensity for patients with CVD is mandatory, both for aerobic and resistance exercises. In this EAPC position paper, it will be explained in detail which objective and subjective methods for CR exercise intensity determination exist for aerobic and resistance training, together with their (dis)advantages and practical applications.
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Affiliation(s)
- Dominique Hansen
- Department of Cardiology, Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
- UHasselt, Faculty of Rehabilitation Sciences, BIOMED-REVAL-Rehabilitation Research Centre, Hasselt University, Agoralaan, Building A, 3590 Hasselt, Belgium
| | - Ana Abreu
- Cardiology Department, Hospital Universitário de Santa Maria/Centro Académico de Medicina de Lisboa (CAML), Exercise and Cardiovascular Rehabilitation Laboratory, Centro Cardiovascular da Universidade de Lisboa (CCUL), Lisbon, Portugal
| | - Marco Ambrosetti
- Cardiac Rehabilitation Unit, ASST Ospedale Maggiore Crema, Crema, Italy
| | - Veronique Cornelissen
- Research Unit of Cardiovascular Exercise Physiology, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Belgium
| | - Andreas Gevaert
- Research Group Cardiovascular Diseases, GENCOR Department, University of Antwerp, Antwerp, Belgium
- Department of Cardiology, Antwerp University Hospital (UZA), Belgium
| | - Hareld Kemps
- Department of Cardiology, Maxima Medical Centre, Veldhoven, The Netherlands
- Department of Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jari A Laukkanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Cardiovascular Department, IRCCS MultiMedica, Care and Research Institute, Sesto San Giovanni, Milano, Italy
| | - Roberto Pedretti
- Heart Transplantation Outpatient Department, Cardiopulmonary Exercise Test Research Department, Almazov National Medical Research Centre, St. Petersburg, Russia
| | - Maria Simonenko
- Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Matthias Wilhelm
- Cardiovascular Research Laboratory, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Constantinos H Davos
- BCRT-Berlin Institute of Health Center for Regenerative Therapies, Department of Cardiology (Virchow Klinikum), Charité - Universitätsmedizin Berlin, Partner Site Berlin, Germany
| | - Wolfram Doehner
- Cardiac Rehabilitation and Secondary Prevention Department, Corentin Celton Hospital, Assistance Publique Hopitaux de Paris Centre Université de Paris, Paris, France
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin D-1220, Germany
| | - Marie-Christine Iliou
- Charité - University Medicine Berlin, Campus Benjamin Franklin, Department of Cardiology, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Nicolle Kränkel
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin D-1220, Germany
- Klinik am See, Rehabilitation Centers for Internal Medicine, Berlin, Germany
| | - Heinz Völler
- Department of Rehabilitation Medicine, University of Potsdam, Potsdam, Germany
- Heart Failure Unit, G. da Saliceto Hospital, AUSL Piacenza and University of Parma, Parma, Italy
| | - Massimo Piepoli
- Heart Failure Unit, G. da Saliceto Hospital, AUSL Piacenza and University of Parma, Parma, Italy
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Yan ZW, Li WG. Battle between high-intensity interval training and moderate-intensity continuous training in cardiac rehabilitation practice. Eur J Prev Cardiol 2022; 29:e264-e265. [DOI: 10.1093/eurjpc/zwac013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Indexed: 11/13/2022]
Affiliation(s)
- Zhi-Wei Yan
- College of Kinesiology, Shenyang Sport University, No. 36 Jinqiansong East Road, Sujiatun District, Shenyang 110102, China
| | - Wei-Guang Li
- Cardiology Department, Liaoning Province Jinqiu Hospital, No. 317, Xiaonan Street, Shenhe District, Shenyang 110016, China
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Karageorghis CI, Jones L, Howard LW, Thomas RM, Moulashis P, Santich SJ. When It HIITs, You Feel No Pain: Psychological and Psychophysiological Effects of Respite-Active Music in High-Intensity Interval Training. JOURNAL OF SPORT & EXERCISE PSYCHOLOGY 2021; 43:41-52. [PMID: 33378741 DOI: 10.1123/jsep.2019-0335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 07/30/2020] [Accepted: 08/01/2020] [Indexed: 06/12/2023]
Abstract
The authors investigated the effects of respite-active music (i.e., music used for active recovery in between high-intensity exercise bouts) on psychological and psychophysiological outcomes. Participants (N = 24) made four laboratory visits for a habituation, medium- and fast-tempo music conditions, and a no-music control. A high-intensity interval-training protocol comprising 8 × 60-s exercise bouts at 100% Wmax with 90-s active recovery was administered. Measures were taken at the end of exercise bouts and recovery periods (rating of perceived exertion [RPE], state attention, and core affect) and then upon cessation of the protocol (enjoyment and remembered pleasure). Heart rate was measured throughout. Medium-tempo music enhanced affective valence during exercise and recovery, while both music conditions increased dissociation (only during recovery), enjoyment, and remembered pleasure relative to control. Medium-tempo music lowered RPE relative to control, but the heart rate results were inconclusive. As predicted, medium-tempo music, in particular, had a meaningful effect on a range of psychological outcomes.
