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Keltz RR, Faricier R, Prior PL, Hartley T, Huitema AA, McKelvie RS, Suskin NG, Keir DA. A standardized approach to evaluate effectiveness of aerobic exercise training interventions in cardiovascular disease at the individual level. Int J Cardiol 2024; 412:132335. [PMID: 38964557 DOI: 10.1016/j.ijcard.2024.132335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/31/2024] [Accepted: 07/01/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Reliable change indices can determine pre-post intervention changes at an individual level that are greater than chance or practice effect. We applied previously developed minimal meaningful change (MMCRCI) scores for oxygen uptake (V̇O2) values associated with estimated lactate threshold (θLT), respiratory compensation point (RCP), and peak oxygen uptake (V̇O2peak) to evaluate the effectiveness of exercise training in cardiovascular disease patients. METHODS 303 patients (65 ± 11 yrs.; 27% female) that completed a symptom-limited cardiopulmonary exercise test (CPET) before and after 6-months of guideline-recommended exercise training were assessed to determine absolute and relative V̇O2 at θLT, RCP, and V̇O2peak. Using MMCRCI ∆V̇O2 scores of ±3.9 mL·kg-1·min-1, ±4.0 mL·kg-1·min-1, and ± 3.6 mL·kg-1·min-1 for θLT, RCP, and V̇O2peak, respectively, patients were classified as "positive" (ΔθLT, ΔRCP, and/or ΔV̇O2peak ≥ +MMCRCI), "non-" (between ±MMCRCI), or "negative" responders (≤ -MMCRCI). RESULTS Mean RCP (n = 86) and V̇O2peak (n = 303) increased (p < 0.05) from 19.4 ± 3.6 mL·kg-1·min-1 and 18.0 ± 6.3 mL·kg-1·min-1 to 20.1 ± 3.8 mL·kg-1·min-1 and 19.2 ± 7.0 mL·kg-1·min-1 at exit, respectively, whereas θLT (n = 140) did not change (15.5 ± 3.4 mL·kg-1·min-1 versus 15.7 ± 3.8 mL·kg-1·min-1, p = 0.324). For changes in θLT, 6% were classified as "positive" responders, 90% as "non-responders", and 4% as "negative" responders. For RCP, 10% exhibited "positive" changes, 87% were "non-responders", and 2% were "negative" responders. For ΔV̇O2peak, 57 patients (19%) were classified as "positive" responders, 229 (76%) as "non-responders", and 17 (6%) as "negative" responders. CONCLUSION Most patients that completed the exercise training program did not achieve reliable improvements greater than that of chance or practice at an individual level in θLT, RCP and V̇O2peak.
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Affiliation(s)
- Randi R Keltz
- School of Kinesiology, University of Western Ontario, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada
| | - Robin Faricier
- School of Kinesiology, University of Western Ontario, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada
| | - Peter L Prior
- Lawson Health Research Institute, London, Ontario, Canada; Cardiac Rehabilitation and Secondary Prevention Program, St. Joseph's Health Care, London, Ontario, Canada
| | - Tim Hartley
- Lawson Health Research Institute, London, Ontario, Canada; Cardiac Rehabilitation and Secondary Prevention Program, St. Joseph's Health Care, London, Ontario, Canada
| | - Ashlay A Huitema
- Cardiac Rehabilitation and Secondary Prevention Program, St. Joseph's Health Care, London, Ontario, Canada; Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Robert S McKelvie
- Cardiac Rehabilitation and Secondary Prevention Program, St. Joseph's Health Care, London, Ontario, Canada; Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Neville G Suskin
- Lawson Health Research Institute, London, Ontario, Canada; Cardiac Rehabilitation and Secondary Prevention Program, St. Joseph's Health Care, London, Ontario, Canada; Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Daniel A Keir
- School of Kinesiology, University of Western Ontario, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Toronto General Hospital Research Institute, Toronto General Hospital, Toronto, Ontario, Canada.
