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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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Dadova K, Slaby K, Radvansky J, Matous M, Varekova J, Hodis J, Steffl M, Tufano JJ. Exercise prescription in cardiac patients treated with metoprolol - should the time of day for stress tests and training coincide? Eur J Prev Cardiol 2018; 25:1026-1027. [PMID: 29676165 DOI: 10.1177/2047487318771776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Klara Dadova
- 1 Department of Adapted Physical Education and Sports Medicine, Charles University - Faculty of Physical Education and Sport, Prague, Czech Republic
| | - Krystof Slaby
- 2 Department of Sports Medicine, Charles University - 2nd Faculty of Medicine, Prague, Czech Republic
| | - Jiri Radvansky
- 2 Department of Sports Medicine, Charles University - 2nd Faculty of Medicine, Prague, Czech Republic
| | - Milos Matous
- 3 Department for the Study of Obesity and Diabetes, Charles University - 3rd Faculty of Medicine, Prague, Czech Republic
| | - Jitka Varekova
- 1 Department of Adapted Physical Education and Sports Medicine, Charles University - Faculty of Physical Education and Sport, Prague, Czech Republic
| | - Jiri Hodis
- 4 Department of Pharmacology, Charles University - 1st Faculty of Medicine, Prague, Czech Republic
| | - Michal Steffl
- 5 Department of Physiology, Charles University - Faculty of Physical Education and Sport, Prague, Czech Republic
| | - James J Tufano
- 5 Department of Physiology, Charles University - Faculty of Physical Education and Sport, Prague, Czech Republic
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Abstract
PURPOSE To derive specific maximal heart rate (HRmax) prediction equations for a coronary artery disease (CAD) population based upon status of β-blocker (BB) therapy and to compare these to prior HRmax equations (Fox and Brawner-specific for CAD). METHODS We retrospectively reviewed stress echocardiogram treadmill tests in patients with CAD, dividing subjects into 3 groups based upon BB use on test day: not prescribed BB therapy (no BB group; n = 110); held for 12 to 24 hr prior (held BB group; n = 155); and continued taking (took BB group; n = 72). RESULTS Derived HRmax equations for our CAD population were no BB = 200 - 0.79 × age; held BB = 193 - 0.71 × age; and took BB = 168 - 0.51 × age. Achieved HRmax mean was not significantly different between held BB and no BB groups; however, HRmax in the took BB group was significantly lower. Fox and Brawner (no BB)-HRmax equations significantly overestimated (+6 and +9 mean bias) and underestimated (-8 and -6 mean bias) achieved HRmax in no BB and held BB groups, respectively. The Brawner (no BB) equation intercept and slope were not significantly different from our CAD-held BB and no BB equations. The Brawner (on BB) equation intercept and slope were similar to our took BB equation, but greatly underestimated achieved HRmax (-17 mean bias). CONCLUSION For patients holding BB therapy on test day, a similar CAD HRmax estimation equation to those patients never on BB can be used, comparable to the Brawner (no BB) equation. Further research is needed to determine when patients should take their BB therapy in conjunction with exercise testing.
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Graded Cycling Test Combined With the Talk Test Is Responsive in Cardiac Rehabilitation. J Cardiopulm Rehabil Prev 2016; 36:368-74. [DOI: 10.1097/hcr.0000000000000180] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Casillas JM, Joussain C, Gremeaux V, Hannequin A, Rapin A, Laurent Y, Benaïm C. A study of the 200-metre fast walk test as a possible new assessment tool to predict maximal heart rate and define target heart rate for exercise training of coronary heart disease patients. Clin Rehabil 2014; 29:175-83. [DOI: 10.1177/0269215514540922] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To develop a new predictive model of maximal heart rate based on two walking tests at different speeds (comfortable and brisk walking) as an alternative to a cardiopulmonary exercise test during cardiac rehabilitation. Design: Evaluation of a clinical assessment tool. Setting: A Cardiac Rehabilitation Department in France. Subjects: A total of 148 patients (133 men), mean age of 59 ±9 years, at the end of an outpatient cardiac rehabilitation programme. Main measures: Patients successively performed a 6-minute walk test, a 200 m fast-walk test (200mFWT), and a cardiopulmonary exercise test, with measure of heart rate at the end of each test. An all-possible regression procedure was used to determine the best predictive regression models of maximal heart rate. The best model was compared with the Fox equation in term of predictive error of maximal heart rate using the paired t-test. Results: Results of the two walking tests correlated significantly with maximal heart rate determined during the cardiopulmonary exercise test, whereas anthropometric parameters and resting heart rate did not. The simplified predictive model with the most acceptable mean error was: maximal heart rate = 130 − 0.6 × age + 0.3 × HR200mFWT (R2 = 0.24). This model was superior to the Fox formula (R2 = 0.138). The relationship between training target heart rate calculated from measured reserve heart rate and that established using this predictive model was statistically significant ( r = 0.528, p < 10−6). Conclusions: A formula combining heart rate measured during a safe simple fast walk test and age is more efficient than an equation only including age to predict maximal heart rate and training target heart rate.