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Franklin BA, Quindry J. High level physical activity in cardiac rehabilitation: Implications for exercise training and leisure-time pursuits. Prog Cardiovasc Dis 2021; 70:22-32. [PMID: 34971650 DOI: 10.1016/j.pcad.2021.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 12/22/2021] [Indexed: 12/13/2022]
Abstract
IMPORTANCE Regular moderate-to-vigorous physical activity and increased levels of cardiorespiratory fitness (CRF) are widely promoted as cardioprotective measures in secondary prevention interventions. OBSERVATIONS A low level of CRF increases the risk of cardiovascular disease (CVD) to a greater extent than merely being physically inactive. An exercise capacity <5 metabolic equivalents (METs), generally corresponding to the bottom 20% of the fitness continuum, indicates a higher mortality group. Accordingly, a key objective in early cardiac rehabilitation (CR) is to increase the intensity of training to >3 METs, to empower patients to vacate this "high risk" group. Moreover, a "good" exercise capacity, expressed as peak METs, identifies individuals with a favorable long-term prognosis, regardless of the underlying extent of coronary disease. On the other hand, vigorous-to-high intensity physical activity, particularly when unaccustomed, and some competitive sports are associated with a greater incidence of acute cardiovascular events. Marathon and triathlon training/competition also have limited applicability and value in CR, are associated with acute cardiac events each year, and do not necessarily provide immunity to the development of or the progression of CVD. Furthermore, extreme endurance exercise regimens are associated with an increased incidence of atrial fibrillation and accelerated coronary artery calcification. CONCLUSIONS AND RELEVANCE High-intensity training offers a time-saving alternative to moderate intensity continuous training, as well as other potential advantages. Additional long-term studies assessing safety, adherence, and morbidity and mortality are required before high-intensity CR training can be more widely recommended, especially in previously sedentary patients with known or suspected CVD exercising in non-medically supervised settings.
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Affiliation(s)
- Barry A Franklin
- Preventive Cardiology and Cardiac Rehabilitation, Beaumont Health, Royal Oak, MI, United States of America; Internal Medicine, Oakland University William Beaumont School of Medicine, Rochester, MI, United States of America.
| | - John Quindry
- Integrative Physiology and Athletic Training, University of Montana, Missoula, Montana, Bulgaria; International Heart Institute - St Patrick's Hospital, Providence Medical Center, Missoula, Montana, Bulgaria
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22
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Effect of High-Intensity Interval Training on Physical Health in Coronary Artery Disease Patients: A Meta-Analysis of Randomized Controlled Trials. J Cardiovasc Dev Dis 2021; 8:jcdd8110158. [PMID: 34821711 PMCID: PMC8622669 DOI: 10.3390/jcdd8110158] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/10/2021] [Accepted: 11/15/2021] [Indexed: 01/02/2023] Open
Abstract
The effects of exercise-based cardiac rehabilitation (CR) on physical health in coronary artery disease (CAD) patients has long been established, while the optimal exercise mode remains to be determined. This meta-analysis compared the efficacy of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) in CAD patients. Databases were searched up to December 2020. Twenty-five studies with 1272 participants were analyzed. The results showed that both HIIT and MICT induced significant VO2peak improvement with a 4.52 mL/kg/min (p < 0.01) and 2.36 mL/kg/min (p < 0.01), respectively. Additionally, a larger improvement of VO2peak (1.92 mL/kg/min, p < 0.01) was observed in HIIT over MICT. HIIT with medium and long intervals, higher work/rest ratio induced larger VO2peak improvement than the compared subgroup. Interestingly, non-isocaloric exercise protocols induced larger VO2peak improvement compared with isocaloric protocols. In addition, both HIIT and MICT significantly increased anaerobic threshold and peak power with HIIT superior to MICT. No significant different changes were observed in blood pressure after HIIT or MICT intervention, however when HIIT was compared with MICT, MICT seems superior to HIIT in reducing systolic blood pressure (−3.61 mmHg, p < 0.01) and diastolic blood pressure (−2.37 mmHg, p < 0.01). Although, HIIT and MICT induced significant improvement of most other parameters, like HRrest, HRpeak, left ventricular ejection fraction (LVEF), quality of life (QoL), no significant differences were noted between groups. This meta-analysis suggested that HIIT is superior to MICT in increasing VO2peak, anaerobic threshold, peak power in CAD patients. Additionally, the efficacy of HIIT over MICT in improving VO2peaks was influenced by HIIT intervals, work/rest ratio and total caloric consumption. Both HIIT and MICT did not significantly influence resting BP, however, MICT seemed to be more effective in reducing BP than HIIT. HIIT and MICT equally significantly influenced HRrest, HRpeak, HRR1min, OUES, LVEF%, QoL.
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Menglu S, Suyong Y, Xiaoyan W, Schöllhorn WI, Dong Z. Cognitive effectiveness of high-intensity interval training for individuals with methamphetamine dependence: a study protocol for randomised controlled trial. Trials 2021; 22:650. [PMID: 34556153 PMCID: PMC8460192 DOI: 10.1186/s13063-021-05615-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 09/13/2021] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Cognitive deficit is a common syndrome of methamphetamine (MA) dependence. It is related to decision-making, control ability, and social functioning. High-intensity interval training (HIIT) is a training technique that requires people to work out at full intensity during a short period. Many studies have already shown the potential effects of HIIT on cognitive functions. The purpose of this trial is to evaluate the cognitive effects of HIIT on individuals with MA dependence. METHODS AND ANALYSIS A total of 240 individuals with MA dependence will be randomly assigned to the HIIT group, moderate-intensity continuous training (MICT) group and control (CON) group. HIIT will consist of a 24-min HIIT exercise on a treadmill. MICT will consist of a 1-h body-mind exercise. CON will be their traditional intervention. The experimental period will be 12 months with 3 interventions weekly for the first 6 months and follow-up for the next 6 months. All subjects will be given cognitive tests at baseline, after intervention and at follow-up. Cognitive performances will be compared by a mixed-model analysis for repeated measures. DISCUSSION HIIT training may reduce illicit drug cravings amongst individuals with MA dependence; hence, HIIT may have a good effect on the cognitive functions, such as memory and executive function, of individuals with MA dependence. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2000032492 . Registered on April 30, 2020 ( http://www.chictr.org.cn/edit.aspx?pid=52127&htm=4 ).