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Kirsch M, Vitiello D, Trachsel LD, Boidin M, Lalongé J, Juneau M, Bherer L, Nigam A, Gayda M. Cardiac hemodynamics phenotypes and individual responses to training in coronary heart disease patients. Scand J Med Sci Sports 2024; 34:e14633. [PMID: 38650385 DOI: 10.1111/sms.14633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/18/2024] [Accepted: 04/04/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND In patients with coronary heart disease (CHD), individualized exercise training (ET) programs are strongly recommended to optimize peak oxygen uptake (V ̇ $$ \dot{\mathrm{V}} $$ O2peak) improvement and prognosis. However, the cardiac hemodynamic factors responsible for a positive response to training remain unclear. The aim of this study was to compare cardiac hemodynamic changes after an ET program in responder (R) versus non-responder (NR) CHD patients. METHODS A total of 72 CHD patients completed a 3-month ET program and were assessed by cycle ergometer cardiopulmonary exercise test (CPET:V ̇ $$ \dot{\mathrm{V}} $$ O2peak assessment) with impedance cardiography (ICG) for hemodynamic measurements before and after training. Cardiac hemodynamics (e.g., CO, CI, SV, ESV, EDV, and SVR) were measured by ICG during CPET. The R and NR groups were classified using the median change inV ̇ $$ \dot{\mathrm{V}} $$ O2peak (>the median for R and ≤the median for NR). RESULTS In the R group,V ̇ $$ \dot{\mathrm{V}} $$ O2peak (+17%, p < 0.001), CO, CI, SV, and HR increased by 17%, 17%, 13%, and 5%, respectively (p < 0.05) after the training program. In the NR group,V ̇ $$ \dot{\mathrm{V}} $$ O2peak, CO, CI, and SV increased by 0.5%, 5%, 8%, and 6%, respectively (p < 0.01). The SVR decreased in both groups (-19% in R and -11% in NR, p < 0.001). CONCLUSION Among CHD patients, the R group showed a better improvement in peak cardiac output via an increase in peak stroke volume and heart rate and a reduced systemic vascular resistance than the NR group. Different cardiac phenotype adaptations and clinical individual responses were identified in CHD patients according to the aerobic fitness responder's status.
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Affiliation(s)
- Marine Kirsch
- Preventive Medicine and Physical Activity Center (ÉPIC) & Research Center, Montreal Heart Institute and Université de Montréal, Montréal, Quebec, Canada
- Université Paris Cité, Institut des Sciences du Sport Santé de Paris (I3SP), URP 3625, Paris, France
| | - Damien Vitiello
- Université Paris Cité, Institut des Sciences du Sport Santé de Paris (I3SP), URP 3625, Paris, France
| | - Lukas-Daniel Trachsel
- University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Maxime Boidin
- Liverpool Centre for Cardiovascular Science, Liverpool John Moores University, Liverpool, UK
| | - Julie Lalongé
- Preventive Medicine and Physical Activity Center (ÉPIC) & Research Center, Montreal Heart Institute and Université de Montréal, Montréal, Quebec, Canada
| | - Martin Juneau
- Preventive Medicine and Physical Activity Center (ÉPIC) & Research Center, Montreal Heart Institute and Université de Montréal, Montréal, Quebec, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Louis Bherer
- Preventive Medicine and Physical Activity Center (ÉPIC) & Research Center, Montreal Heart Institute and Université de Montréal, Montréal, Quebec, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Anil Nigam
- Preventive Medicine and Physical Activity Center (ÉPIC) & Research Center, Montreal Heart Institute and Université de Montréal, Montréal, Quebec, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Mathieu Gayda
- Preventive Medicine and Physical Activity Center (ÉPIC) & Research Center, Montreal Heart Institute and Université de Montréal, Montréal, Quebec, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Quebec, Canada
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Ma M, Zhang B, Yan X, Ji X, Qin D, Pu C, Zhao J, Zhang Q, Lowis H, Li T. Adaptive Posture-Balance Cardiac Rehabilitation Exercise Significantly Improved Physical Tolerance in Patients with Cardiovascular Diseases. J Clin Med 2022; 11:jcm11185345. [PMID: 36142993 PMCID: PMC9504163 DOI: 10.3390/jcm11185345] [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: 07/30/2022] [Revised: 09/03/2022] [Accepted: 09/07/2022] [Indexed: 12/03/2022] Open
Abstract
