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Klophaus N, Wehmeier UF, Forstner J, Jansen A, Probst H, Grüter S, Hilberg T. The Impact of Medical Face Masks and Rehabilitation Duration on the Performance Output and Outcomes of Cardiologic Rehabilitants. J Clin Med 2024; 13:1086. [PMID: 38398399 PMCID: PMC10889284 DOI: 10.3390/jcm13041086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/19/2024] [Accepted: 02/08/2024] [Indexed: 02/25/2024] Open
Abstract
During the COVID-19 pandemic, wearing a medical face mask became mandatory in daily life and also in cardiological rehabilitation. In order to investigate whether the performance and outcomes of cardiological rehabilitation were affected by face masks, we compared data from patients who underwent rehabilitation with face masks with data from patients without face masks. In total, 114 patients from an ambulant rehabilitation center were included. Of them, 60 patients completed rehabilitation without a face mask (NFM). In contrast, 54 patients (with a face mask, WFM) completed their rehabilitation during the COVID-19 pandemic and had to wear medical face masks for the entire day and also during ergometer training or other interventions. Subgroups were formed with patients who accepted to extend rehabilitation for one week (4 WG); the other patients only completed 3-week rehabilitation (3 WG). We analyzed the performance and outcomes of all groups (NFM; WFM, 3 WG and 4 WG). At baseline, no group differences were detected. All groups significantly improved their power output and heart rate recovery, without any group differences. We conclude that face masks and also an additional rehabilitation week do not affect the exercise performance or outcomes of out-house cardiological rehabilitation.
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Affiliation(s)
- Nils Klophaus
- Department of Sports Medicine, University of Wuppertal, Moritzstr. 14, 42117 Wuppertal, Germany; (N.K.); (T.H.)
- Cardiowell, Arrenberger Str. 20, 42117 Wuppertal, Germany
| | - Udo F. Wehmeier
- Department of Sports Medicine, University of Wuppertal, Moritzstr. 14, 42117 Wuppertal, Germany; (N.K.); (T.H.)
| | - Julia Forstner
- Department of Sports Medicine, University of Wuppertal, Moritzstr. 14, 42117 Wuppertal, Germany; (N.K.); (T.H.)
| | - Armin Jansen
- Cardiowell, Arrenberger Str. 20, 42117 Wuppertal, Germany
| | - Herbert Probst
- Cardiowell, Arrenberger Str. 20, 42117 Wuppertal, Germany
| | - Stephan Grüter
- Cardiowell, Arrenberger Str. 20, 42117 Wuppertal, Germany
| | - Thomas Hilberg
- Department of Sports Medicine, University of Wuppertal, Moritzstr. 14, 42117 Wuppertal, Germany; (N.K.); (T.H.)
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2
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Jaafar Z, Lim YZ. A comparison of low and high dose of moderate intensity aerobic exercise on heart rate recovery of the sedentary adults: a pragmatic randomized controlled trial. J Sports Med Phys Fitness 2023; 63:310-318. [PMID: 35620954 DOI: 10.23736/s0022-4707.22.13958-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Heart rate recovery (HRR) has been used as a prognostication marker of health. A slower drop in HRR is linked to a higher risk of cardiovascular diseases and all-cause mortality. Since aerobic exercise has been shown to have favorable effects on HRR, we aimed to compare the effects of two different aerobic exercise doses on HRR among a sedentary adult population. METHODS A pragmatic randomised controlled trial was conducted on 29 healthy sedentary adults (seven males and 22 females) in a 12-week exercise program. They were randomly assigned to group A (75 min/week, N.=15) or group B (150 min/week, N.=14) of moderate intensity aerobic exercise groups. HRR at 1-minute (HRR1), HRR at 2-minute (HRR2), and peak oxygen uptake (VO<inf>2peak</inf>) were measured pre- and post-intervention. RESULTS The improvements of HRR1 and HRR2 were seen in both groups but was only significant (P<0.05) for group A with HRR1, -4.07 bpm (post 24.47±6.42 - pre 20.40±5.51, P=0.018) and HHR2, -3.93 bpm (post 43.40±13.61 - pre 39.47±10.68, P=0.046). Group B showed increment of HRR1, -1.14 bpm (post 21.14±5.35 - pre 20.00±6.30, P=0.286) and HRR2, -2.5 bpm, (post 39.36±8.01 - pre 36.86±9.57, P=0.221). Improvement of the VO<inf>2peak</inf> was only significant in group B with an increment of 1.52±2.61 (P=0.049). CONCLUSIONS In conclusion, our study suggests that improvements in heart rate recovery (HRR1 and HRR2) among sedentary healthy adults can be achieved by engaging in moderate intensity exercise at a dose lower than the current recommended guidelines. The lower dose seems to be more attainable and may encourage exercise compliance. Future studies should further explore the effects of different exercise volumes on HRR in a larger sample size and also by controlling for BMI or gender.
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Affiliation(s)
- Zulkarnain Jaafar
- Sports Medicine Unit, Faculty of Medicine, Malaya University, Kuala Lumpur, Malaysia - .,Sports and Exercise Medicine Research and Education Group, Faculty of Medicine, Malaya University, Kuala Lumpur, Malaysia -
| | - Yi Z Lim
- Sports Medicine Unit, Faculty of Medicine, Malaya University, Kuala Lumpur, Malaysia
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3
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Aztatzi-Aguilar OG, Vargas-Domínguez C, Debray-Garcia Y, Ortega-Romero MS, Almeda-Valdés P, Aguilar-Salinas CA, Naranjo-Meneses MA, Mena-Orozco DA, Lam-Chung CE, Cruz-Bautista I, Sierra-Vargas MP. Biochemical and Hematological Relationship with the Evaluation of Autonomic Dysfunction by Heart Rate Recovery in Patients with Asthma and Type 2 Diabetes. Diagnostics (Basel) 2021; 11:diagnostics11122187. [PMID: 34943423 PMCID: PMC8699903 DOI: 10.3390/diagnostics11122187] [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: 08/30/2021] [Revised: 10/30/2021] [Accepted: 11/11/2021] [Indexed: 11/16/2022] Open
Abstract
There are several methods to assess the function of the autonomic nervous system. Among them, heart rate recovery (HRR) is an accepted, easy, low-cost technique. Different pathological conditions have been related to the development of autonomic dysfunction. Our study aimed to evaluate the relationship between HRR and HRR-derived parameters in ambulatory patients with asthma or type 2 diabetes followed at the National Institutes of Health in Mexico City. A total of 78 participants, 50 women and, 28 men were enrolled; anthropometric, respiratory evaluations, and fasting blood samples were taken before participants performed a 6-min walking test (6MWT). Abnormal HRR was defined as a drop of ≤8 and ≤11 beats/min at 1 or 2 min and correlated negatively with basal oxygen saturation at 1 min. Heart rate at 1 min, correlated negatively with final oxygen saturation (p < 0.01). Statistically significant negative correlations were also observed between red cell count and white blood cell count and HOMA-IR with a p < 0.01. Since discrete hematological but significant changes correlated with HRR and HRR-derived parameters, we consider that these measures are helpful in clinical settings to identify subclinical autonomic dysfunction that permits us to prevent or anticipate chronic and fatal clinical outcomes.
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Affiliation(s)
- O. Gamaliel Aztatzi-Aguilar
- Departamento de Investigación en Toxicología y Medicina Ambiental, Instituto de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México 14080, Mexico; (O.G.A.-A.); (C.V.-D.); (Y.D.-G.); (M.S.O.-R.)
| | - Claudia Vargas-Domínguez
- Departamento de Investigación en Toxicología y Medicina Ambiental, Instituto de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México 14080, Mexico; (O.G.A.-A.); (C.V.-D.); (Y.D.-G.); (M.S.O.-R.)
| | - Yazmin Debray-Garcia
- Departamento de Investigación en Toxicología y Medicina Ambiental, Instituto de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México 14080, Mexico; (O.G.A.-A.); (C.V.-D.); (Y.D.-G.); (M.S.O.-R.)
| | - Manolo S. Ortega-Romero
- Departamento de Investigación en Toxicología y Medicina Ambiental, Instituto de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México 14080, Mexico; (O.G.A.-A.); (C.V.-D.); (Y.D.-G.); (M.S.O.-R.)