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Affiliation(s)
- Shen Menglu
- Wushu College, Shanghai University of Sport, 399 Changhai Road, Shanghai, China
| | - Yang Suyong
- School of Sport Psychology, Shanghai University of Sport, Shanghai, China
| | - Wang Xiaoyan
- School of Physical Education, Hangzhou Normal University, Zhejiang, China
| | | | - Zhu Dong
- School of International Education, Shanghai University of Sport, 399 Changhai Road, Shanghai, China
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Taylor JL, Bonikowske AR, Olson TP. Optimizing Outcomes in Cardiac Rehabilitation: The Importance of Exercise Intensity. Front Cardiovasc Med 2021; 8:734278. [PMID: 34540924 PMCID: PMC8446279 DOI: 10.3389/fcvm.2021.734278] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 07/31/2021] [Indexed: 01/04/2023] Open
Abstract
Exercise based cardiac rehabilitation (CR) is recognized internationally as a class 1 clinical practice recommendation for patients with select cardiovascular diseases and heart failure with reduced ejection fraction. Over the past decade, several meta-analyses have generated debate regarding the effectiveness of exercise-based CR for reducing all-cause and cardiovascular mortality. A common theme highlighted in these meta-analyses is the heterogeneity and/or lack of detail regarding exercise prescription methodology within CR programs. Currently there is no international consensus on exercise prescription for CR, and exercise intensity recommendations vary considerably between countries from light-moderate intensity to moderate intensity to moderate-vigorous intensity. As cardiorespiratory fitness [peak oxygen uptake (VO2peak)] is a strong predictor of mortality in patients with coronary heart disease and heart failure, exercise prescription that optimizes improvement in cardiorespiratory fitness and exercise capacity is a critical consideration for the efficacy of CR programming. This review will examine the evidence for prescribing higher-intensity aerobic exercise in CR, including the role of high-intensity interval training. This discussion will highlight the beneficial physiological adaptations to pulmonary, cardiac, vascular, and skeletal muscle systems associated with moderate-vigorous exercise training in patients with coronary heart disease and heart failure. Moreover, this review will propose how varying interval exercise protocols (such as short-duration or long-duration interval training) and exercise progression models may influence central and peripheral physiological adaptations. Importantly, a key focus of this review is to provide clinically-relevant recommendations and strategies to optimize prescription of exercise intensity while maximizing safety in patients attending CR programs.
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Affiliation(s)
- Jenna L Taylor
- Division of Preventative Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
| | - Amanda R Bonikowske
- Division of Preventative Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
| | - Thomas P Olson
- Division of Preventative Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
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Borghi-Ricardo M, Simões RP, Santos DA, Archiza B, Borghi-Silva A. Effects of Aging on Hemodynamic Kinetics in Different Intensities of Dynamic Exercise. Int J Sports Med 2021; 43:61-67. [PMID: 34157777 DOI: 10.1055/a-1487-6628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Healthy aging hemodynamics is known to exhibit a time-dependent loss of function. We aimed at verifying whether older men would have a slowed cardiac output and stroke volume dynamics in response to the onset ("on") and on recovery ("off") of exercise in comparison to young men. Twenty healthy active men (10 young and 10 older) were recruited. Participants performed an incremental cardiopulmonary exercise testing on a cycle ergometer, and on another day, 3 constant workload tests in different intensities. Compared to younger, older men exhibited a slower cardiac output and stroke volume dynamics in both on and off transients for all exercise intensities (all P < 0.05). During higher intensities, both younger and older men had slower hemodynamic kinetics compared to lower intensities (all P < 0.05). There was strong negative relationship between the time constant of cardiac output on-kinetics during high-intensity with maximal exercise performance in both groups (r = -0.88, P < 0.01). We interpret these findings to mean that healthy older men have slowed hemodynamic kinetics compared to younger, but this difference becomes less evident in higher intensities of exercise.
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Affiliation(s)
| | | | - Daniel Augusto Santos
- Department of Physiotherapy, Cardiopulmonary Physiotherapy Laboratory, Nucleus of Research in Physical Exercise, Federal University of Sao Carlos, Sao Carlos, Brazil
| | - Bruno Archiza
- Department of Physiotherapy, Cardiopulmonary Physiotherapy Laboratory, Nucleus of Research in Physical Exercise, Federal University of Sao Carlos, Sao Carlos, Brazil
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High-intensity interval training in cardiac rehabilitation. SPORT SCIENCES FOR HEALTH 2021. [DOI: 10.1007/s11332-021-00731-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Exercise Preconditioning as a Cardioprotective Phenotype. Am J Cardiol 2021; 148:8-15. [PMID: 33675772 DOI: 10.1016/j.amjcard.2021.02.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/11/2021] [Accepted: 02/19/2021] [Indexed: 12/24/2022]
Abstract
Cardiovascular disease (CVD) is potentiated by risk factors including physical inactivity and remains a leading cause of morbidity and mortality. Although regular physical activity does not reverse atherosclerotic coronary disease, precursory exercise improves clinical outcomes in those experiencing life-threatening CVD events. Exercise preconditioning describes the cardioprotective phenotype whereby even a few exercise bouts confer short-term multifaceted protection against acute myocardial infarction. First described decades ago in animal investigations, cardioprotective mechanisms responsible for exercise preconditioning have been identified through reductionist preclinical studies, including the upregulation of endogenous antioxidant enzymes, improved calcium handling, and enhanced bioenergetic regulation during a supply-demand mismatch. Until recently, translation of this research was only inferred from clinically-directed animal models of exercise involving ischemia-reperfusion injury, and reinforced by the gene products of exercise preconditioning that are common to mammalian species. However, recent clinical investigations confirm that exercise preconditions the human heart. This discovery means that simply the initiation of a remedial exercise regimen in those with abnormal CVD risk factor profiles will provide immediate cardioprotective benefits and improved clinical outcomes following acute cardiac events. In conclusion, the prophylactic biochemical adaptations to aerobic exercise are complemented by the long-term adaptive benefits of vascular and architectural remodeling in those who adopt a physically active lifestyle.
