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Nazir A, Heryaman H, Juli C, Ugusman A, Martha JW, Moeliono MA, Atik N. Resistance Training in Cardiovascular Diseases: A Review on Its Effectiveness in Controlling Risk Factors. Integr Blood Press Control 2024; 17:21-37. [PMID: 38523733 PMCID: PMC10959113 DOI: 10.2147/ibpc.s449086] [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: 11/09/2023] [Accepted: 03/06/2024] [Indexed: 03/26/2024] Open
Abstract
Cardiovascular Disease (CVD), a term encompassing various disorders affecting the heart and blood vessels, includes coronary artery disease (CAD). CAD is primarily due to the development of atherosclerotic plaques that disrupt blood flow, oxygenation, and nutrient delivery to the myocardium. Risk factors contributing to CAD progression include smoking, hypertension, diabetes mellitus (DM), dyslipidaemia, and obesity. While aerobic exercise (AE) has shown promising results in controlling CVD risk factors, the impact of resistance training (RT) has not been extensively investigated. This review aims to describe the effects of RT on CVD risk factors based on studies retrieved from PubMed and Google Scholar databases. Both isometric and isotonic RT have been found to decrease systolic blood pressure (SBP), diastolic blood pressure, or mean arterial pressure, with SBP showing a more significant reduction. Hypertensive patients engaging in RT alongside a calorie-restricted diet demonstrated significant improvements in blood pressure. RT is associated with increased nitric oxide bioavailability, sympathetic modulation, and enhanced endothelial function. In type-2 DM patients, 8-12 weeks of RT led to improvements in fasting blood glucose levels, insulin secretion, metabolic syndrome risk, and glucose transporter numbers. Combining AE with RT had a more significant impact in reducing insulin resistance and enhancing blood glucose compared to performing exercises separately. It also significantly decreased total cholesterol, triglycerides, and low-density lipoprotein levels while increasing high-density lipoprotein within 12 weeks of application. However, improvements are considered insignificant when lipid levels are already low to normal at baseline. The administration of RT resulted in weight loss and improved body mass index, with more pronounced effects seen when combining AE with RT and a calorie-restricted diet. Considering these results, the administration of RT, either alone or in combination with AE, proves beneficial in rehabilitating CAD patients by improving various risk factors.
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Affiliation(s)
- Arnengsih Nazir
- Doctoral Program, Faculty of Medicine, Padjadjaran University, Bandung, WJ, Indonesia
- Department of Physical and Rehabilitation Medicine, Dr. Hasan Sadikin General Hospital/Faculty of Medicine, Padjadjaran University, Bandung, WJ, Indonesia
| | - Henhen Heryaman
- Doctoral Program, Faculty of Medicine, Padjadjaran University, Bandung, WJ, Indonesia
- Department of Biomedical Sciences, Faculty of Medicine, Padjadjaran University, Bandung, WJ, Indonesia
| | - Cep Juli
- Department of Neurology, Dr. Hasan Sadikin General Hospital/Faculty of Medicine Padjadjaran University, Bandung, WJ, Indonesia
| | - Azizah Ugusman
- Department of Physiology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Januar Wibawa Martha
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University, Bandung, WJ, Indonesia
| | - Marina Annette Moeliono
- Department of Physical and Rehabilitation Medicine, Dr. Hasan Sadikin General Hospital/Faculty of Medicine, Padjadjaran University, Bandung, WJ, Indonesia
| | - Nur Atik
- Department of Biomedical Sciences, Faculty of Medicine, Padjadjaran University, Bandung, WJ, Indonesia
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Kambič T, Hansen D, Harber MP. Resistance Training in Cardiac Rehabilitation: PAST, PRESENT, AND FUTURE. J Cardiopulm Rehabil Prev 2024; 44:79-82. [PMID: 38407806 DOI: 10.1097/hcr.0000000000000851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Affiliation(s)
- Tim Kambič
- Department of Medical Sciences in Sport, Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia (Dr Kambič); Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium (Dr Hansen); BIOMED (Biomedical Research Institute) and REVAL (Rehabilitation Research Centre) (REVAL/BIOMED), Hasselt University, Diepenbeek, Belgium (Dr Hansen); and Clinical Exercise Physiology Program, Human Performance Laboratory, Ball State University, Muncie, Indiana (Dr Harber)
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Gillet A, Lamotte M, Forton K, Roussoulières A, Dewachter C, Bouziotis J, Deboeck G, van de Borne P. Hemodynamic Tolerance of New Resistance Training Methods in Patients With Heart Failure and Coronary Artery Disease: A RANDOMIZED CROSSOVER STUDY. J Cardiopulm Rehabil Prev 2023; 43:453-459. [PMID: 37040560 DOI: 10.1097/hcr.0000000000000794] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