- Centro de Investigación y de Estudios Avanzados, Instituto Politécnico Nacional, Ciudad de México 07360, Mexico
| | - Paloma Almeda-Valdés
- Unidad de Investigación en Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México 14080, Mexico; (P.A.-V.); (C.A.A.-S.); (M.A.N.-M.); (D.A.M.-O.); (C.E.L.-C.); (I.C.-B.)
| | - Carlos A. Aguilar-Salinas
- Unidad de Investigación en Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México 14080, Mexico; (P.A.-V.); (C.A.A.-S.); (M.A.N.-M.); (D.A.M.-O.); (C.E.L.-C.); (I.C.-B.)
| | - M. Augusta Naranjo-Meneses
- Unidad de Investigación en Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México 14080, Mexico; (P.A.-V.); (C.A.A.-S.); (M.A.N.-M.); (D.A.M.-O.); (C.E.L.-C.); (I.C.-B.)
| | - D. Abril Mena-Orozco
- Unidad de Investigación en Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México 14080, Mexico; (P.A.-V.); (C.A.A.-S.); (M.A.N.-M.); (D.A.M.-O.); (C.E.L.-C.); (I.C.-B.)
| | - César E. Lam-Chung
- Unidad de Investigación en Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México 14080, Mexico; (P.A.-V.); (C.A.A.-S.); (M.A.N.-M.); (D.A.M.-O.); (C.E.L.-C.); (I.C.-B.)
| | - Ivette Cruz-Bautista
- Unidad de Investigación en Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México 14080, Mexico; (P.A.-V.); (C.A.A.-S.); (M.A.N.-M.); (D.A.M.-O.); (C.E.L.-C.); (I.C.-B.)
| | - M. Patricia Sierra-Vargas
- Subdirección de Investigación Clínica, Instituto de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México 14080, Mexico
- Facultad Mexicana de Medicina, Universidad La Salle, Ciudad de México 14000, Mexico
- Correspondence:
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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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Reer M, Rauschenberg S, Hottenrott K, Schwesig R, Heinze V, Huta D, Schwark N, Schlitt A. Comparison between bicycle ergometric interval and continuous training in patients early after coronary artery bypass grafting: A prospective, randomized study. SAGE Open Med 2021; 9:20503121211038202. [PMID: 34394935 PMCID: PMC8358495 DOI: 10.1177/20503121211038202] [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: 10/14/2020] [Accepted: 07/21/2021] [Indexed: 12/04/2022] Open
Abstract
Objectives: Continuous and interval training have previously been compared in patients with cardiac diseases. However, data comparing the safety and effectiveness of the two exercise methods are lacking in patients early after coronary artery bypass grafting. Methods: In all, 120 patients were prospectively randomized in a 1:1 fashion approximately 17 days after coronary artery bypass grafting to an interval group or continuous group. All patients participated in bicycle ergometric training six times/week for 20 min each during a 3-week inpatient rehabilitation program. The combined primary endpoint was safety as defined by incidence of scar pain and cardiac events related to the exercise intervention. Secondary outcomes included the effect of the interventions on parameters such as heart rate and peak power output. Results: Four patients (12.1%) in the interval group reported pain on the saphenectomy scar as a result of the training intervention in comparison to six patients (20.0%) in the continuous group (χ2 (1, n = 63) = 0.73, p = 0.393). No cardiac events were related to exercise intervention. No effect on heart rate was found during the intervention, nor was a difference observed between the groups. Peak power output, as one of the analyzed markers, improved significantly in both groups, but no differences were found between groups. Conclusion: Ergometry training performed as interval or continuous training was safe and effective regarding increase in physical fitness early after coronary artery bypass grafting in an inpatient rehabilitation setting, with no differences observed between the groups.
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Affiliation(s)
- Marco Reer
- Paracelsus-Harz Clinic, Quedlinburg, Germany
| | | | - Kuno Hottenrott
- Institute of Sports Science, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Rene Schwesig
- Department of Orthopedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | | | - Dana Huta
- Paracelsus-Harz Clinic, Quedlinburg, Germany
| | - Nadja Schwark
- Martin-Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Axel Schlitt
- Paracelsus-Harz Clinic, Quedlinburg, Germany.,Martin-Luther University Halle-Wittenberg, Halle (Saale), Germany
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6
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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: 14] [Impact Index Per Article: 4.7] [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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Eser P, Jaeger E, Marcin T, Herzig D, Trachsel L, Wilhelm M. Acute and chronic effects of high-intensity interval and moderate-intensity continuous exercise on heart rate and its variability after recent myocardial infarction: A randomized controlled trial. Ann Phys Rehabil Med 2020; 65:101444. [DOI: 10.1016/j.rehab.2020.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/25/2020] [Accepted: 09/11/2020] [Indexed: 10/23/2022]
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8
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Rodrigues JAL, Philbois SV, de Paula Facioli T, Gastaldi AC, de Souza HCD. Should Heartbeats/Training Session Be Considered When Comparing the Cardiovascular Benefits of High-Intensity Interval Aerobic and Moderate-Intensity Continuous Training? A Critical Appraisal. SPORTS MEDICINE-OPEN 2020; 6:29. [PMID: 32671632 PMCID: PMC7363749 DOI: 10.1186/s40798-020-00257-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 06/30/2020] [Indexed: 11/10/2022]
Abstract
The prescription of physical training as a therapeutic measure in the treatment and control of chronic degenerative diseases, mainly cardiovascular disease and metabolic disease, is an increasingly used clinical approach, often preceding the pharmacological prescription. Despite the advances in exercise physiology and cardio functional performance in recent decades, the main challenge is to identify the most appropriate modality, intensity, and training volume for each pathophysiological situation. In this case, the superiority of high-intensity interval training (HIIT) over moderate-intensity continuous training (MICT) has been questioned, since many studies have shown similar results in the different physiological parameters evaluated, especially regarding cardiorespiratory fitness, cardiovascular autonomic control, and cardiac morpho functionality. The cause of conflicting results observed by different studies may be related to standardization, application, and comparison of the two protocols. HIIT would have a higher number of heartbeats compared to MICT, when maintaining high heart rate is disregarded. In this since, our hypothesis for the greatest gains in cardiorespiratory fitness and in the autonomic and cardiovascular adaptations promoted by HIIT is based on the higher volume of training performed as a function of the higher number of heartbeats per unit of time, since the intermittence was calculated based on a percentage of maximum heart rate or reserve heart rate. Nevertheless, the intermittency between the established heart rate percentages is not necessarily accompanied by the intermittent heart rate. Therefore, considering and matching the number of heartbeats performed per training session in both models seems to be a more appropriate way to compare the two training protocols.
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Affiliation(s)
- Jhennyfer Aline Lima Rodrigues
- Department of Health Sciences, Exercise Physiology Laboratory, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900 - Vila Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Stella Vieira Philbois
- Department of Health Sciences, Exercise Physiology Laboratory, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900 - Vila Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Tábata de Paula Facioli
- Department of Health Sciences, Exercise Physiology Laboratory, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900 - Vila Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Ada Clarice Gastaldi
- Department of Health Sciences, Exercise Physiology Laboratory, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900 - Vila Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Hugo Celso Dutra de Souza
- Department of Health Sciences, Exercise Physiology Laboratory, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900 - Vila Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil.
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Comparative Effects of High-Intensity Interval Training vs Moderate-Intensity Continuous Training in Phase III of a Tennis-Based Cardiac Rehabilitation Program: A Pilot Randomized Controlled Trial. SUSTAINABILITY 2020. [DOI: 10.3390/su12104134] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of the present study was to investigate the effects of two tennis-based cardiac rehabilitation programs using two protocols: high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) in the body composition, physical fitness, heart rate variability, and health-related quality of life. It was performed as a single-blinded randomized controlled trial of 21 people with acute coronary syndrome. The 12-week cardiac rehabilitation program consisted of three sessions per week of 60 min with the main part consisting of 10 sets of 15 s with 15 s of active recovery at 85%–90% of their maximum heart rate or 40 min at 70%–85% of their maximum heart rate in the HIIT and the MICT groups, respectively. Results show that both cardiac rehabilitation programs improved the agility and the mental components of the health-related quality of life (p-value < 0.05). The HIIT protocol also showed a significant improvement in the flexibility of upper and lower limbs (p-value < 0.05). Moreover, significant group × time interaction was found in the handgrip strength in favor of the HIIT group (p-value = 0.035). Nevertheless, no significant effects on cardiorespiratory fitness or heart rate variability were found. Importantly, no adverse event was detected, so HIIT appears to be a safe and effective alternative for the rehabilitation of patients with acute coronary syndrome.