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Zhang X, Xu D, Sun G, Jiang Z, Tian J, Shan Q. Effects of high-intensity interval training in patients with coronary artery disease after percutaneous coronary intervention: A systematic review and meta-analysis. Nurs Open 2021; 8:1424-1435. [PMID: 33528117 PMCID: PMC8046134 DOI: 10.1002/nop2.759] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 11/03/2020] [Accepted: 11/23/2020] [Indexed: 12/17/2022] Open
Abstract
AIM To evaluate whether high-intensity interval training (HIIT) was superior to low-intensity training or usual care among patients after percutaneous coronary intervention. The hypothesis was that HIIT would help patients after percutaneous coronary intervention (PCI) improve cardiopulmonary function, lipid profiles and in-stent restenosis. DESIGN A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA)2009 Checklist. METHODS Randomized controlled trials (RCTs) focusing on HIIT programme in patients after PCI were searched in Cochrane Library, Web of Science Core Collection, EMbase, PubMed, China National Knowledge Infrastructure (CNKI) and SinoMed from the inception to 24 March 2020. Standard Mean difference (SMD) and 95% confidence intervals (CI) were performed to summarize the effect sizes. RESULTS Six RCTs (247 patients) met the criteria. HIIT programme had a statistically significant effect on raising left ventricular ejection function (LVEF) (SMD = 0.38, 95%CI [0.03, 0.73], I2 = 3%), VO2peak (SMD = 0.94, 95%CI [0.61, 1.28], I2 = 0%), as well as improving the serum level of high-density lipoprotein (SMD = 0.55, 95%CI [0.06, 1.03], I2 = 0%) and late luminal loss (SMD = -0.65, 95%CI [-1.07, -0.23], I2 = 0%). But HIIT had no prominent effect on improving heart rate (SMD = -0.04, 95%CI [-0.29, 0.21], I2 = 0%). Summarily, HIIT programme appears to be favourable for CAD patients after PCI by improving cardiopulmonary function, such as LVEF and VO2peak , as well as reducing late luminal loss in per stented arteries. Nevertheless, HIIT has no advantage for adjusting heart rate. More researches with rigorous methods are warranted to explore the controversy about lipid profiles.
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Affiliation(s)
- Xinyue Zhang
- Department of CardiologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Dongmei Xu
- Department of CardiologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Guozhen Sun
- Department of CardiologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Zhixin Jiang
- Department of CardiologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Jinping Tian
- Department of CardiologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Qijun Shan
- Department of CardiologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
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Pineda-García AD, Lara-Vargas JA, Ku-González A, Lastra-Silva VJ, Arteaga R, Pineda-Juárez JA. Safety and improvement in exercise tolerance with interval training vs moderate-intensity continuous training in heart disease patient of very high cardiovascular risk. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2021; 91:178-185. [PMID: 33887755 PMCID: PMC8295877 DOI: 10.24875/acm.20000071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Objetivo: Evaluar la seguridad y el efecto del entrenamiento por intervalos de moderada y alta intensidad (EIMI, EIAI) y compararlo con el entrenamiento de intensidad moderada continua (EIMC) en pacientes de riesgo cardiovascular (RCV) muy alto. Método: Estudio cuasi experimental de 81 pacientes que ingresaron al programas de rehabilitación cardíaca y prevención secundaria (PRHCPS); en la estratificación de riesgo, todos los pacientes presentaron ≥ 2 factores de RCV alto. Entrenamiento concurrente: aeróbico supervisado: 2 semanas de entrenamiento de base de EIMC; luego el grupo EIMC con la misma prescripción, EIMI a 3 intervalos de 3’ al 70 a 80% de FCR con pausas activas de 3’ al 60 a 70% de FCR; EIAI, 3 intervalos de 3’ a 80 a 90% de FCR con pausas activas de 3’ al 70 a 80% de FCR, entrenamiento de fuerza con tres sesiones semanales de ejercicios isotónicos y una de calistenia e intervención multidisciplinaria. Resultados: 81 pacientes asignados en tres grupos: 61 a EIMC, 13 a EIMI y 7 a EIAI, sin diferencias significativas en las variables epidemiológicas. Hubo ganancias porcentuales en MET-carga de 45%, 60% y 86% (p = 0.17) y carga-vatios de 51, 44 y 48 en EIMC, EIMI, EIAI, respectivamente (p = 0.54). A pesar de no existir diferencias estocásticamente significativas intergrupales, sí se registró una ganancia mayor en MET-carga en el grupo de EIAI. No se observó desenlace adverso en ningún tipo de entrenamiento. Conclusiones: En cardiópatas de riesgo cardiovascular muy alto, el entrenamiento interválico EIMI/EIAI supervisado es seguro, con tendencia a mayor ganancia en tolerancia al esfuerzo (MET-carga) con el EIAI en comparación con el EIMC.