PURPOSE The purpose of this study was to determine and compare the effectiveness of three different resistance training (RT) methods for cardiac rehabilitation. METHODS Individuals with heart failure with reduced ejection fraction (HFrEF, n = 23) or coronary artery disease (CAD, n = 22) and healthy controls (CTRL, n = 29) participated in this randomized crossover trial of RT exercises at 70% of the one-maximal repetition on a leg extension machine. Peak heart rate (HR) and blood pressure (BP) were measured noninvasively. The three RT methods were five sets of increasing repetitions from three to seven (RISE), of decreasing repetitions from seven to three (DROP), and three sets of nine repetitions (USUAL). Interset rest intervals were 15 sec for RISE and DROP and 60 sec for USUAL. RESULTS Peak HR differed on average by <4 bpm between methods in the HFrEF and CAD groups ( P < .02). Rises in systolic BP (SBP) in the HFrEF group were comparable across methods. In the CAD group, mean SBP at peak exercise increased more in RISE and DROP than in USUAL ( P < .001), but the increase was ≤10 mm Hg. In the CTRL group, SBP was higher for DROP than for USUAL (152 ± 22 vs 144 ± 24 mm Hg, respectively; P < .01). Peak cardiac output and perceived exertion did not differ between methods. CONCLUSIONS The RISE, DROP, and USUAL RT methods induced a similar perception of effort and similar increases in peak HR and BP. The RISE and DROP methods appear more efficient as they allow a comparable training volume in a shorter time than the USUAL method.
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Affiliation(s)
- Alexis Gillet
- Departments of Cardiology (Mr Gillet and Drs Lamotte, Forton, Roussoulières, Dewachter, and van de Borne), Physiotherapy (Mr Gillet and Drs Lamotte and Forton), and Biomedical Research (Mr Bouziotis), Hôpital Universitaire de Bruxelles (H.U.B.), CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; Research Unit in Rehabilitation, Faculty of Motor Skills Science (Mr Gillet and Dr Deboeck) and Laboratory of Physiology and Pharmacology, Faculty of Medicine (Dr Dewachter), Université Libre de Bruxelles, Brussels, Belgium
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Kambič T. Effects of low-load and high-load resistance training combined with aerobic training in patients with coronary artery disease: a dose-dependent randomised, controlled trial (PhD Academy Award). Br J Sports Med 2023; 57:1337-1338. [PMID: 37595991 DOI: 10.1136/bjsports-2023-107011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2023] [Indexed: 08/20/2023]
Affiliation(s)
- Tim Kambič
- Department of Medical Sciences in Sport, University of Ljubljana Faculty of Sport, Ljubljana, Slovenia
- Cardiac Rehabilitation Unit, General Hospital Murska Sobota, Murska Sobota, Slovenia
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Sharma A, Sharma N, Vats S, Jain M, Chahal A, Kashoo FZ, Hakamy A, Alajam RA, Alshehri MM, Bharath Kumar M, Sanjeevi RR, Alwadaani F, Shaphe MA. Effect of Resistance Training on Body Composition, Hemodynamic Parameters and Exercise Tolerance among Patients with Coronary Artery Disease: A Systematic Review. Healthcare (Basel) 2022; 11:healthcare11010131. [PMID: 36611590 PMCID: PMC9819119 DOI: 10.3390/healthcare11010131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Effectiveness and safety of Resistance Training in treating various Cerebrovascular Disease diagnoses have drawn attention in recent years. Patients suffering with coronary artery disease should be offered individually tailored Resistance Training in their exercise regimen. Resistance Training was developed to help individuals with their functional status, mobility, physical performance, and muscle strength. OBJECTIVE The objective of this review was to collect, summarize and present information on the state of science focusing on usefulness, viability, safety and efficacy of Resistance Training in treating coronary artery disease and enhancing the aerobic capacity and improving overall health-related quality of life. METHODS The review is prepared in accordance with Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Searches were conducted in Cochrane Library, PubMed/MEDLINE, PEDro and Scopus database. PEDro scale was used for methodological quality assessment of included studies. Two independent reviewers determined the inclusion criteria of studies by classifying interventions based on core components, outcome measures, diagnostic population and rated the quality of evidence and strength of recommendations using GRADE criteria. RESULTS Total 13 studies with 1025 patients were included for the detailed analysis. Findings emphasize the importance of assessing effectiveness and safety of Resistance Training in individuals with coronary artery disease. Patient specific designed exercise programs as Resistance Training targets at enhancing patients' exercise tolerance, improves hemodynamic response and muscular strength with reduction in body fat composition. CONCLUSION Resistance Training is an effective exercise that should be incorporated to counteract the loss of muscle strength, muscle mass, and physiological vulnerability, as well as to combat the associated debilitating effects on physical functioning, mobility and overall independence and Quality of Life during rehabilitation of patients with coronary artery disease.