Cardiac rehabilitation (CR) requires more professional exercise modalities to improve the efficiency of treatment. Adaptive posture-balance cardiac rehabilitation exercise (APBCRE) is an emerging, balance-based therapy from clinical experience, but lacks evidence of validity. Our study aimed to observe and assess the rehabilitation effect of APBCRE on patients with cardiovascular diseases (CVDs). All participants received one-month APBCRE therapy evenly three times per week and two assessments before and after APBCRE. Each assessment included cardiopulmonary exercise testing (CPET), resting metabolic rate (RMR) detection, and three questionnaires about general health. The differences between two assessments were analyzed to evaluate the therapeutic effects of APBCRE. A total of 93 participants (80.65% male, 53.03 ± 12.02 years) were included in the analysis. After one-month APBCRE, oxygen uptake (VO2, 11.16 ± 2.91 to 12.85 ± 3.17 mL/min/kg, p < 0.01) at anaerobic threshold (AT), ventilation (VE, 28.87 ± 7.26 to 32.42 ± 8.50 mL/min/kg, p < 0.01) at AT, respiratory exchange ratio (RER, 0.93 ± 0.06 to 0.95 ± 0.05, p < 0.01) at AT and oxygen uptake efficiency slope (OUES, 1426.75 ± 346.30 to 1547.19 ± 403.49, p < 0.01) significantly improved in CVD patients. The ≤55-year group had more positive improvements (VO2 at AT, 23% vs. 16%; OUES, 13% vs. 6%) compared with the >55-year group. Quality of life was also increased after APBCRE (47.78 ± 16.74 to 59.27 ± 17.77, p < 0.001). This study proved that APBCRE was a potentially available exercise rehabilitation modality for patients with CVDs, which performed significant increases in physical tolerance and quality of life, especially for ≤55-year patients.
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Affiliation(s)
- Mei Ma
- Department of Rehabilitation Medicine, Tianjin Chest Hospital, Tianjin 300192, China
| | - Bowen Zhang
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300192, China
| | - Xinxin Yan
- Department of Cardiology, Key Laboratory of Pulmonary Vascular Medicine, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Xiang Ji
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300192, China
| | - Deyu Qin
- Department of Rehabilitation Medicine, Tianjin Chest Hospital, Tianjin 300192, China
| | - Chaodong Pu
- Department of Rehabilitation Medicine, Tianjin Chest Hospital, Tianjin 300192, China
| | - Jingxiang Zhao
- Department of Rehabilitation Medicine, Tianjin Chest Hospital, Tianjin 300192, China
| | - Qian Zhang
- Department of Rehabilitation Medicine, Tianjin Chest Hospital, Tianjin 300192, China
| | - Heinz Lowis
- Drei-Burgen-Klinik of German Pension Insurance of Rhineland-Palatinate, 55583 Bad Kreuznach, Germany
| | - Ting Li
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300192, China
- Correspondence: ; Tel.: +86-180-0212-7296
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Forent B, Maxime B, Catherine-Alexandra G, Christine G, Nathalie TT, Eric T, Anil N, Martin J, Jonathan T, Mathieu G, Louis B. Differences in cognitive function, cardiorespiratory fitness and BDNF concentration in physically active CHD patients vs healthy controls. Brain Res 2022; 1793:148019. [PMID: 35863462 DOI: 10.1016/j.brainres.2022.148019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/05/2022] [Accepted: 07/14/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Coronary heart disease (CHD) is frequently associated with cognitive impairment (CI), whereas physical exercise may improve cognition. To date, the cognitive profile of physically active CHD patients remains poorly understood. Physical activity and cognition has been associated with neurotrophic biomarkers that are positively modulated by a higher cardiorespiratory fitness (V̇ O2peak) and/or active lifestyle. This study aimed to compare the cognitive functions, V̇ O2peak and trophic biomarkers in physically active CHD patients vs healthy controls. METHODS Thirty-nine CHD patients and 20 controls performed a cardiopulmonary exercise test, a neuropsychological assessment (short-term and working memory, processing speed, executive functions, and long-term verbal memory), and a blood draw to measure brain-derived neurotrophic factor (BDNF), insulin-like growth factor-1 (IGF1), and cathepsin B (CTSB) plasma concentrations. Physical activity was also measured with an accelerometer for 1 week. RESULTS Compared to controls, CHD patients had lower V̇ O2peak (22.2 vs 29.3 mL/min/kg, p<0.001), but similar moderate to vigorous physical activity levels (27.5 vs 34.4 min/day, p=0.114). CHD patients had poorer performances for executive functions (0.198 vs -0.370, p=0.004) and processing speed (0.150 vs -0.293, p=0.025), as well as lower BDNF concentrations (166.4 vs 300.2 ng/ml, p=0.027), but similar IGF-1 and CTSB concentrations (p>0.05) when compared to controls. BDNF was an independent predictor of processing speed in CHD, and IGF-1 and BDNF were independent predictors of verbal memory in healthy controls. CONCLUSION Despite similar physical activity levels, fit CHD patients had lower V̇ O2peak values, cognitive performances (executive functions and processing speed) and BDNF concentrations when compared to controls.