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Affiliation(s)
- Alfredo D Pineda-García
- Servicio de Rehabilitación Cardíaca, División de Servicios Modulares, Facultad Mexicana de Medicina, Universidad La Salle
| | - Jorge A Lara-Vargas
- Servicio de Rehabilitación Cardíaca, División de Servicios Modulares, Facultad Mexicana de Medicina, Universidad La Salle
| | - Andrés Ku-González
- Servicio de Rehabilitación Cardíaca, División de Servicios Modulares, Facultad Mexicana de Medicina, Universidad La Salle
| | - Víctor J Lastra-Silva
- Servicio de Rehabilitación Cardíaca, División de Servicios Modulares, Facultad Mexicana de Medicina, Universidad La Salle
| | - Rodolfo Arteaga
- Servicio de Rehabilitación Cardíaca, División de Servicios Modulares, Facultad Mexicana de Medicina, Universidad La Salle
| | - Juan A Pineda-Juárez
- Departamento de Investigación Clínica. Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México
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Cheng X, Huang J, Zhu J, Li H, Gu H. Clinical evaluation of high intensity interval training exercise in coronary heart disease patients after percutaneous coronary intervention: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e25472. [PMID: 33832163 PMCID: PMC8036031 DOI: 10.1097/md.0000000000025472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 03/18/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND: Although the effect of high intensity interval training (HIIT) was gradually explicit, little is explored about the role and the validity of HIIT on patients following percutaneous coronary intervention (PCI). As far as we know, no evidence has been established to assess HIIT program for coronary heart disease (CHD) patients attending cardiac rehabilitation after PCI. Therefore, this systematic review and meta-analysis will be conducted to assess the efficacy and safety of HIIT program for CHD patients attending cardiac rehabilitation after PCI. METHODS: Seven electronic databases including Web of Science, Embase, PubMed, Wanfang Data, Scopus, Science Direct, Cochrane Library will be searched in March 2021 by 2 independent reviewers. Study included in this systematic review and meta-analysis has to meet all of the following inclusion criteria in the PICOS order: 1. Participants: CHD patients after PCI; 2. Intervention: patients received HIIT; 3. Comparator: patients received other treatment; 4. Outcomes: cardiopulmonary function, lipid profiles and in- stent restenosis; 5. Study design: cohort trials. Data extraction will be performed independently, and any conflict will be resolved before final analysis. Review Manager software (v 5.3; Cochrane Collaboration) is used for the meta-analysis. RESULTS: The results of this research will be delivered in a peer-reviewed journal. CONCLUSION: This study expects to provide credible and scientific clinical evidence for the efficacy and safety of HIIT program for CHD patients attending cardiac rehabilitation after PCI. OSF REGISTRATION NUMBER: 10.17605/OSF.IO/AUMR6.
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Affiliation(s)
| | - Jian Huang
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Jiangsu, China
| | - Jing Zhu
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Jiangsu, China
| | - Hui Li
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Jiangsu, China
| | - Haibo Gu
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Jiangsu, China
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Dunford EC, Valentino SE, Dubberley J, Oikawa SY, McGlory C, Lonn E, Jung ME, Gibala MJ, Phillips SM, MacDonald MJ. Brief Vigorous Stair Climbing Effectively Improves Cardiorespiratory Fitness in Patients With Coronary Artery Disease: A Randomized Trial. Front Sports Act Living 2021; 3:630912. [PMID: 33665614 PMCID: PMC7921461 DOI: 10.3389/fspor.2021.630912] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/26/2021] [Indexed: 12/19/2022] Open
Abstract
Background: Cardiac rehabilitation exercise reduces the risk of secondary cardiovascular disease. Interval training is a time-efficient alternative to traditional cardiac rehabilitation exercise and stair climbing is an accessible means. We aimed to assess the effectiveness of a high-intensity interval stair climbing intervention on improving cardiorespiratory fitness (V˙O2peak) compared to standard cardiac rehabilitation care. Methods: Twenty participants with coronary artery disease (61 ± 7 years, 18 males, two females) were randomly assigned to either traditional moderate-intensity exercise (TRAD) or high-intensity interval stair climbing (STAIR). V˙O2peak was assessed at baseline, following 4 weeks of six supervised exercise sessions and after 8 weeks of ~24 unsupervised exercise sessions. TRAD involved a minimum of 30 min at 60–80%HRpeak, and STAIR consisted of three bouts of six flights of 12 stairs at a self-selected vigorous intensity (~90 s/bout) separated by recovery periods of walking (~90 s). This study was registered as a clinical trial at clinicaltrials.gov (NCT03235674). Results: Two participants could not complete the trial due to the time commitment of the testing visits, leaving n = 9 in each group who completed the interventions without any adverse events. V˙O2peak increased after supervised and unsupervised training in comparison to baseline for both TRAD [baseline: 22.9 ± 2.5, 4 weeks (supervised): 25.3 ± 4.4, and 12 weeks (unsupervised): 26.5 ± 4.8 mL/kg/min] and STAIR [baseline: 21.4 ± 4.5, 4 weeks (supervised): 23.4 ± 5.6, and 12 weeks (unsupervised): 25 ± 6.2 mL/kg/min; p (time) = 0.03]. During the first 4 weeks of training (supervised) the STAIR vs. TRAD group had a higher %HRpeak (101 ± 1 vs. 89 ± 1%; p ≤ 0.001), across a shorter total exercise time (7.1 ± 0.1 vs. 36.7 ± 1.1 min; p = 0.009). During the subsequent 8 weeks of unsupervised training, %HRpeak was not different (87 ± 8 vs. 96 ± 8%; p = 0.055, mean ± SD) between groups, however, the STAIR group continued to exercise for less time per session (10.0 ± 3.2 vs. 24.2 ± 17.0 min; p = 0.036). Conclusions: Both brief, vigorous stair climbing, and traditional moderate-intensity exercise are effective in increasing V˙O2peak, in cardiac rehabilitation exercise programmes.