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Exercise-based cardiac rehabilitation and parasympathetic function in patients with coronary artery disease: a systematic review and meta-analysis. Clin Auton Res 2020; 31:187-203. [PMID: 32270406 DOI: 10.1007/s10286-020-00687-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/24/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE The effects of exercise-based cardiac rehabilitation (CR) on parasympathetic modulation are controversial. This systematic review and meta-analysis aims to (a) determine the effect of exercise-based CR on heart-rate-derived indices associated with cardiac parasympathetic modulation in resting and post-exercise conditions in coronary artery disease (CAD) patients and (b) identify the possible moderator variables of the effect of exercise-based CR on parasympathetic modulation. METHODS We searched CENTRAL and Web of Science up to November 2018 for the following terms: adult CAD patients, controlled exercise-based CR interventions and parasympathetic modulation measured in resting (vagal-related heart rate variability [HRV] indices of the root mean square of the differences in successive in RR interval [RMSSD] and high frequency [HF]) and post-exercise (heart rate recovery [HRR]) pre- and post-intervention. We estimated a random-effects model of standardised mean difference (SMD) and mean difference (MD) for vagal-related HRV indices and HRR, respectively. We assessed the influence of categorical and continuous variables. RESULTS The overall effect size showed significant differences in RMSSD (SMD+ = 0.30; 95% confidence interval [CI] = 0.12-0.49) and HRR (MD+ = 5.35; 95% CI = 4.08-6.61 bpm) in favour of the exercise-based CR group. The overall effect size showed no differences in HF between groups (SMD+ = 0.14; 95% CI, -0.12-0.40). Heterogeneity analyses reached statistical significance, with high heterogeneity for HF (p < 0.001; I2 = 70%) and HRR (p < 0.001; I2 = 85%). Analysis of the moderator variables showed that the effect on HRR is greater in young patients (p = 0.008) and patients treated with percutaneous intervention (p = 0.020). CONCLUSIONS Exercise-based CR improves the post-exercise parasympathetic function, with greater effects in younger CAD patients and in those who were revascularised with percutaneous intervention. The effects on resting parasympathetic function are more controversial due to methodological inconsistencies in measuring HRV, with the use of RMSSD recommended instead of HF because its results show higher consistency. Future studies involving women, focusing on methodological issues, and performing other training methods are needed to increase our knowledge about this topic.
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High-Intensity Interval Versus Moderate-Intensity Continuous Training in Individuals With Parkinson's Disease: Hemodynamic and Functional Adaptation. J Phys Act Health 2020; 17:85-91. [PMID: 31810064 DOI: 10.1123/jpah.2018-0588] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 08/20/2019] [Accepted: 10/07/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE To investigate the effect of high-intensity interval training (HIIT) versus moderate-intensity continuous exercise training (MICE) on hemodynamic and functional variables in individuals with Parkinson's disease. METHODS Twenty participants (13 men) were randomly assigned to a thrice-weekly HIIT (n = 12) or MICE (n = 8) for 12 weeks. Hemodynamic (resting heart rate and blood pressure, carotid femoral pulse wave velocity, endothelial reactivity, and heart rate variability) and functional variables (5-time sit-to-stand, timed up and go, and 6-min walking tests) assessed before and after training. RESULTS Demographic, hemodynamic and functional variables were similar between groups at baseline. Endothelial reactivity tended to increase after HIIT, but not after MICE, resulting in improved level (∼8%, P < .01) of this variable in HIIT versus MICE during follow-up. Six-minute walking test improved after HIIT (10.4 ± 3.8%, P < .05), but did not change after MICE. Sit to stand improved similarly after HIIT (27.2 ± 6.1%, P < .05) and MICE (21.5 ± 5.4%, P < .05). No significant changes were found after HIIT or MICE in any other variable assessed. CONCLUSION These results suggest that exercise intensity may influence training-induced adaptation on endothelial reactivity and aerobic capacity in individuals with Parkinson's disease.
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Badrov MB, Wood KN, Lalande S, Sawicki CP, Borrell LJ, Barron CC, Vording JL, Fleischhauer A, Suskin N, McGowan CL, Shoemaker JK. Effects of 6 Months of Exercise-Based Cardiac Rehabilitation on Autonomic Function and Neuro-Cardiovascular Stress Reactivity in Coronary Artery Disease Patients. J Am Heart Assoc 2019; 8:e012257. [PMID: 31438760 PMCID: PMC6755845 DOI: 10.1161/jaha.119.012257] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 05/28/2019] [Indexed: 11/16/2022]
Abstract
Background Autonomic dysregulation represents a hallmark of coronary artery disease (CAD). Therefore, we investigated the effects of exercise-based cardiac rehabilitation (CR) on autonomic function and neuro-cardiovascular stress reactivity in CAD patients. Methods and Results Twenty-two CAD patients (4 women; 62±8 years) were studied before and following 6 months of aerobic- and resistance-training-based CR. Twenty-two similarly aged, healthy individuals (CTRL; 7 women; 62±11 years) served as controls. We measured blood pressure, muscle sympathetic nerve activity, heart rate, heart rate variability (linear and nonlinear), and cardiovagal (sequence method) and sympathetic (linear relationship between burst incidence and diastolic blood pressure) baroreflex sensitivity during supine rest. Furthermore, neuro-cardiovascular reactivity during short-duration static handgrip (20s) at 40% maximal effort was evaluated. Six months of CR lowered resting blood pressure (P<0.05), as well as muscle sympathetic nerve activity burst frequency (48±8 to 39±11 bursts/min; P<0.001) and burst incidence (81±7 to 66±17 bursts/100 heartbeats; P<0.001), to levels that matched CTRL and improved sympathetic baroreflex sensitivity in CAD patients (P<0.01). Heart rate variability (all P>0.05) and cardiovagal baroreflex sensitivity (P=0.11) were unchanged following CR, yet values were not different pre-CR from CTRL (all P>0.05). Furthermore, before CR, CAD patients displayed greater blood pressure and muscle sympathetic nerve activity reactivity to static handgrip versus CTRL (all P<0.05); yet, responses were reduced following CR (all P<0.05) to levels observed in CTRL. Conclusions Six months of exercise-based CR was associated with marked improvement in baseline autonomic function and neuro-cardiovascular stress reactivity in CAD patients, which may play a role in the reduced cardiac risk and improved survival observed in patients following exercise training.
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Affiliation(s)
- Mark B. Badrov
- School of KinesiologyWestern UniversityLondonOntarioCanada
| | | | - Sophie Lalande
- School of KinesiologyWestern UniversityLondonOntarioCanada
| | | | | | | | | | | | - Neville Suskin
- Cardiac Rehabilitation and Secondary Prevention Program of St. Joseph's Health Care LondonLondonOntarioCanada
- Department of Medicine (Cardiology) and Program of Experimental MedicineWestern UniversityLondonOntarioCanada
| | - Cheri L. McGowan
- School of KinesiologyWestern UniversityLondonOntarioCanada
- Department of KinesiologyUniversity of WindsorWindsorOntarioCanada
| | - J. Kevin Shoemaker
- School of KinesiologyWestern UniversityLondonOntarioCanada
- Department of Physiology and PharmacologyWestern UniversityLondonOntarioCanada
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Effects of interval training on risk markers for arrhythmic death: a randomized controlled trial. Clin Rehabil 2019; 33:1320-1330. [DOI: 10.1177/0269215519840388] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Objective: To compare the effects of high-intensity interval training versus moderate-intensity continuous training on risk markers of arrhythmic death in patients who recently suffered from an acute coronary syndrome. Design: Double-blind (patient and evaluator) randomized controlled trial. Setting: Cardiovascular Prevention and Rehabilitation Centre (EPIC Centre) of the Montreal Heart Institute, Montreal, Canada. Subjects: A total of 43 patients were randomized following an acute coronary syndrome. Interventions: Patients were assigned to either high-intensity interval training (n = 18) or isocaloric moderate-intensity continuous training (n = 19), three times a week for a total of 36 sessions. Main measures: Heart rate recovery for 5 minutes, heart rate variability for 24 hours, occurrence of ventricular arrhythmias, and QT dispersion were measured before and after the 36 sessions of training. Results: Among the 43 patients randomized, 6 participants in the high-intensity interval training group stopped training for reasons unrelated to exercise training and were excluded from the analyses. Heart rate recovery improved solely in the high-intensity interval training group, particularly at the end of recovery period ( p < 0.05). There were no differences in heart rate variability, occurrence of ventricular arrhythmias, or QT dispersion parameters between the groups at study end. Conclusion: Despite the lack of power to detect any large difference between the two interventions with respect to risk markers of arrhythmic death, high-intensity interval training appears safe and may be more effective at improving heart rate recovery relative to moderate-intensity continuous training in our patients following acute coronary syndrome.