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Affiliation(s)
- Besnier Forent
- Research center, Montreal Heart Institute, Montreal, Canada; Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Boidin Maxime
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; School of Kinesiology and Exercise Science, Faculty of Medicine, University of Montreal, Montreal, Canada
| | | | | | | | - Thorin Eric
- Research center, Montreal Heart Institute, Montreal, Canada; Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Nigam Anil
- Research center, Montreal Heart Institute, Montreal, Canada; Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Juneau Martin
- Research center, Montreal Heart Institute, Montreal, Canada; Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Tremblay Jonathan
- School of Kinesiology and Exercise Science, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Gayda Mathieu
- Research center, Montreal Heart Institute, Montreal, Canada; Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Bherer Louis
- Research center, Montreal Heart Institute, Montreal, Canada; Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Canada; Research Centre, Institut Universitaire de Gériatrie de Montréal, Montreal, Canada.
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5
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Bérubé B, Boidin M, Gayda M, Vincent T, Tremblay J, Juneau M, Nigam A, Bherer L. Acute effects of exercise on cerebrovascular response and cognitive performance in individuals with stable coronary heart disease. Brain Res 2021; 1772:147671. [PMID: 34606749 DOI: 10.1016/j.brainres.2021.147671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 09/24/2021] [Accepted: 09/25/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Individuals with coronary heart disease (CHD) exhibit cognitive deficits and cerebrovascular dysfunctions, and are at higher risk of developing dementia. Cognitive function in individuals with CHD has never been studied during acute aerobic exercise. Given the increasing popularity of training at high peak power output (PPO), its impact on cerebrovascular and cognitive functions in individuals with CHD should be further studied. METHOD Thirty-eight individuals with CHD and 16 healthy controls completed two exercise bouts at 30% and 70% of their individualized PPO on an ergocycle while performing a cognitive task including non-executive and executive conditions. Variations of oxy- deoxy-hemoglobin, and total hemoglobin concentrations were measured on left prefrontal cortex at both PPO using near-infrared spectroscopy. RESULTS Cognitive task performances were equivalent between groups at all intensity levels. Individuals with CHD exhibited larger variation of deoxyhemoglobin in the executive condition and larger variation in total hemoglobin concentration in all task conditions compared to healthy controls at 70% of PPO. CONCLUSION Exercising at high intensity seems to have a larger impact on cerebral blood volume in CHD patients compared to healthy age-matched controls. Higher exercise intensity has negative impacts on cerebral blood volume variations during a cognitive task in CHD patients and could potentially lead to other neurocognitive dysfunctions. Other studies are needed to determine if a cognitive task administered during an exercise test could help identify individuals with CHD at higher risk of developing cognitive decline.
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Affiliation(s)
- B Bérubé
- Research Center and Preventive Medicine and Physical Activity Center (EPIC), Montreal Heart Institute, Montréal, Québec, Canada; Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada; Department of Psychology, Université de Montréal, Montréal, Québec, Canada.