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Affiliation(s)
- Emily C Dunford
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | | | | | - Sara Y Oikawa
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Chris McGlory
- School of Kinesiology and Health Studies, Queens University, Kingston, ON, Canada
| | - Eva Lonn
- Hamilton Health Sciences, ON, Canada.,Population Health Research Institute, Hamilton, ON, Canada.,Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Mary E Jung
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
| | - Martin J Gibala
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
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Taylor JL, Holland DJ, Keating SE, Bonikowske AR, Coombes JS. Adherence to High-Intensity Interval Training in Cardiac Rehabilitation: A REVIEW AND RECOMMENDATIONS. J Cardiopulm Rehabil Prev 2021; 41:61-77. [PMID: 33647920 DOI: 10.1097/hcr.0000000000000565] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE High-intensity interval training (HIIT) is gaining popularity as a training approach for patients attending cardiac rehabilitation (CR). While the literature has focused on the efficacy of HIIT for improving cardiorespiratory fitness (CRF), particularly when compared with moderate intensity exercise, less emphasis has been placed on adherence to HIIT. The aim of this review was to summarize the current literature regarding adherence to HIIT in CR patients with coronary artery disease. REVIEW METHODS A review identified 36 studies investigating HIIT in CR patients with coronary artery disease. Methods and data were extracted for exercise or training adherence (to attendance, intensity, and duration), feasibility of protocols, and CRF. The review summarizes reporting of adherence; adherence to HIIT and comparator/s; the influence of adherence on changes in CRF; and feasibility of HIIT. SUMMARY Adherence to the attendance of HIIT sessions was high and comparable with moderate-intensity exercise. However, adherence to the intensity and duration of HIIT was variable and underreported, which has implications for determining the treatment effect of the exercise interventions being compared. Furthermore, additional research is needed to investigate the utility of home-based HIIT and long-term adherence to HIIT following supervised programs. This review provides recommendations for researchers in the measurement and reporting of adherence to HIIT and other exercise interventions to facilitate a sufficient and consistent approach for future studies. This article also highlights strategies for clinicians to improve adherence, feasibility, and enjoyment of HIIT for their patients.
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Affiliation(s)
- Jenna L Taylor
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota (Drs Taylor and Bonikowske); Centre for Research on Exercise, Physical activity, and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia (Drs Taylor, Holland, Keating, and Coombes); and Department of Cardiology, Sunshine Coast University Hospital, Birtinya, Australia (Dr Holland)
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Acute Medical Conditions: Cardiopulmonary Disease, Medical Frailty, and Renal Failure. BRADDOM'S PHYSICAL MEDICINE AND REHABILITATION 2021. [PMCID: PMC7530618 DOI: 10.1016/b978-0-323-62539-5.00027-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Thompson PD, Baggish AL, Franklin B, Jaworski C, Riebe D. American College of Sports Medicine Expert Consensus Statement to Update Recommendations for Screening, Staffing, and Emergency Policies to Prevent Cardiovascular Events at Health Fitness Facilities. Curr Sports Med Rep 2020; 19:223-231. [PMID: 32516193 DOI: 10.1249/jsr.0000000000000721] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
| | - Aaron L Baggish
- Division of Cardiology, Massachusetts General Hospital, Boston, MA
| | - Barry Franklin
- Division of Cardiology, William Beaumont Hospital, Royal Oak, MI
| | - Carrie Jaworski
- Division of Primary Care Sports Medicine, NorthShore University HealthSystem, Glenview, IL
| | - Deborah Riebe
- Department of Kinesiology, University of Rhode Island, Kingston, RI
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Nichols S, McGregor G, Breckon J, Ingle L. Current Insights into Exercise-based Cardiac Rehabilitation in Patients with Coronary Heart Disease and Chronic Heart Failure. Int J Sports Med 2020; 42:19-26. [PMID: 32650344 DOI: 10.1055/a-1198-5573] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Cardiac rehabilitation is a package of lifestyle secondary prevention strategies designed for patients with coronary heart disease and chronic heart failure. A community-based cardiac rehabilitation programme provides patients with a structured exercise training intervention alongside educational support and psychological counselling. This review provides an update regarding the clinical benefits of community-based cardiac rehabilitation from a psycho-physiological perspective, and also focuses on the latest epidemiological evidence regarding potential survival benefits. Behaviour change is key to long-term adoption of a healthy and active lifestyle following a cardiac event. In order for lifestyle interventions such as structured exercise interventions to be adopted by patients, practitioners need to ensure that behaviour change programmes are mapped against patient's priorities and values, and adapted to their level of readiness and intention to engage with the target behaviour. We review the evidence regarding behaviour change strategies for cardiac patients and provide practitioners with the latest guidance. The 'dose' of exercise training delivered to patients attending exercise-based cardiac rehabilitation is an important consideration because an improvement in peak oxygen uptake requires an adequate physiological stimulus to invoke positive physiological adaptation. We conclude by critically reviewing the latest evidence regarding exercise dose for cardiac patients including the role of traditional and more contemporary training interventions including high intensity interval training.