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Pattyn N, Beulque R, Cornelissen V. Aerobic Interval vs. Continuous Training in Patients with Coronary Artery Disease or Heart Failure: An Updated Systematic Review and Meta-Analysis with a Focus on Secondary Outcomes. Sports Med 2018; 48:1189-1205. [PMID: 29502328 DOI: 10.1007/s40279-018-0885-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND In a previous meta-analysis including nine trials comparing aerobic interval training with aerobic continuous training in patients with coronary artery disease, we found a significant difference in peak oxygen uptake favoring aerobic interval training. OBJECTIVE The objective of this study was to (1) update the original meta-analysis focussing on peak oxygen uptake and (2) evaluate the effect on secondary outcomes. METHODS We conducted a systematic review with a meta-analysis by searching PubMed and SPORTDiscus databases up to March 2017. We included randomized trials comparing aerobic interval training and aerobic continuous training in patients with coronary artery disease or chronic heart failure. The primary outcome was change in peak oxygen uptake. Secondary outcomes included cardiorespiratory parameters, cardiovascular risk factors, cardiac and vascular function, and quality of life. RESULTS Twenty-four papers were identified (n = 1080; mean age 60.7 ± 10.7 years). Aerobic interval training resulted in a higher increase in peak oxygen uptake compared with aerobic continuous training in all patients (1.40 mL/kg/min; p < 0.001), and in the subgroups of patients with coronary artery disease (1.25 mL/kg/min; p = 0.001) and patients with chronic heart failure with reduced ejection fraction (1.46 mL/kg/min; p = 0.03). Moreover, a larger increase of the first ventilatory threshold and peak heart rate was observed after aerobic interval training in all patients. Other cardiorespiratory parameters, cardiovascular risk factors, and quality of life were equally affected. CONCLUSION This meta-analysis adds further evidence to the clinically significant larger increase in peak oxygen uptake following aerobic interval training vs. aerobic continuous training in patients with coronary artery disease and chronic heart failure. More well-designed randomized controlled trials are needed to establish the safety of aerobic interval training and the sustainability of the training response over longer periods.
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Affiliation(s)
- Nele Pattyn
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium. .,Department of Cardiology, KU Leuven, Leuven, Belgium.
| | - Randy Beulque
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
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Abreu RMD, Rehder-Santos P, Simões RP, Catai AM. Can high-intensity interval training change cardiac autonomic control? A systematic review. Braz J Phys Ther 2018; 23:279-289. [PMID: 30293954 DOI: 10.1016/j.bjpt.2018.09.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 09/13/2018] [Accepted: 09/21/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND High intensity interval training (HIIT) has been used as a cardiovascular exercise strategy to promote greater adherence in cardiovascular rehabilitation. However, little is known about the effect of this training modality on cardiac autonomic control. OBJECTIVE To perform a systematic review to evaluate the effects of HIIT on cardiac autonomic responses in humans. METHODS PEDro, SCOPUS and PubMed were searched from the inception to March 29th, 2018. Moreover, the methodological quality and statistical reporting from all eligible clinical trials were assessed by the PEDro scale. The articles were eligible if: The primary objective was related to the effects of HIIT on the cardiac autonomic nervous system. Outcomes evaluated were indirect measures of cardiac autonomic control, represented by HRV indexes. RESULTS The search strategies resulted in 339 citations and 2 additional citations were identified through other sources. After deleting the duplicate articles and revising the full text, 6 articles were included. Overall, the results showed an improvement in parasympathetic and/or sympathetic modulation after HIIT, when evaluated by linear and non-linear indexes of HRV. CONCLUSIONS HIIT is a promising tool to improve the cardiac autonomic control, with more recommendation in healthy individuals and patients with metabolic syndrome.
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Affiliation(s)
- Raphael Martins de Abreu
- Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Universidade Federal de Sao Carlos (UFSCar), São Carlos, SP, Brazil
| | - Patrícia Rehder-Santos
- Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Universidade Federal de Sao Carlos (UFSCar), São Carlos, SP, Brazil
| | - Rodrigo Polaquini Simões
- Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Universidade Federal de Sao Carlos (UFSCar), São Carlos, SP, Brazil
| | - Aparecida Maria Catai
- Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Universidade Federal de Sao Carlos (UFSCar), São Carlos, SP, Brazil.
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16
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Influence of waterpipe smoking on cardiac autonomic function at rest and following high-intensity anaerobic exercise. ACTA GYMNICA 2018. [DOI: 10.5507/ag.2018.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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17
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Fiogbé E, Ferreira R, Sindorf MAG, Tavares SA, de Souza KP, de Castro Cesar M, Lopes CR, Moreno MA. Water exercise in coronary artery disease patients, effects on heart rate variability, and body composition: A randomized controlled trial. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2018. [PMID: 29542251 DOI: 10.1002/pri.1713] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND PURPOSE It is important to assess the effectiveness and efficiency of water-based training programs in order to prescribe it as an alternative in cardiac rehabilitation for patients who have coronary artery disease (CAD). In these patients, autonomic dysfunction is an important physiological change strongly associated with adverse outcomes, morbidity, and mortality. Given that the beneficial effects of physical training in CAD patients have been traditionally evidenced with programs involving land-based aerobic exercises, this study aims to evaluate the effects of water aerobic exercise training (WAET) on the autonomic modulation of heart rate (HR) and body composition, in the rehabilitation of CAD patients. METHODS Twenty-six male subjects with CAD were randomly divided into a training group (n = 14), submitted to the WAET, and a control group (n = 12). The WAET consisted of 3 weekly sessions on alternate days, totalling 48 sessions. The analysis of HR variability was used to evaluate the autonomic modulation of HR, from the recording of R-R intervals for 15 min, at rest in the supine position, and the body composition was evaluated through the bioelectrical impedance analysis. RESULTS Only the training group participants had improvement in the HR variability indices; patterns without variation decreased (0V, p = .005) and an increase of patterns of two different variations (p < .001), Shannon entropy (p = .02), and normalized conditional entropy (p = .03), whereas the control group had an increase of 0V (p = .04) and a decrease of normalized conditional entropy (p = .01). All body composition variables remained unchanged. CONCLUSIONS The WAET protocol improved the cardiac autonomic modulation of patients with CAD and can be considered as exercise training strategy in cardiac rehabilitation programs.
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Affiliation(s)
- Elie Fiogbé
- Post-Graduation Program in Physical Therapy, College of Health Sciences, Methodist University of Piracicaba (UNIMEP), Piracicaba, SP, Brazil.,Post-Graduation Program in Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Rafaela Ferreira
- Post-Graduation Program in Physical Therapy, College of Health Sciences, Methodist University of Piracicaba (UNIMEP), Piracicaba, SP, Brazil
| | - Márcio Antônio Gonçalves Sindorf
- Post-Graduation Program in Physical Education, College of Health Sciences, Methodist University of Piracicaba (UNIMEP), Piracicaba, SP, Brazil
| | - Silvia Aparecida Tavares
- Graduation Program in Physical Therapy, College of Health Sciences, Methodist University of Piracicaba (UNIMEP), Piracicaba, SP, Brazil
| | - Keiti Passoni de Souza
- Graduation Program in Physical Therapy, College of Health Sciences, Methodist University of Piracicaba (UNIMEP), Piracicaba, SP, Brazil
| | - Marcelo de Castro Cesar
- Post-Graduation Program in Physical Education, College of Health Sciences, Methodist University of Piracicaba (UNIMEP), Piracicaba, SP, Brazil
| | - Charles Ricardo Lopes
- Post-Graduation Program in Physical Education, College of Health Sciences, Methodist University of Piracicaba (UNIMEP), Piracicaba, SP, Brazil.,Faculty Adventist of Hortolândia (UNASP), Hortolândia, SP, Brazil
| | - Marlene Aparecida Moreno
- Post-Graduation Program in Physical Therapy, College of Health Sciences, Methodist University of Piracicaba (UNIMEP), Piracicaba, SP, Brazil
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Njemanze H, Warren C, Eggett C, MacGowan GA, Bates MGD, Siervo M, Ivkovic S, Trenell MI, Jakovljevic DG. Age-related decline in cardiac autonomic function is not attenuated with increased physical activity. Oncotarget 2018; 7:76390-76397. [PMID: 27705949 PMCID: PMC5363517 DOI: 10.18632/oncotarget.12403] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 09/23/2016] [Indexed: 12/13/2022] Open
Abstract
Age and physical inactivity are important risk factors for cardiovascular mortality. Heart rate response to exercise (HRRE) and heart rate recovery (HRR), measures of cardiac autonomic function, are strong predictors of mortality. The present study defined the effect of age and physical activity on HRRE and HRR. Healthy women (N=72) grouped according to age (young, 20-30 years; middle, 40-50 years; and older, 65-81 years) and daily physical activity (low active <7500, high active >12,500 steps/day) performed a maximal cardiopulmonary exercise test. The HRRE was defined as an increase in heart rate from rest to 1, 3 and 5 minutes of exercise and at 1/3 of total exercise time, and HRR as the difference in heart rate between peak exercise and 1, 2, and 3 minutes later. Age was associated with a significant decline in HRRE at 1 min and 1/3 of exercise time (r= − 0.27, p=0.04, and r=−0.39, p=0.02) and HRR at 2 min and 3 min (r=−0.35, p=0.01, and r=−0.31, p=0.02). There was no significant difference in HRRE and HRR between high and low-active middle-age and older women (p>0.05). Increased level of habitual physical activity level appears to have a limited effect on age-related decline in cardiac autonomic function in women.