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Affiliation(s)
- Abhishek Sharma
- Department of Paediatric and Neonatal Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana 133207, India
- Correspondence:
| | - Nidhi Sharma
- Department of Neurological Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana 133207, India
| | - Sakshi Vats
- Department of Musculoskeletal Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana 133207, India
| | - Mansi Jain
- Department of Musculoskeletal Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana 133207, India
| | - Aksh Chahal
- Department of Musculoskeletal Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana 133207, India
| | - Faizan Z. Kashoo
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al Majmaah 11952, Saudi Arabia
| | - Ali Hakamy
- Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, P.O. Box 114, Jazan 45142, Saudi Arabia
| | - Ramzi Abdu Alajam
- Physical Therapy Department, College of Applied Medical Sciences, Jazan University, P.O. Box 114, Jazan 45142, Saudi Arabia
| | - Mohammed M. Alshehri
- Physical Therapy Department, College of Applied Medical Sciences, Jazan University, P.O. Box 114, Jazan 45142, Saudi Arabia
| | - Mallela Bharath Kumar
- Physical Therapy Department, College of Applied Medical Sciences, Jazan University, P.O. Box 114, Jazan 45142, Saudi Arabia
| | - Ramya Ramasamy Sanjeevi
- Physical Therapy Department, College of Applied Medical Sciences, Jazan University, P.O. Box 114, Jazan 45142, Saudi Arabia
| | - Fawwaz Alwadaani
- Physical Therapy Department, College of Applied Medical Sciences, Jazan University, P.O. Box 114, Jazan 45142, Saudi Arabia
| | - Mohammad Abu Shaphe
- Physical Therapy Department, College of Applied Medical Sciences, Jazan University, P.O. Box 114, Jazan 45142, Saudi Arabia
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Kambic T, Šarabon N, Hadžić V, Lainscak M. High-Load and Low-Load Resistance Exercise in Patients with Coronary Artery Disease: Feasibility and Safety of a Randomized Controlled Clinical Trial. J Clin Med 2022; 11:jcm11133567. [PMID: 35806853 PMCID: PMC9267855 DOI: 10.3390/jcm11133567] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 11/16/2022] Open
Abstract
Resistance exercise (RE) remains underused in cardiac rehabilitation; therefore, there is insufficient evidence on safety, feasibility, and hemodynamic adaptations to high-load (HL) and low-load (LL) RE in patients with coronary artery disease (CAD). This study aimed to compare the safety, feasibility of HL-RE and LL-RE when combined with aerobic exercise (AE), and hemodynamic adaptations to HL and LL resistance exercise following the intervention. Seventy-nine patients with CAD were randomized either to HL-RE (70−80% of one-repetition maximum [1-RM]) and AE, LL-RE (35−40% of 1-RM) and AE or solely AE (50−80% of maximal power output) as a standard care, and 59 patients completed this study. We assessed safety and feasibility of HL-RE and LL-RE and we measured 1-RM on leg extension machine and hemodynamic response during HL- and LL-RE at baseline and post-training. The training intervention was safe, well tolerated, and completed without any adverse events. Adherence to RE protocols was excellent (100%). LL-RE was better tolerated than HL-RE, especially from the third to the final mesocycle of this study (Borgs’ 0−10 scale difference: 1−2 points; p = 0.001−0.048). Improvement in 1-RM was greater following HL-RE (+31%, p < 0.001) and LL-RE (+23%, p < 0.001) compared with AE. Participation in HL-RE and LL-RE resulted in a decreased rating of perceived exertion during post-training HL- and LL-RE, but in the absence of post-training hemodynamic adaptations. The implementation of HL-RE or LL-RE combined with AE was safe, well tolerated and can be applied in the early phase of cardiac rehabilitation for patients with stable CAD.