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Affiliation(s)
- Simon Nichols
- Sheffield Hallam University Centre for Sports and Exercise Science, Sheffield, United Kingdom of Great Britain and Northern Ireland
| | - Gordon McGregor
- University Hospital Coventry and Warwickshire National Health Service Trust, Coventry, Coventry University, United Kingdom of Great Britain and Northern Ireland
| | - Jeff Breckon
- Academy of Sport and Physical Activity, Sheffield Hallam University, Sheffield, United Kingdom of Great Britain and Northern Ireland
| | - Lee Ingle
- Department of Sport, Health & Exercise Science, University of Hull, Hull, United Kingdom of Great Britain and Northern Ireland
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Way KL, Vidal-Almela S, Keast ML, Hans H, Pipe AL, Reed JL. The feasibility of implementing high-intensity interval training in cardiac rehabilitation settings: a retrospective analysis. BMC Sports Sci Med Rehabil 2020; 12:38. [PMID: 32612840 PMCID: PMC7325048 DOI: 10.1186/s13102-020-00186-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 06/22/2020] [Indexed: 12/03/2022]
Abstract
Background Cardiovascular disease is the leading cause of death worldwide. Notwithstanding the well-known benefits of cardiac rehabilitation (CR), adherence to CR remains low, particularly in women. High-intensity interval training (HIIT) has received specific attention as an emerging exercise-training paradigm that addresses frequently cited barriers to CR (i.e. lack of motivation/enjoyment and time, perceiving exercise regime as tiring/boring) and improves cardiovascular risk factors. Previous studies have examined the safety of HIIT in CR; there is little evidence on the feasibility of HIIT in CR. The aims of this study were to evaluate the feasibility of HIIT within a CR setting and examine the sex differences regarding the feasibility of such programming. Methods Patients attended an on-site HIIT CR program (10-min warm-up, 25 min of interspersed high-intensity [HI - 4 min at 85–95% HRpeak] and lower intensity [LO - 3 min at 60–70% HRpeak] intervals, 10-min cool-down) twice weekly for 10 weeks. Heart rate (HR) and the Borg rating of perceived exertion (RPE) scale (6–20 points) were recorded at each session. Feasibility was assessed by: [1] attendance and compliance: the number of sessions attended and the compliance to the prescribed HI and LO HR ranges; [2] the patient experience: patients’ perceived effort, program difficulty, if the program was challenging and satisfying; and, [3] safety. Descriptive statistics were used to report the means and their variations. Mann-Whitney U tests and Chi-square analyses were performed to examine sex-differences. Results A total of 151 patients (33% women, 57.5 ± 9.1 years) attended the HIIT program and completed 16 ± 5 classes with a low attrition rate (11.3%). Most patients met or exceeded the prescribed target HR for the HI (80%) and LO (84%) intervals, respectively. Patients reported a “somewhat hard” RPE for HI (14 ± 2 points) and “very light” for LO (10 ± 2 points) intervals. All patients were satisfied with the program and found it challenging. Most patients found HIIT to be difficult (7 ± 2 points, scale range 0–10 points), yet safe (97%). Three vasovagal episodes occurred and more women dropped-out of the program than men (p < 0.01). Conclusions HIIT is a feasible, safe and well-received exercise paradigm in a CR setting.
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Affiliation(s)
- Kimberley L Way
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada
| | - Sol Vidal-Almela
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada.,School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.,Institut du Savoir Montfort, Hôpital Montfort, Ottawa, Canada
| | - Marja-Leena Keast
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada
| | - Harleen Hans
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada
| | - Andrew L Pipe
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Jennifer L Reed
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada.,School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, Canada
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37
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Li WG, Huang Z, Chen T, Zhang XA. A call for universal criteria of high-intensity interval training in cardiac rehabilitation. Eur J Prev Cardiol 2020; 28:e30-e32. [PMID: 32484051 DOI: 10.1177/2047487320927618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 04/28/2020] [Indexed: 12/25/2022]
Affiliation(s)
- Wei-guang Li
- Cardiology of Department, Liaoning Province Jinqiu Hospital, Liaoning, Shenyang, China
- College of Kinesiology, Shenyang Sport University, Liaoning, Shenyang, China
| | - Zheng Huang
- Cardiology of Department, Liaoning Province Jinqiu Hospital, Liaoning, Shenyang, China
| | - Tao Chen
- Liaoning Institute of Sports Science, Liaoning, Shenyang, China
| | - Xin-an Zhang
- College of Kinesiology, Shenyang Sport University, Liaoning, Shenyang, China
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38
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Franklin BA, Thompson PD, Al-Zaiti SS, Albert CM, Hivert MF, Levine BD, Lobelo F, Madan K, Sharrief AZ, Eijsvogels TMH. Exercise-Related Acute Cardiovascular Events and Potential Deleterious Adaptations Following Long-Term Exercise Training: Placing the Risks Into Perspective-An Update: A Scientific Statement From the American Heart Association. Circulation 2020; 141:e705-e736. [PMID: 32100573 DOI: 10.1161/cir.0000000000000749] [Citation(s) in RCA: 160] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Epidemiological and biological plausibility studies support a cause-and-effect relationship between increased levels of physical activity or cardiorespiratory fitness and reduced coronary heart disease events. These data, plus the well-documented anti-aging effects of exercise, have likely contributed to the escalating numbers of adults who have embraced the notion that "more exercise is better." As a result, worldwide participation in endurance training, competitive long distance endurance events, and high-intensity interval training has increased markedly since the previous American Heart Association statement on exercise risk. On the other hand, vigorous physical activity, particularly when performed by unfit individuals, can acutely increase the risk of sudden cardiac death and acute myocardial infarction in susceptible people. Recent studies have also shown that large exercise volumes and vigorous intensities are both associated with potential cardiac maladaptations, including accelerated coronary artery calcification, exercise-induced cardiac biomarker release, myocardial fibrosis, and atrial fibrillation. The relationship between these maladaptive responses and physical activity often forms a U- or reverse J-shaped dose-response curve. This scientific statement discusses the cardiovascular and health implications for moderate to vigorous physical activity, as well as high-volume, high-intensity exercise regimens, based on current understanding of the associated risks and benefits. The goal is to provide healthcare professionals with updated information to advise patients on appropriate preparticipation screening and the benefits and risks of physical activity or physical exertion in varied environments and during competitive events.