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Affiliation(s)
- Hugo Njemanze
- Faculty of Medical Sciences, Institute of Cellular Medicine, MoveLab, Newcastle University, Newcastle upon Tyne, UK
| | - Charlotte Warren
- Faculty of Medical Sciences, Institute of Cellular Medicine, MoveLab, Newcastle University, Newcastle upon Tyne, UK.,MRC Centre for Ageing and Vitality, Newcastle University, UK
| | - Christopher Eggett
- Faculty of Medical Sciences, Institute of Cellular Medicine, MoveLab, Newcastle University, Newcastle upon Tyne, UK
| | - Guy A MacGowan
- Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, UK.,Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Matthew G D Bates
- Faculty of Medical Sciences, Institute of Cellular Medicine, MoveLab, Newcastle University, Newcastle upon Tyne, UK.,Cardiothoracic Department, James Cook University Hospital, Middleborough, UK
| | - Mario Siervo
- Faculty of Medical Sciences, Institute of Cellular Medicine, MoveLab, Newcastle University, Newcastle upon Tyne, UK
| | - Srdjan Ivkovic
- Faculty of Medical Sciences, Centre for Rehabilitation, University of Pristina, Kosovska Mitrovica, Serbia
| | - Michael I Trenell
- Faculty of Medical Sciences, Institute of Cellular Medicine, MoveLab, Newcastle University, Newcastle upon Tyne, UK.,MRC Centre for Ageing and Vitality, Newcastle University, UK
| | - Djordje G Jakovljevic
- Faculty of Medical Sciences, Institute of Cellular Medicine, MoveLab, Newcastle University, Newcastle upon Tyne, UK.,MRC Centre for Ageing and Vitality, Newcastle University, UK.,Clinical Research Facility, Royal Victoria Infirmary, Newcastle upon Tyne, UK
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19
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Heart rate recovery of individuals undergoing cardiac rehabilitation after acute coronary syndrome. Ann Phys Rehabil Med 2017; 61:65-71. [PMID: 29223653 DOI: 10.1016/j.rehab.2017.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 10/16/2017] [Accepted: 10/17/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND An efficient cardiac rehabilitation programme (CRP) can improve the functional ability of patients after acute coronary syndrome (ACS). OBJECTIVE To examine the effect of a CRP on parasympathetic reactivation and heart rate recovery (HRR) measured after a 6-min walk test (6MWT), and correlation with 6MWT distance and well-being after ACS. METHODS Eleven normoweight patients after ACS (BMI<25kg/m2; 10 males; mean [SD] age 61 [9] years) underwent an 8-week CRP. Before (pre-) and at weeks 4 (W4) and 8 (W8) during the CRP, they performed a 6MWT on a treadmill, followed by 10-min of seated passive recovery, with HRR and HR variability (HRV) recordings. HRR was measured at 1, 3, 5 and 10min after the 6MWT (HRR1, HRR3, HRR5, HRR10), then modelized by a mono-exponential function. Time-domain (square root of the mean of the sum of the squares of differences between adjacent normal R-R intervals [RMSSD]) and frequency-domain (with high- and low-frequency band powers) were used to analyse HRV. Participants completed a mental and physical well-being questionnaire at pre- and W8. Exhaustion after tests was assessed by the Borg scale. Pearson correlation was used to assess correlations. RESULTS HRR3, HRR5 and HRR10 increased by 37%, 36% and 28%, respectively, between pre- and W8 (P<0.05), and were positively correlated with change in 6MWT distance (r=0.58, 0.66 and 0.76; P<0.05). Percentage change in HRR3 was positively correlated with change in well-being (r=0.70; P=0.01). Parasympathic reactivation (RMSSD) was improved only during the first 30sec of recovery (P=0.04). CONCLUSION Among patients undergoing a CRP after ACS, increased HRR after a 6MWT, especially at 3min, was positively correlated with 6MWT distance and improved well-being. HRR raw data seem more sensitive than post-exercise HRV analysis for monitoring functional and autonomic improvement after ACS.
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20
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Ramos JS, Dalleck LC, Borrani F, Beetham KS, Mielke GI, Dias KA, Wallen MP, Keating SE, Fassett RG, Coombes JS. High-intensity interval training and cardiac autonomic control in individuals with metabolic syndrome: A randomised trial. Int J Cardiol 2017; 245:245-252. [PMID: 28747269 DOI: 10.1016/j.ijcard.2017.07.063] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 06/24/2017] [Accepted: 07/18/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Insulin resistance has been postulated to play a central role in the co-appearance of various cardiovascular disease risk factors constituting the metabolic syndrome (MetS). There is evidence that altered cardiac autonomic function (CAF) may precede the onset of insulin resistance. Exercise training has been shown to improve CAF in different populations, yet little is known regarding the exercise dose response for CAF. The aim of this study was to investigate the impact of different volumes of high-intensity interval training (HIIT) and traditional moderate-intensity continuous training (MICT) on CAF in participants with MetS. METHODS Individuals with MetS (n=56) were randomised into the following 16-week training interventions: i) MICT (n=16, 30min at 60-70%HRpeak, 5×/week); ii) 4HIIT (n=19, 4×4min bouts at 85-95%HRpeak, interspersed with 3min of active recovery at 50-70%HRpeak, 3×/week); or iii) 1HIIT (n=21, 1×4min bout at 85-95%HRpeak, 3×/week). R-R interval recorded for 5min in a supine position at pre- and post-intervention was used to derive linear (SDNN, RMSSD, pNN50, LF, HF, LF/HF) and non-linear (SD1, SD2, Alpha1, Alpha2, SampEn) heart rate variability (HRV) indices as measures of CAF. Group×time interaction effects were examined (ANCOVA) and Eta squared (η2) interaction effect sizes calculated. RESULTS While there were no significant between-group differences in CAF indices, there were small-to-medium group×time interaction effects on SDNN [F(2,52)=0.70, p=0.50, η2=0.02], RMSSD [F(2,52)=1.35, p=0.27, η2=0.03], HF power [F(2,52)=1.27, p=0.29, η2=0.03], SD1 [F(2,52)=0.47, p=0.63, η2=0.01], and SD2 [F(2,52)=0.41, p=0.67, η2=0.01]. The following represent the relative percentage increases across these variables for 4HIIT, MICT, and 1HIIT respectively (SDNN, +30%, +17%, 9%; RMSSD, +30%, +22%, -2%; HF power, +69%, +18%, +7%; SD1, +30%, +22%,-2%; SD2, +22%, +14%, 4%). CONCLUSIONS There were no significant between-group differences for the effects of exercise dose on CAF indices, however; high-volume HIIT demonstrated the greatest magnitude of effect for improving CAF in individuals with MetS.
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Affiliation(s)
- Joyce S Ramos
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Australia; Health and Exercise Science, Flinders University, South Australia, Australia
| | - Lance C Dalleck
- Recreation, Exercise, and Sport Science Department, Western State Colorado University, Gunnison, CO, United States
| | - Fabio Borrani
- Institut des Sciences du Sport de l'Universite de Lausanne (ISSUL), Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Kassia S Beetham
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - Gregore Iven Mielke
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - Katrin A Dias
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - Matthew P Wallen
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - Shelley E Keating
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - Robert G Fassett
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - Jeff S Coombes
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Australia.
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21
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Pattyn N, Beckers PJ, Cornelissen VA, Coeckelberghs E, De Maeyer C, Frederix G, Goetschalckx K, Possemiers N, Schepers D, Van Craenenbroeck EM, Wuyts K, Conraads VM, Vanhees L. The effect of aerobic interval training and continuous training on exercise capacity and its determinants. Acta Cardiol 2017. [PMID: 28636505 DOI: 10.1080/00015385.2017.1304712] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Objective We aimed to investigate (1) the effects of aerobic interval training (AIT) and aerobic continuous training (ACT) on (sub)maximal exercise measures and its determinants including endothelial function, muscle strength and cardiac autonomic function, and (2) the relationship between exercise capacity and these determinants. Methods Two-hundred coronary artery disease (CAD) patients (58.4 ± 9.1 years) were randomized to AIT or ACT for 12 weeks. All patients performed a cardiopulmonary exercise test and endothelial function measurements before and after the intervention; a subpopulation underwent muscle strength and heart rate variability (HRV) assessments. Results The VO2, heart rate and workload at peak and at first and second ventilatory threshold increased (P-time <0.001); the oxygen uptake efficiency slope (P-time <0.001) and half time of peak VO2 (P-time <0.001) improved. Endothelial function and heart rate recovery (HRR) at 1 and 2 min improved (P-time <0.001), while measures of muscle strength and HRV did not change. Both interventions were equally effective. Significant correlations were found between baseline peak VO2 and (1) quadriceps strength (r = 0.44; P < 0.001); (2) HRR at 2 min (r = 0.46; P < 0.001). Changes in peak VO2 correlated significantly with changes in (1) FMD (ρ = 0.17; P < 0.05); (2) quadriceps strength (r = 0.23; P < 0.05); (3) HRR at 2 min (ρ = 0.18; P < 0.05) and Total power of HRV (ρ = 0.41; P < 0.05). Conclusions This multicentre trial shows equal improvements in maximal and submaximal exercise capacity, endothelial function and HRR after AIT and ACT, while these training methods seem to be insufficient to improve muscle strength and HRV. Changes in peak VO2 were linked to changes in all underlying parameters.