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Affiliation(s)
- Jean-Marie Casillas
- Plateforme d’Investigation Technologique CIC-P Inserm 803, University Hospital of Dijon, Dijon, France
- Inserm U1093, Dijon, France
- Cardiac Rehabilitation Department, University Hospital of Dijon, Dijon, France
| | - Charles Joussain
- Cardiac Rehabilitation Department, University Hospital of Dijon, Dijon, France
| | - Vincent Gremeaux
- Plateforme d’Investigation Technologique CIC-P Inserm 803, University Hospital of Dijon, Dijon, France
- Inserm U1093, Dijon, France
- Cardiac Rehabilitation Department, University Hospital of Dijon, Dijon, France
| | - Armelle Hannequin
- Cardiac Rehabilitation Department, University Hospital of Dijon, Dijon, France
| | - Amandine Rapin
- Cardiac Rehabilitation Department, University Hospital of Dijon, Dijon, France
| | - Yves Laurent
- Plateforme d’Investigation Technologique CIC-P Inserm 803, University Hospital of Dijon, Dijon, France
- Cardiac Rehabilitation Department, University Hospital of Dijon, Dijon, France
| | - Charles Benaïm
- Plateforme d’Investigation Technologique CIC-P Inserm 803, University Hospital of Dijon, Dijon, France
- Inserm U1093, Dijon, France
- Cardiac Rehabilitation Department, University Hospital of Dijon, Dijon, France
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The Graded Cycling Test Combined With the Talk Test Is Reliable for Patients With Ischemic Heart Disease. J Cardiopulm Rehabil Prev 2014; 34:276-80. [DOI: 10.1097/hcr.0000000000000067] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Comparison of the Observed Heart Rate during Blood Lactate-based Exercise Intensity vs. Three Heart Rate-based Methods in Cardiovascular Rehabilitation. Cardiopulm Phys Ther J 2014. [DOI: 10.1097/01823246-201406000-00003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Seo DY, Lee S, Kim N, Ko KS, Rhee BD, Park BJ, Han J. Morning and evening exercise. Integr Med Res 2013; 2:139-144. [PMID: 28664065 PMCID: PMC5481716 DOI: 10.1016/j.imr.2013.10.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 10/04/2013] [Accepted: 10/04/2013] [Indexed: 11/21/2022] Open
Abstract
A growing body of evidence suggests that exercise may contribute to preventing pathological changes, treating multiple chronic diseases, and reducing mortality and morbidity ratios. Scientific evidence moreover shows that exercise plays a key role in improving health-related physical fitness components and hormone function. Regular exercise training is one of the few strategies that has been strictly adapted in healthy individuals and in athletes. However, time-dependent exercise has different outcomes, based on the exercise type, duration, and hormone adaptation. In the present review, we therefore briefly describe the type, duration, and adaptation of exercise performed in the morning and evening. In addition, we discuss the clinical considerations and indications for exercise training.