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Zhao J, Wang Y, Zhao D, Zhang L, Chen P, Xu X. Integration of metabolomics and proteomics to reveal the metabolic characteristics of high-intensity interval training. Analyst 2020; 145:6500-6510. [DOI: 10.1039/d0an01287d] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Metabolomics and proteomics were integrated to research the molecular characterization of high-intensity interval training, revealing changes in biological pathways.
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Affiliation(s)
- Jingjing Zhao
- Shanghai anti-doping laboratory
- Shanghai University of Sport
- Shanghai
- China
| | - Yang Wang
- Shanghai anti-doping laboratory
- Shanghai University of Sport
- Shanghai
- China
| | - Dan Zhao
- Shanghai anti-doping laboratory
- Shanghai University of Sport
- Shanghai
- China
| | - Lizhen Zhang
- Shanghai anti-doping laboratory
- Shanghai University of Sport
- Shanghai
- China
| | - Peijie Chen
- Shanghai anti-doping laboratory
- Shanghai University of Sport
- Shanghai
- China
| | - Xin Xu
- Shanghai anti-doping laboratory
- Shanghai University of Sport
- Shanghai
- China
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Pengelly J, Pengelly M, Lin KY, Royse C, Karri R, Royse A, Bryant A, Williams G, El-Ansary D. Exercise Parameters and Outcome Measures Used in Cardiac Rehabilitation Programs Following Median Sternotomy in the Elderly: A Systematic Review and Meta-Analysis. Heart Lung Circ 2019; 28:1560-1570. [PMID: 31176628 DOI: 10.1016/j.hlc.2019.05.098] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 04/04/2019] [Accepted: 05/03/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The aim of this systematic review was to identify exercise parameters and outcome measures used in cardiac rehabilitation programs following median sternotomy, in the elderly cardiac population. DATA SOURCES Five (5) electronic databases were searched for relevant studies published in English after 1997. STUDY SELECTION The screening process was completed by two independent researchers, with a third independent reviewer for overall agreement. Studies were selected if they included only cardiac patients aged ≥65 years who had undergone valve surgery and/or coronary artery bypass grafting via median sternotomy, and who had undertaken a postoperative cardiac rehabilitation exercise intervention assessing physical function and/or cognitive recovery as outcomes. DATA EXTRACTION Two researchers independently completed the data extraction and quality assessment. Quality was assessed using a modified Downs and Black tool. DATA SYNTHESIS In total, 11 articles were included for appraisal with respect to the quality of the study. Only two randomised controlled trials were suitable for meta-analysis. A higher volume of exercise was shown to have a positive effect on functional recovery, assessed using the 6-minute walk test (6MWT) (mean difference=26.97m; 95% confidence interval [CI], 6.96-46.97; p=0.008; I2=0%). No significant improvement was shown between additional exercise compared to standard care in improving VO2peak, maximal power output or quality of life. No studies evaluated the effect of exercise on cognitive recovery. CONCLUSIONS Exercise significantly improves functional recovery in the post-surgical elderly cardiac population, however uncertainty still exists with regard to which modes of exercise and their specific parameters are most effective in improving cognitive recovery.
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Affiliation(s)
- Jacqueline Pengelly
- Department of Health Professions, Swinburne University of Technology, Melbourne, Vic, Australia.
| | | | - Kuan-Yin Lin
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Vic, Australia
| | - Colin Royse
- Department of Health Professions, Swinburne University of Technology, Melbourne, Vic, Australia; Department of Surgery, University of Melbourne, Melbourne, Vic, Australia; Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, Vic, Australia
| | - Roshan Karri
- Department of Surgery, University of Melbourne, Melbourne, Vic, Australia
| | - Alistair Royse
- Department of Health Professions, Swinburne University of Technology, Melbourne, Vic, Australia; Department of Surgery, University of Melbourne, Melbourne, Vic, Australia; Department of Cardiothoracic Surgery, Royal Melbourne Hospital, Melbourne, Vic, Australia
| | - Adam Bryant
- Department of Physiotherapy, University of Melbourne, Melbourne, Vic, Australia
| | - Gavin Williams
- Department of Physiotherapy, University of Melbourne, Melbourne, Vic, Australia
| | - Doa El-Ansary
- Department of Health Professions, Swinburne University of Technology, Melbourne, Vic, Australia; Department of Surgery, University of Melbourne, Melbourne, Vic, Australia
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