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Affiliation(s)
- Nele Pattyn
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Paul J. Beckers
- Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
- University of Antwerp, Antwerp, Belgium
| | | | | | - Catherine De Maeyer
- Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
- University of Antwerp, Antwerp, Belgium
| | - Geert Frederix
- Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
- Laboratory of Cellular and Molecular Cardiology, Antwerp University Hospital, Edegem, Belgium
| | - Kaatje Goetschalckx
- Department of Cardiovascular Diseases, University Hospital Leuven, Leuven, Belgium
| | - Nadine Possemiers
- Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
| | - Dirk Schepers
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- Department of Cardiovascular Diseases, University Hospital Leuven, Leuven, Belgium
| | | | - Kurt Wuyts
- Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
| | - Viviane M. Conraads
- Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
- University of Antwerp, Antwerp, Belgium
| | - Luc Vanhees
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- Department of Cardiovascular Diseases, University Hospital Leuven, Leuven, Belgium
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Ribeiro PA, Boidin M, Juneau M, Nigam A, Gayda M. High-intensity interval training in patients with coronary heart disease: Prescription models and perspectives. Ann Phys Rehabil Med 2017; 60:50-57. [DOI: 10.1016/j.rehab.2016.04.004] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 04/04/2016] [Accepted: 04/09/2016] [Indexed: 01/01/2023]
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Effect of High-Intensity Interval Versus Continuous Exercise Training on Functional Capacity and Quality of Life in Patients With Coronary Artery Disease: A RANDOMIZED CLINICAL TRIAL. J Cardiopulm Rehabil Prev 2016; 36:96-105. [PMID: 26872000 DOI: 10.1097/hcr.0000000000000156] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
PURPOSE There is strong evidence that exercise training has beneficial health effects in patients with cardiovascular disease. Most studies have focused on moderate continuous training (MCT); however, a body of evidence has begun to emerge demonstrating that high-intensity interval training (HIIT) has significantly better results in terms of morbidity and mortality. The aim of this study was to compare the effects of MCT versus HIIT on functional capacity and quality of life and to assess safety. METHODS Seventy-two patients with ischemic heart disease were assigned to either HIIT or MCT for 8 weeks. We analyzed cardiopulmonary exercise test data, quality of life, and adverse events. RESULTS High-intensity interval training resulted in a significantly greater increase in (Equation is included in full-text article.)O2peak (4.5 ± 4.7 mL·kg·min) compared with MCT (2.5 ± 3.6 mL·kg·min) (P < .05). The aerobic threshold (VT1) increased by 21% in HIIT and 14% in MCT. Furthermore, there was a significant (P < .05) increase in the distance covered in the 6-minute walk distance test in the HIIT group (49.6 ± 6.3 m) when compared with the MCT group (29.6 ± 12.0 m). Both training protocols improved quality of life. No adverse events were reported in either of the groups. CONCLUSIONS On the basis of the results of this study, HIIT should be considered for use in cardiac rehabilitation as it resulted in a greater increase in functional capacity compared with MCT. We also observed greater improvement in quality of life without any increase in cardiovascular risk.
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High-Intensity Interval Training Versus Moderate-Intensity Continuous Training in the Prevention/Management of Cardiovascular Disease. Cardiol Rev 2016; 24:273-281. [DOI: 10.1097/crd.0000000000000124] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Besnier F, Labrunée M, Pathak A, Pavy-Le Traon A, Galès C, Sénard JM, Guiraud T. Exercise training-induced modification in autonomic nervous system: An update for cardiac patients. Ann Phys Rehabil Med 2016; 60:27-35. [PMID: 27542313 DOI: 10.1016/j.rehab.2016.07.002] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 07/01/2016] [Accepted: 07/07/2016] [Indexed: 12/14/2022]
Abstract
Patients with cardiovascular disease show autonomic dysfunction, including sympathetic activation and vagal withdrawal, which leads to fatal events. This review aims to place sympathovagal balance as an essential element to be considered in management for cardiovascular disease patients who benefit from a cardiac rehabilitation program. Many studies showed that exercise training, as non-pharmacologic treatment, plays an important role in enhancing sympathovagal balance and could normalize levels of markers of sympathetic flow measured by microneurography, heart rate variability or plasma catecholamine levels. This alteration positively affects prognosis with cardiovascular disease. In general, cardiac rehabilitation programs include moderate-intensity and continuous aerobic exercise. Other forms of activities such as high-intensity interval training, breathing exercises, relaxation and transcutaneous electrical stimulation can improve sympathovagal balance and should be implemented in cardiac rehabilitation programs. Currently, the exercise training programs in cardiac rehabilitation are individualized to optimize health outcomes. The sports science concept of the heart rate variability (HRV)-vagal index used to manage exercise sessions (for a goal of performance) could be implemented in cardiac rehabilitation to improve cardiovascular fitness and autonomic nervous system function.
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Affiliation(s)
- Florent Besnier
- Institute of Cardiovascular and Metabolic Diseases, National Institute of Health and Medical Research (INSERM), UMR-1048, Toulouse, France; Clinic of Saint-Orens, Cardiovascular and Pulmonary Rehabilitation Center, Saint-Orens-de-Gameville, France
| | - Marc Labrunée
- Institute of Cardiovascular and Metabolic Diseases, National Institute of Health and Medical Research (INSERM), UMR-1048, Toulouse, France; Department of Rehabilitation, Toulouse University Hospital, Toulouse, France
| | - Atul Pathak
- Institute of Cardiovascular and Metabolic Diseases, National Institute of Health and Medical Research (INSERM), UMR-1048, Toulouse, France; Unit of Hypertension, Risk Factors and Heart Failure, Clinique Pasteur, Toulouse, France
| | - Anne Pavy-Le Traon
- Institute of Cardiovascular and Metabolic Diseases, National Institute of Health and Medical Research (INSERM), UMR-1048, Toulouse, France
| | - Céline Galès
- Institute of Cardiovascular and Metabolic Diseases, National Institute of Health and Medical Research (INSERM), UMR-1048, Toulouse, France
| | - Jean-Michel Sénard
- Institute of Cardiovascular and Metabolic Diseases, National Institute of Health and Medical Research (INSERM), UMR-1048, Toulouse, France
| | - Thibaut Guiraud
- Institute of Cardiovascular and Metabolic Diseases, National Institute of Health and Medical Research (INSERM), UMR-1048, Toulouse, France; Clinic of Saint-Orens, Cardiovascular and Pulmonary Rehabilitation Center, Saint-Orens-de-Gameville, France.
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Nascimento PMC, Vieira MC, Sperandei S, Manoel Serra S. Supervised exercise improves autonomic modulation in participants in cardiac rehabilitation programs. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.repce.2015.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Rutkowski Ł, Zatoń M, Michalik K. Maximum Oxygen Uptake and Post-Exercise Recovery in Professional Road Cyclists. HUMAN MOVEMENT 2016. [DOI: 10.1515/humo-2016-0024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AbstractThe aim was to investigate the relationship between aerobic fitness as ascribed by maximum oxygen uptake (VOA sample of 17 professional cyclists (age 17.4 ± 3.1 years; VOPost-exercise VOAs recovery potential is associated with the aerobic fitness level, training effects may be monitored based on the recovery of VO
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Nascimentoa PMC, Vieiraa MC, Sperandeib S, Serraa SM. Supervised exercise improves autonomic modulation in participants in cardiac rehabilitation programs. Rev Port Cardiol 2015; 35:19-24. [PMID: 26711536 DOI: 10.1016/j.repc.2015.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 09/21/2015] [Accepted: 10/16/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES An attenuated heart rate recovery (HRR) response after exercise testing is a robust predictor of mortality. Regular exercise can enhance various physiological parameters. Studies indicate that participation in a cardiac rehabilitation program can improve heart rate recovery. The aim of this study was to analyze changes in functional capacity and autonomic modulation in patients following a cardiac rehabilitation program. METHODS Between 2009 and 2014, 248 individuals were assessed through exercise testing, at baseline and after six months of participation in a cardiac rehabilitation program. The exercise test was performed on a treadmill using a ramp protocol. The first minute of active recovery was standardized at a speed of 1.5 mph and slope of 2.5%. The degree of parasympathetic modulation was assessed by the difference between peak exercise heart rate and heart rate at one minute of recovery. The subjects were divided into two groups according to pre-training HRR (≤ 12 bpm and >12 bpm). RESULTS Exercise training resulted in a similar increase in metabolic equivalent values in both groups, but only the HRR ≤ 12 bpm group showed improvement after training (F=16.13; p<0.001), with a mean increase from 7.4 ± 3.69 bpm to 13.0 ± 9.74 bpm. CONCLUSIONS The cardiac rehabilitation program had a positive impact in a group that had both low functional capacity and reduced parasympathetic activity, producing a favorable effect on these recognized prognostic markers.