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Affiliation(s)
- Tim Kambic
- Cardiac Rehabilitation Unit, Department of Research and Education, General Hospital Murska Sobota, Ulica dr. Vrbnjaka 6, Rakičan, 9000 Murska Sobota, Slovenia
- Correspondence: (T.K.); (M.L.); Tel.: +386-(02)-5123-238 (T.K.); +386-(02)-5123-733 (M.L.)
| | - Nejc Šarabon
- Faculty of Health Sciences, University of Primorska, Polje 42, 6310 Izola, Slovenia;
- InnoRenew CoE, Human Health Department, Livade 6, 6310 Izola, Slovenia
- S2P, Science to Practice, Ltd., Laboratory for Motor Control and Motor Behavior, Tehnološki Park 19, 1000 Ljubljana, Slovenia
| | - Vedran Hadžić
- Faculty of Sport, University of Ljubljana, Gortanova Ulica 22, 1000 Ljubljana, Slovenia;
| | - Mitja Lainscak
- Division of Cardiology, General Hospital Murska Sobota, Ulica dr. Vrbnjaka 6, Rakičan, 9000 Murska Sobota, Slovenia
- Faculty of Medicine, University of Ljubljana, Vrazov Trg 2, 1000 Ljubljana, Slovenia
- Correspondence: (T.K.); (M.L.); Tel.: +386-(02)-5123-238 (T.K.); +386-(02)-5123-733 (M.L.)
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Acute Left Atrial Response to Different Eccentric Resistance Exercise Loads in Patients with Heart Failure with Middle Range Ejection Fraction: A Pilot Study. J Pers Med 2022; 12:jpm12050689. [PMID: 35629111 PMCID: PMC9145268 DOI: 10.3390/jpm12050689] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 04/16/2022] [Accepted: 04/22/2022] [Indexed: 02/04/2023] Open
Abstract
In this study, we aimed to assess acute changes occurring on atrial function following single bouts of eccentric resistance exercise (ECC-RE) performed at two different loads. Twenty-five patients with chronic heart failure with middle range ejection fraction (HFmrEF) participated in three experimental sessions in a randomized order and on separate days: two sessions of ECC RE at 20% (ECC-20) of one-repetition maximum (1-RM) and 50% (ECC-50) 1-RM, and one session of control, without exercise. Each session lasted three minutes. Before and immediately after the sessions, patients underwent echocardiography and blood pressure and heart rate measurement. Peak atrial longitudinal strain (PALS) and peak atrial contractile strain (PACS) significantly increased after both ECC-20 (+16.3%) and ECC-50 (+18.1%) compared to control (between sessions p = 0.022). Peak atrial contractile strain (PACS) significantly increased after ECC-50 (+28.4%) compared to ECC-20 (+17.0%) and control (between sessions p = 0.034). The ratio of transmitral and annular velocities (E/E') increased significantly after ECC-20 (+10.4%) and ECC-50 (+19.0%) compared to control (between groups p = 0.003). EF, left ventricular longitudinal strain, and stroke volume did not change after ECC-RE sessions compared to control. Cardiac output increased significantly after ECC-20 and ECC-50 compared to control, (between groups p = 0.025). In conclusion, both ECC-RE sessions were well tolerated, and LA functional reserve was properly mobilized in response to ECC-RE in patients with HFmrEF. Cardiac output increased at the cost of an increased LV filling pressure, but no detrimental changes of LV function occurred.
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OUP accepted manuscript. Eur J Prev Cardiol 2022; 29:e338-e342. [DOI: 10.1093/eurjpc/zwac063] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 03/09/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022]
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