| | - M Boidin
- Research Center and Preventive Medicine and Physical Activity Center (EPIC), Montreal Heart Institute, Montréal, Québec, Canada; School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - M Gayda
- Research Center and Preventive Medicine and Physical Activity Center (EPIC), Montreal Heart Institute, Montréal, Québec, Canada; Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - T Vincent
- Research Center and Preventive Medicine and Physical Activity Center (EPIC), Montreal Heart Institute, Montréal, Québec, Canada; Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - J Tremblay
- School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - M Juneau
- Research Center and Preventive Medicine and Physical Activity Center (EPIC), Montreal Heart Institute, Montréal, Québec, Canada; Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - A Nigam
- Research Center and Preventive Medicine and Physical Activity Center (EPIC), Montreal Heart Institute, Montréal, Québec, Canada; Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - L Bherer
- Research Center and Preventive Medicine and Physical Activity Center (EPIC), Montreal Heart Institute, Montréal, Québec, Canada; Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
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Trachsel LD, David LP, Gayda M, Boidin M, Lalongé J, Juneau M, Nigam A, Henri C. Impact of aerobic training periodisation on global and regional right ventricular strain in coronary heart disease. Appl Physiol Nutr Metab 2021; 46:1502-1509. [PMID: 34310883 DOI: 10.1139/apnm-2021-0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Linear aerobic training periodisation (LP) is recommended for patients with coronary heart disease (CHD). However, the effects of training periodisation on the right heart mechanics in patients with CHD have never been examined. This study aimed to explore the effects of LP and non-linear periodisation (NLP) on right heart mechanics. We prospectively randomised CHD patients to 12 weeks of aerobic training with LP or NLP. While there was a weekly increase in energy expenditure with LP, there was a steeper increase during the first 3 weeks, followed by a decrease in the fourth week with NLP. Echocardiography was performed at baseline and after the training period to assess the right ventricular free wall (RVFW) and right atrial strain. Thirty patients with CHD were included (NLP, n = 16; LP, n = 14). The traditional right and left heart parameters showed no significant time effects. There was a decrease of RVFW strain with time in both groups (+1.3 ± 0.9% with NLP, and +1.5 ± 0.8% with LP; p = 0.033). Mid-ventricular RVFW strain changed significantly with time (+2.0 ± 1.3% with NLP, and from +2.3 ± 1.2% with LP; p = 0.025). There was no time effect on the right atrial strain. In stable CHD patients, LP and NLP resulted in right ventricular strain decrements with a segment-specific pattern. This study was registered at ClinicalTrials.gov (identifier number: NCT03414996). Novelty: In stable coronary heart disease patients, both linear and non-linear aerobic training periodisation programs result in right ventricular strain decrements with time, particularly in the mid-ventricular segment. Traditional right and left heart parameters and right atrial strain showed no significant time effect in both 12 weeks aerobic training periodisation programs.
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Affiliation(s)
- Lukas D Trachsel
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Louis-Philippe David
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Mathieu Gayda
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Research Centre, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
| | - Maxime Boidin
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada.,School of Kinesiology & Exercise Science, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Julie Lalongé
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada
| | - Martin Juneau
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Research Centre, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
| | - Anil Nigam
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Research Centre, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
| | - Christine Henri
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Research Centre, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
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Pinto R, Melo X, Angarten V, Pires ML, Borges M, Santos V, Abreu A, Santa-Clara H. The effects of 12-months supervised periodized training on health-related physical fitness in coronary artery disease: a randomized controlled trial. J Sports Sci 2021; 39:1893-1902. [PMID: 33775203 DOI: 10.1080/02640414.2021.1907062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
We compared the impact of a one-year periodized exercise training versus a non-periodized exercise training on health-related physical fitness (HRPF) including body composition, cardiorespiratory and muscular fitness in patients with coronary artery disease (CAD). Fifty CAD patients (60.4 ± 9.9 years) were randomized to either a periodized training group (PG) (n = 25) or a non-periodized training group (NPG) (n = 25). Both consisted of a combined training programme, performed 3 days/week for 12 months. Thirty-six CAD patients (PG: n = 18, NPG: n = 18) successfully completed the exercise regimes. In both groups, a favourable main effect for time was evident for peak VO2, peak workload, anaerobic threshold and respiratory compensation point workloads and VO2, whole body skeletal muscle mass and quality index at 12 months.In conclusion, a periodized model is as effective as a non-periodized model in promoting increases in HRPF outcomes following a one-year intervention. These findings indicate that health-professionals can add variation to cardiac rehabilitation workouts without compromising effectiveness.