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Tamburus NY, Paula RFL, Kunz VC, César MC, Moreno MA, da Silva E. Interval training based on ventilatory anaerobic threshold increases cardiac vagal modulation and decreases high-sensitivity c-reative protein: randomized clinical trial in coronary artery disease. Braz J Phys Ther 2015; 19:441-50. [PMID: 26647745 PMCID: PMC4668337 DOI: 10.1590/bjpt-rbf.2014.0124] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Accepted: 06/07/2015] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Autonomic dysfunction and inflammatory activity are involved in the development and progression of coronary artery disease (CAD), and exercise training has been shown to confer a cardiovascular benefit. OBJECTIVE To evaluate the effects that interval training (IT) based on ventilatory anaerobic threshold (VAT) has on heart rate variability (HRV) and high-sensitivity C-reactive protein (hs-CRP) levels, as well as the relationship between both levels, in patients with CAD and/or cardiovascular risk factors (RF). METHOD Forty-two men (aged 57.88±6.20 years) were divided into two training groups, CAD-T (n= 12) and RF-T (n= 10), and two control groups, CAD-C (n= 10) and RF-C (n=10). Heart rate and RR intervals in the supine position, cardiopulmonary exercise tests, and hs-CRP levels were measured before and after IT. HRV was analyzed by spectral and symbolic analysis. The CAD-T and RF-T underwent a 16-week IT program of three weekly sessions at training intensities based on the VAT. RESULTS In the RF-T, cardiac sympathetic modulation index and hs-CRP decreased (p<0.02), while cardiac parasympathetic modulation index increased (p<0.02). In the CAD-T, cardiac parasympathetic modulation index increased, while hs-CRP, systolic, and diastolic blood pressures decreased (p<0.02). Both control groups showed increase in hs-CRP parameters (p<0.02). There was a strong and significant association between parasympathetic and sympathetic modulations with hs-CRP. CONCLUSION The IT program based on the VAT promoted a decrease in hs-CRP associated with improvement in cardiac autonomic modulation.
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Affiliation(s)
- Nayara Y Tamburus
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Roberta F L Paula
- Faculdade de Ciências da Saúde, Universidade Metodista de Piracicaba, Piracicaba, SP, Brazil
| | - Vandeni C Kunz
- Centro Universitário Adventista, Engenheiro Coelho, SP, Brazil
| | - Marcelo C César
- Faculdade de Ciências da Saúde, UNIMEP, Piracicaba, SP, Brazil
| | - Marlene A Moreno
- Faculdade de Ciências da Saúde, Universidade Metodista de Piracicaba, Piracicaba, SP, Brazil
| | - Ester da Silva
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brazil
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Physical activity prescription for improving health in patients with cardiometabolic risk: Using empirical evidence to provide clear public health messages. Ann Phys Rehabil Med 2015; 58:305-7. [DOI: 10.1016/j.rehab.2015.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 05/12/2015] [Accepted: 05/12/2015] [Indexed: 11/19/2022]
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Shepherd SO, Wilson OJ, Taylor AS, Thøgersen-Ntoumani C, Adlan AM, Wagenmakers AJM, Shaw CS. Low-Volume High-Intensity Interval Training in a Gym Setting Improves Cardio-Metabolic and Psychological Health. PLoS One 2015; 10:e0139056. [PMID: 26402859 PMCID: PMC4581708 DOI: 10.1371/journal.pone.0139056] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 09/07/2015] [Indexed: 11/28/2022] Open
Abstract
Background Within a controlled laboratory environment, high-intensity interval training (HIT) elicits similar cardiovascular and metabolic benefits as traditional moderate-intensity continuous training (MICT). It is currently unclear how HIT can be applied effectively in a real-world environment. Purpose To investigate the hypothesis that 10 weeks of HIT, performed in an instructor-led, group-based gym setting, elicits improvements in aerobic capacity (VO2max), cardio-metabolic risk and psychological health which are comparable to MICT. Methods Ninety physically inactive volunteers (42±11 y, 27.7±4.8 kg.m-2) were randomly assigned to HIT or MICT group exercise classes. HIT consisted of repeated sprints (15–60 seconds, >90% HRmax) interspersed with periods of recovery cycling (≤25 min.session-1, 3 sessions.week-1). MICT participants performed continuous cycling (~70% HRmax, 30–45 min.session-1, 5 sessions.week-1). VO2max, markers of cardio-metabolic risk, and psychological health were assessed pre and post-intervention. Results Mean weekly training time was 55±10 (HIT) and 128±44 min (MICT) (p<0.05), with greater adherence to HIT (83±14% vs. 61±15% prescribed sessions attended, respectively; p<0.05). HIT improved VO2max, insulin sensitivity, reduced abdominal fat mass, and induced favourable changes in blood lipids (p<0.05). HIT also induced beneficial effects on health perceptions, positive and negative affect, and subjective vitality (p<0.05). No difference between HIT and MICT was seen for any of these variables. Conclusions HIT performed in a real-world gym setting improves cardio-metabolic risk factors and psychological health in physically inactive adults. With a reduced time commitment and greater adherence than MICT, HIT offers a viable and effective exercise strategy to target the growing incidence of metabolic disease and psychological ill-being associated with physical inactivity.
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Affiliation(s)
- Sam O. Shepherd
- Research Institute for Sport & Exercise Sciences (RISES), Liverpool John Moores University, Liverpool, United Kingdom
| | - Oliver J. Wilson
- Institute for Sport, Physical Activity & Leisure, Carnegie Faculty, Leeds Beckett University, Leeds, United Kingdom
| | - Alexandra S. Taylor
- UBSport Hi Performance Centre, University of Birmingham, Birmingham, United Kingdom
| | | | - Ahmed M. Adlan
- Department of Cardiology, Heartlands Hospital, Birmingham, United Kingdom
| | - Anton J. M. Wagenmakers
- Research Institute for Sport & Exercise Sciences (RISES), Liverpool John Moores University, Liverpool, United Kingdom
| | - Christopher S. Shaw
- School of Exercise & Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
- * E-mail:
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Ramos-Filho D, Chicaybam G, de-Souza-Ferreira E, Guerra Martinez C, Kurtenbach E, Casimiro-Lopes G, Galina A. High Intensity Interval Training (HIIT) Induces Specific Changes in Respiration and Electron Leakage in the Mitochondria of Different Rat Skeletal Muscles. PLoS One 2015; 10:e0131766. [PMID: 26121248 PMCID: PMC4488295 DOI: 10.1371/journal.pone.0131766] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 06/05/2015] [Indexed: 01/09/2023] Open
Abstract
High intensity interval training (HIIT) is characterized by vigorous exercise with short rest intervals. Hydrogen peroxide (H2O2) plays a key role in muscle adaptation. This study aimed to evaluate whether HIIT promotes similar H2O2 formation via O2 consumption (electron leakage) in three skeletal muscles with different twitch characteristics. Rats were assigned to two groups: sedentary (n=10) and HIIT (n=10, swimming training). We collected the tibialis anterior (TA-fast), gastrocnemius (GAST-fast/slow) and soleus (SOL-slow) muscles. The fibers were analyzed for mitochondrial respiration, H2O2 production and citrate synthase (CS) activity. A multi-substrate (glycerol phosphate (G3P), pyruvate, malate, glutamate and succinate) approach was used to analyze the mitochondria in permeabilized fibers. Compared to the control group, oxygen flow coupled to ATP synthesis, complex I and complex II was higher in the TA of the HIIT group by 1.5-, 3.0- and 2.7-fold, respectively. In contrast, oxygen consumed by mitochondrial glycerol phosphate dehydrogenase (mGPdH) was 30% lower. Surprisingly, the oxygen flow coupled to ATP synthesis was 42% lower after HIIT in the SOL. Moreover, oxygen flow coupled to ATP synthesis and complex II was higher by 1.4- and 2.7-fold in the GAST of the HIIT group. After HIIT, CS activity increased 1.3-fold in the TA, and H2O2 production was 1.3-fold higher in the TA at sites containing mGPdH. No significant differences in H2O2 production were detected in the SOL. Surprisingly, HIIT increased H2O2 production in the GAST via complex II, phosphorylation, oligomycin and antimycin by 1.6-, 1.8-, 2.2-, and 2.2-fold, respectively. Electron leakage was 3.3-fold higher in the TA with G3P and 1.8-fold higher in the GAST with multiple substrates. Unexpectedly, the HIIT protocol induced different respiration and electron leakage responses in different types of muscle.
