Energy expenditure during an exercise training session for cardiac patients

Increasing energy expenditure (EE) in cardiac patients remains a challenge. Exercise approaches in cardiac rehabilitation/secondary prevention programs (CR/SP) have consistently resulted in minimal weight loss, due in part to the low exercise-related EE. The purpose of this study was to measure the EE among patients participating in a routine exercise session of Phase III maintenance CR/SP, where a recreational activity was introduced. Twelve overweight/obese male patients with coronary artery disease (aged 62.6 ± 8.5 years) had their total EE measured during a combined aerobic (circuit workout (ACW) and recreational activity) and resistance training (RT) session using a portable gas analyzer. Subjects were instructed to exercise at 60%–70% of heart rate reserve. Activity EE was calculated from total EE and resting EE. The duration of the session was 75.3 ± 1.5 min, of which 59.7 ± 8.8 min were above moderate intensity (3–6 METs). Activity EE was 309 ± 76 kcal, concurring to a total EE of 457 ± 80 kcal (3.9 ± 0.8 METs-h). ACW, recreational activity, and RT fulfilled 34.4% ± 6.4%, 25.0% ± 5.3%, and 14.2% ± 2.7% of the activity EE, respectively. Absolute intensities (METs) were significantly different between the RT (3.9 ± 1.0) and the ACW (6.9 ± 1.8) and recreational activity (5.9 ± 0.8). In conclusion, a combined aerobic and resistance training following standard exercise prescription practices, coupled with a recreational activity, is an effective tool to promote exercise above moderate intensity in male coronary artery disease patients. Clinicians can adopt concepts from recreational activity to develop CR/SP sessions.

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The Effects of Combined Same Session Aerobic and Resistance Training on Physical Performance in Coronary Artery Disease Patients: Protocol Comparison

Austin Journal of Clinical Cardiology ◽

10.26420/austinjclincardiolog.2021.1077 ◽

2021 ◽

Vol 7 (2) ◽

Author(s):

Clavario P ◽

◽

Barbara C ◽

Porcile A ◽

Russo C ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Resistance Training ◽

Physical Performance ◽

Aerobic Training ◽

Stable Coronary Artery Disease ◽

Training Session ◽

Moderate Intensity ◽

Leg Extension ◽

Artery Disease

Aerobic training is included to cardiac rehabilitation programs together with resistance training. The effects of combined aerobic and resistance training performed in a same session with different protocols on peak aerobic capacity (VO2peak) and maximal dynamic strength (1RM: one repetition maximum) are not well known. We compared the effectiveness of two different combined aerobic and resistance training programs for 12 weeks performed three times in a week in stable Coronary Artery Disease (CAD) patients (n=30) who had previously performed aerobic training only. The patients were randomized to High Volume- Low Intensity Group (HLG) or Low Volume-High Intensity Group (LHG). Both groups performed laboratory controlled aerobic exercise first (60min, 80% of lactate threshold) followed by six major muscle group resistance exercises (HLG: 30-35% of 1RM, 3 sets, 12 repetitions) or (LHG: 60-70% of 1RM, 3 sets, 6 repetitions). VO2peak remained at the baseline level for whole study group (23 ± 6 vs. 24 ± 7 ml·kg-1·min-1, p=0.380) and the responses did not differ between the HLG and LHG (p=0.891). Muscle strength increased when analyzed as one group for both upper (Push Up; 24 ± 8 vs. 30 ± 7 kg, p <0.0001) and lower body (Leg Extension; 20 ± 6 vs. 27 ± 6 kg, p <0.0001) with no difference between subgroups (p=0.240 and p=0.504, respectively). As conclusion, combined aerobic and resistance training in the same training session for 12 weeks improved maximal strength independently of the intensity of resistance training. These results highlight the importance of regular resistance training, even at moderate intensity, for CAD patients in terms of physical performance and independent living.

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