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Affiliation(s)
- Dae Yun Seo
- National Research Laboratory for Mitochondrial Signaling, Department of Physiology, College of Medicine, Cardiovascular and Metabolic Disease Center, Inje University, Busan, Korea
| | - SungRyul Lee
- National Research Laboratory for Mitochondrial Signaling, Department of Physiology, College of Medicine, Cardiovascular and Metabolic Disease Center, Inje University, Busan, Korea
| | - Nari Kim
- National Research Laboratory for Mitochondrial Signaling, Department of Physiology, College of Medicine, Cardiovascular and Metabolic Disease Center, Inje University, Busan, Korea
| | - Kyung Soo Ko
- National Research Laboratory for Mitochondrial Signaling, Department of Physiology, College of Medicine, Cardiovascular and Metabolic Disease Center, Inje University, Busan, Korea
| | - Byoung Doo Rhee
- National Research Laboratory for Mitochondrial Signaling, Department of Physiology, College of Medicine, Cardiovascular and Metabolic Disease Center, Inje University, Busan, Korea
| | - Byung Joo Park
- Division of Leisure and Sports Science, Dong Seo University, Busan, Korea
| | - Jin Han
- National Research Laboratory for Mitochondrial Signaling, Department of Physiology, College of Medicine, Cardiovascular and Metabolic Disease Center, Inje University, Busan, Korea
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Hansen D, Stevens A, Eijnde BO, Dendale P. Endurance exercise intensity determination in the rehabilitation of coronary artery disease patients: a critical re-appraisal of current evidence. Sports Med 2012; 42:11-30. [PMID: 22145810 DOI: 10.2165/11595460-000000000-00000] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
In the care of coronary artery disease (CAD) patients, the benefits of exercise therapy are generally established. Even though the selected endurance exercise intensity might affect medical safety, therapy adherence and effectiveness in the rehabilitation of CAD patients in how to determine endurance exercise intensity properly remains difficult. The aim of this review is to describe the available methods for endurance exercise intensity determination in the rehabilitation of CAD patients, accompanied with their (dis)advantages, validity and reproducibility. In general, endurance exercise intensity can objectively be determined in CAD patients by calculating a fraction of maximal exercise tolerance and/or determining ventilatory threshold after execution of a cardiopulmonary exercise test with ergospirometry. This can be translated to a corresponding training heart rate (HR) or workload. In the absence of ergospirometry equipment, target exercise HR can be calculated directly by different ways (fraction of maximal HR and/or Karvonen formula), and/or anaerobic threshold can be determined. However, the use of HR for determining exercise intensity during training sessions seems complicated, because many factors/conditions affect the HR. In this regard, proper standardization of the exercise sessions, as well as exercise testing, might be required to improve the accuracy of exercise intensity determination. Alternatively, subjective methods for the determination of endurance exercise intensity in CAD patients, such as the Borg ratings of perceived exertion and the talk test, have been developed. However, these methods lack proper validity and reliability to determine endurance exercise intensity in CAD patients. In conclusion, a practical and systematic approach for the determination of endurance exercise intensity in CAD patients is presented in this article.
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Zhao D, Wang Y, Wei Y, Tang K, Yu X, Xu Y. QT restitution properties of middle-aged women with different exercise capacities. J Electrocardiol 2010; 44:340-5. [PMID: 20719335 DOI: 10.1016/j.jelectrocard.2010.06.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Indexed: 11/17/2022]
Abstract
BACKGROUND Framingham Study data indicate an incremental risk of cardiovascular death in relation to low exercise capacity in women. The reason for death is still not clear. METHODS QT restitution properties in 80 middle-aged women were investigated to confirm whether the cardiac restitution property was affected by the exercise capacity. Exercise tests were performed according to the Bruce protocol. Seventy cases were divided into the low-exercise capacity group (LEC group) and high-exercise capacity group (HEC group) by median exercise capacities. Sequential QT intervals and their preceding TQ intervals were measured, and the QT restitution curve (QTRC) was constructed. Two exponential equations were used to match the data and calculate the maximum slope (Smax) of QTRC, respectively. RESULTS With elevation in the exercise level, the women in the LEC group had a higher change rate of QT intervals (41 ± 10 vs 29 ± 3 ms/Met, P = .001) and TQ intervals (46 ± 12 vs 41 ± 7 ms/Met, P = .046); and the ratio of QT interval alterations to TQ interval alterations increased (0.41 ± 0.09 vs 0.36 ± 0.07, P = .003). The Smax of the QTRC in the LEC group was higher than that in the HEC group (1.43 ± 0.44 vs 1.13 ± 0.34, P = .002). There was an inverse relationship between Smax and exercise capacity (r = -0.43, P = .001). CONCLUSION Middle-aged women with low exercise capacity have steeper QTRCs than those with high exercise capacity, denoting a more unstable alternation of QT interval with elevation in exercise level.
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Affiliation(s)
- Dongdong Zhao
- Department of Cardiology, The Tenth People's Hospital of Tongji University, Shanghai, China
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Beattie WS, Wijeysundera DN, Karkouti K, McCluskey S, Tait G. Does Tight Heart Rate Control Improve Beta-Blocker Efficacy? An Updated Analysis of the Noncardiac Surgical Randomized Trials. Anesth Analg 2008; 106:1039-48, table of contents. [DOI: 10.1213/ane.0b013e318163f6a9] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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