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Affiliation(s)
- Dionizio Ramos-Filho
- Laboratory of Bioenergetics and Mitochondrial Physiology-Institute of Medical Biochemistry Leopoldo de Meis-Federal University of Rio de Janeiro, UFRJ, Rio de Janeiro, Rio de Janeiro, Brazil
- * E-mail: (AG); (DRF)
| | - Gustavo Chicaybam
- Laboratory of Bioenergetics and Mitochondrial Physiology-Institute of Medical Biochemistry Leopoldo de Meis-Federal University of Rio de Janeiro, UFRJ, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Eduardo de-Souza-Ferreira
- Laboratory of Bioenergetics and Mitochondrial Physiology-Institute of Medical Biochemistry Leopoldo de Meis-Federal University of Rio de Janeiro, UFRJ, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Camila Guerra Martinez
- Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro UFRJ, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Eleonora Kurtenbach
- Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro UFRJ, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gustavo Casimiro-Lopes
- Institute of Physical Education and Sports-State University of Rio de Janeiro, UERJ, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Antonio Galina
- Laboratory of Bioenergetics and Mitochondrial Physiology-Institute of Medical Biochemistry Leopoldo de Meis-Federal University of Rio de Janeiro, UFRJ, Rio de Janeiro, Rio de Janeiro, Brazil
- * E-mail: (AG); (DRF)
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Yaylalı YT, Fındıkoğlu G, Yurtdaş M, Konukçu S, Şenol H. The effects of baseline heart rate recovery normality and exercise training protocol on heart rate recovery in patients with heart failure. Anatol J Cardiol 2014; 15:727-34. [PMID: 25592094 PMCID: PMC5368481 DOI: 10.5152/akd.2014.5710] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: It is unclear which exercise training protocol yields superior heart rate recovery (HRR) improvement in heart failure (HF) patients. Whether baseline HRR normality plays a role in the improvement is unknown. We hypothesized that an exercise training protocol and baseline HRR normality would be factors in altering HRR in HF patients. Methods: In this prospective, randomized, controlled and 3 group parallel study, 41 stable HF patients were randomly assigned to 3-times-weekly training sessions for 12 weeks, consisting of i) 30 minutes of interval training (IT) (n=17, 63.7±8.8 years old) versus ii) 30 minutes of continuous training (CT) (n=13, 59.6±6.8 years old) versus iii) no training (CON) (n=11, 60.6±9.9 years old). Each patient had cardiopulmonary exercise testing before and after the training program. Maximum heart rates attained during the test and heart rates at 1 and 2 min (HRR1 and HRR2) during the recovery phase were recorded. Paired samples t-test or Wilcoxon signed-rank test was used for comparisons before and after training. One-way ANOVA or Kruskal-Wallis variance analysis was used for comparisons among groups. Results: HRR1 was unchanged after training. HRR2 improved in the IT group after training, and post-training HRR2 values were significantly faster in the IT group than in controls. Both HRR1 and HRR2 was significantly faster, irrespective of exercise protocol in patients with abnormal baseline values after training. Conclusion: HRR1 did not improve after training. HRR2 improved only in the IT group. Both HRRs in patients with abnormal baseline values improved after both exercise protocols. IT might be superior to CT in improving HRR2. Baseline HRR might play a role in its response to exercise.
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Affiliation(s)
- Yalın Tolga Yaylalı
- Department of Cardiology, Faculty of Medicine, Pamukkale University; Denizli-Turkey.
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Matsuo T, Saotome K, Seino S, Eto M, Shimojo N, Matsushita A, Iemitsu M, Ohshima H, Tanaka K, Mukai C. Low-volume, high-intensity, aerobic interval exercise for sedentary adults: VO₂max, cardiac mass, and heart rate recovery. Eur J Appl Physiol 2014; 114:1963-72. [PMID: 24917354 DOI: 10.1007/s00421-014-2917-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 05/15/2014] [Indexed: 02/08/2023]
Abstract
PURPOSE The aim of this study was to compare the effects of low-volume, high-intensity aerobic interval training (HAIT) on maximal oxygen consumption (VO₂max), left ventricular (LV) mass, and heart rate recovery (HRR) with high-volume, moderate-intensity continuous aerobic training (CAT) in sedentary adults. METHODS Twenty-four healthy but sedentary male adults (aged 29.2 ± 7.2 years) participated in an 8-week, 3-day a week, supervised exercise intervention. They were randomly assigned to either HAIT (18 min, 180 kcal per exercise session) or CAT (45 min, 360 kcal). VO₂max, LV mass (3T-MRI), and HRR at 1 min (HRR-1) and 2 min (HRR-2) after maximal exercise were measured pre- and post-intervention. RESULTS Changes in VO₂max during the 8-week intervention were significant (P < 0.01) in both groups (HAIT, 8.7 ± 3.2 ml kg(-1) min(-1), 22.4 ± 8.9%; CAT, 5.5 ± 2.8 ml kg(-1) min(-1), 14.7 ± 9.5%), while the VO₂max improvement in HAIT was greater (P = 0.02) than in CAT. LV mass in HAIT increased (5.1 ± 8.4 g, 5.7 ± 9.1%, P = 0.05), but not in CAT (0.9 ± 7.8 g, 1.1 ± 8.4%, P = 0.71). While changes in HRR-1 were not significant in either group, change in HRR-2 for HAIT (9.5 ± 6.4 bpm, 19.0 ± 16.0%, P < 0.01) was greater (P = 0.03) than for CAT (1.6 ± 10.9 bpm, 3.9 ± 16.2%, P = 0.42). CONCLUSIONS This study suggests that HAIT has potential as a time-efficient training mode to improve cardiorespiratory capacity and autonomic nervous system function in sedentary adults.
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Affiliation(s)
- Tomoaki Matsuo
- Hazard Evaluation and Epidemiology Research Group, National Institute of Occupational Safety and Health, Japan, 6-21-1 Nagao, Tama-ku, Kawasaki, 214-8585, Japan,
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Oliveira NL, Ribeiro F, Teixeira M, Campos L, Alves AJ, Silva G, Oliveira J. Effect of 8-week exercise-based cardiac rehabilitation on cardiac autonomic function: A randomized controlled trial in myocardial infarction patients. Am Heart J 2014; 167:753-61.e3. [PMID: 24766987 DOI: 10.1016/j.ahj.2014.02.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 02/11/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this study is to evaluate the effects of an 8-week exercise-based cardiac rehabilitation program on traditional and nonlinear heart rate variability (HRV) indexes, assessing the potential confounding influences of habitual physical activity (PA) and dietary intake. METHODS In this parallel-group trial, 96 patients (56 ± 10 years old) were randomized to the exercise group (EG) or to the control group (CG) 4 weeks after an acute myocardial infarction. Exercise-based cardiac rehabilitation program consisted of aerobic exercise at 70% to 85% of maximal heart rate for 3 sessions per week plus usual care. The CG received only usual care. The baseline and final assessments comprised resting short-term HRV (primary outcome) by a Polar R-R recorder under controlled breathing (12 breaths per minute), habitual PA by accelerometers, and dietary intake by a 4-day food diary. RESULTS Two patients in each group dropped out and were not included in the intention-to-treat analysis. In the remaining 92 patients (EG = 47 and CG = 45), at baseline, only a difference in the proportion of nitrate medication use was significant between groups. After 8 weeks, no significant changes were found between groups on traditional and nonlinear HRV indexes (eg, ln HF, EG from 5.7 ± 1.5 to 5.9 ± 1.3 and CG from 5.5 ± 1.6 to 5.5 ± 1.5), habitual PA, and dietary intake. CONCLUSION Eight weeks of exercise-based cardiac rehabilitation program is an insufficient stimulus to improve cardiac autonomic function in post-myocardial infarction patients under optimal medication and with high levels of traditional and nonlinear HRV indexes at baseline.
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Affiliation(s)
- Nórton Luís Oliveira
- Research Center in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal.
| | - Fernando Ribeiro
- Research Center in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal; School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Madalena Teixeira
- Cardiology Department, Centro Hospitalar de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Lilibeth Campos
- Physical Medicine and Rehabilitation Department, Centro Hospitalar de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Alberto Jorge Alves
- Research Center in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Gustavo Silva
- Research Center in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - José Oliveira
- Research Center in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
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