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Affiliation(s)
- Rita Pinto
- Serviço de Cardiologia, Departamento Coração E Vasos, Centro Hospitalar Universitário Lisboa Norte, CAML, CCUL, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Xavier Melo
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, Portugal.,Ginásio Clube Português, Research & Development Department, GCP Lab, Lisboa, Portugal
| | - Vitor Angarten
- Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, Portugal
| | - Madalena Lemos Pires
- Serviço de Cardiologia, Departamento Coração E Vasos, Centro Hospitalar Universitário Lisboa Norte, CAML, CCUL, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Mariana Borges
- Serviço de Cardiologia, Departamento Coração E Vasos, Centro Hospitalar Universitário Lisboa Norte, CAML, CCUL, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Vanessa Santos
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, Portugal
| | - Ana Abreu
- Serviço de Cardiologia, Departamento Coração E Vasos, Centro Hospitalar Universitário Lisboa Norte, CAML, CCUL, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Helena Santa-Clara
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, Portugal
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8
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Kataoka R, Vasenina E, Loenneke J, Buckner SL. Periodization: Variation in the Definition and Discrepancies in Study Design. Sports Med 2021; 51:625-651. [PMID: 33405190 DOI: 10.1007/s40279-020-01414-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2020] [Indexed: 02/07/2023]
Abstract
Over the past several decades, periodization has been widely accepted as the gold standard of training theory. Within the literature, there are numerous definitions for periodization, which makes it difficult to study. When examining the proposed definitions and related studies on periodization, problems arise in the following domains: (1) periodization has been proposed to serve as the macro-management of the training process concerning the annual plan, yet research on long-term effects is scarce; (2) periodization and programming are being used interchangeably in research; and (3) training is not periodized alongside other stressors such as sport (i.e., only resistance training is being performed without the inclusion of sport). Overall, the state of the literature suggests that the inability to define periodization makes the statement of its superiority difficult to experimentally test. This paper discusses the proposed definitions of periodization and the study designs which have been employed to examine the concept.
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Affiliation(s)
- Ryo Kataoka
- USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, FL, USA
| | - Ecaterina Vasenina
- USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, FL, USA
| | - Jeremy Loenneke
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Samuel L Buckner
- USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, FL, USA.
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Boidin M, David LP, Trachsel LD, Gayda M, Tremblay J, Lalongé J, Juneau M, Nigam A, Henri C. Impact of 2 different aerobic periodization training protocols on left ventricular function in patients with stable coronary artery disease: an exploratory study. Appl Physiol Nutr Metab 2020; 46:436-442. [PMID: 33108743 DOI: 10.1139/apnm-2020-0423] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We compared the impacts of linear (LP) and nonlinear (NLP) aerobic training periodizations on left ventricular (LV) function and geometry in coronary artery disease (CAD) patients. Thirty-nine CAD patients were randomized to either a 3-month isoenergetic supervised LP or NLP. All underwent standard echocardiography with assessment of 3D LV ejection fraction (LVEF), diastolic function, strain (global longitudinal, radial, and circumferential), and strain rate at baseline and study end. Training was performed 3 times/week and included high-intensity interval and moderate-intensity continuous training sessions. Training load was progressively increased in the LP group, while it was deeply increased and intercepted with a recovery week each fourth week in the NLP group. For the 34 analyzed patients, we found similar improvements for 3D LVEF (effect size (ES): LP, 0.29; NLP, 0.77), radial strain (ES: LP, 0.58; NLP, 0.48), and radial strain rate (ES: LP, 0.87; NLP, 0.17) in both groups (time for all: p ≤ 0.01). All other parameters of cardiac function remained similar. In conclusion, NLP and LP led to similar improvements in 3D LVEF and radial strain, suggesting a favourable positive cardiac remodelling through myofibers reorganization. These findings must be investigated in patients with more severe cardiac dysfunction. The study was registered on ClinicalTrials.gov (NCT03443193). Novelty: Linear and nonlinear periodization programs improved radial strain, accompanied by improvement of ejection fraction. Both aerobic periodization programs did not negatively impact cardiac function in coronary artery disease patients.
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Affiliation(s)
- Maxime Boidin
- School of Kinesiology and Exercise Science, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada.,Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Montreal, QC H1T 1N6, Canada
| | - Louis-Philippe David
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada
| | - Lukas D Trachsel
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Montreal, QC H1T 1N6, Canada.,University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, 3010 Switzerland
| | - Mathieu Gayda
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada.,Research Centre, Montreal Heart Institute, Montreal, QC H1T 1C8, Canada
| | - Jonathan Tremblay
- School of Kinesiology and Exercise Science, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada
| | - Julie Lalongé
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Montreal, QC H1T 1N6, Canada.,Research Centre, Montreal Heart Institute, Montreal, QC H1T 1C8, Canada
| | - Martin Juneau
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada.,Research Centre, Montreal Heart Institute, Montreal, QC H1T 1C8, Canada
| | - Anil Nigam
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada.,Research Centre, Montreal Heart Institute, Montreal, QC H1T 1C8, Canada
| | - Christine Henri
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada.,Research Centre, Montreal Heart Institute, Montreal, QC H1T 1C8, Canada
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Trachsel LD, Boidin M, Henri C, Fortier A, Lalongé J, Juneau M, Nigam A, Gayda M. Women and men with coronary heart disease respond similarly to different aerobic exercise training modalities: a pooled analysis of prospective randomized trials. Appl Physiol Nutr Metab 2020; 46:417-425. [PMID: 33096006 DOI: 10.1139/apnm-2020-0650] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We aimed to compare cardiopulmonary exercise test (CPET) parameters, cardiac adaptations, and proportion of responders after different aerobic training programs amongst women and men with coronary heart disease (CHD). Patients with CHD were evaluated with a CPET and echocardiography before and after 3 months of aerobic exercise training. Peak oxygen uptake exercise training response was assessed according to the median peak oxygen uptake change for post- versus pretraining in the whole cohort (stratification non/low responders (NLR) vs. high-responders) and normalized for lean body mass (LBM). Eighty-three CHD patients were included (19 women, 64 men; 27 patients with interval, 19 with continuous, and 37 with combination exercises). Peak oxygen uptake, peak workload normalized for LBM, pulmonary variables (i.e., ventilation and oxygen uptake efficiency slope), and O2 pulse were significantly lower in women versus men. These parameters improved similarly with training in both sexes (p < 0.05). There were no differences in the proportion of NLR among women and men with CHD (7/19 (37%) vs. 35/64 (55%), p = 0.1719). Left ventricular ejection fraction and mean peak early diastolic mitral annulus velocity improved similarly with training in both sexes (p < 0.05). Women and men with CHD have a similar exercise training response regarding key CPET and echocardiographic parameters. The proportion of responders is similar. ClinicalTrials.gov: NCT03414996, NCT02048696, NCT03443193. Novelty: Cardiopulmonary adaptations to exercise training are similar among CHD men and women. Proportion of peak oxygen uptake for non/low/high responders is similar in CHD men and women. Left ventricular systolic and diastolic function improved similarly after exercise training in CHD men and women.
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Affiliation(s)
- Lukas-Daniel Trachsel
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1N6, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada.,University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, CH-3010 Switzerland
| | - Maxime Boidin
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1N6, Canada.,Research Centre, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1C8, Canada.,School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Christine Henri
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada.,Research Centre, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1C8, Canada
| | - Annik Fortier
- Montreal Health Innovations Coordinating Center, Montreal Heart Institute, Montreal, QC H1T 1C8, Canada
| | - Julie Lalongé
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1N6, Canada.,Research Centre, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1C8, Canada
| | - Martin Juneau
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1N6, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada.,Research Centre, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1C8, Canada
| | - Anil Nigam
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1N6, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada.,Research Centre, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1C8, Canada
| | - Mathieu Gayda
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1N6, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada.,Research Centre, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1C8, Canada
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11
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Corrà U. Alternative aerobic training session in coronary artery disease patients in cardiac rehabilitation. A new stone thrown in the pond. Eur J Prev Cardiol 2020; 27:1688-1690. [PMID: 32053011 DOI: 10.1177/2047487319901062] [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: 11/16/2022]
Affiliation(s)
- Ugo Corrà
- Exercise Pathophysiology Laboratory, Istituti Clinici Scientifici Maugeri, Veruno Institute, Italy
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