In our clinical controlled trial, patients with coronary heart disease will be randomly assigned into the exercise intervention (low intensity resistance training with vascular occlusion) or usual physical activity group (control group).
Physical activity in patients with coronary heart disease improves health, quality of life, and reduces risk of coronary events, morbidity and mortality. Aerobic training is preferred as a part of cardiac rehabilitation with its well established evidence-based guidelines. On the other hand, the resistance training was first introduced as a part of cardiac rehabilitation just over a decade ago, due to its positive effects on performance, quality of life and muscle hypertrophy and strength. Despite the positive effects of resistance training, there still lacks evidence about its effect on cardiovascular health. Furthermore, guidelines still do not specify the exact training volumes, doses and types of resistance training for patients with coronary heart disease. In clinical practice, it is often difficult and contraindicated to use near-maximal loads (e.g., in the early stages of cardiac rehabilitation, after sport injury, etc.). Muscle atrophy and weakness often occur rapidly in the affected area due to the effects of trauma (or disease) and inactivity. Consequently, training modalities that promote hypertrophy or counteract atrophy without the use of heavy loads should be of special interest in the rehabilitation of some chronic diseases for which high musculoskeletal forces are contraindicated. Occlusive strength training with tourniquet cuffs was first used nearly twenty years ago. Studies have shown that low to-moderate intensity (20-50% of 1RM) resistance training with vascular occlusion leads to gains in muscle strength and volume comparable to those seen after conventional heavy resistance training. This effects suggest, that ischemic strength training may be a useful method in rehabilitation and other contexts. To conclude, the aim of this study is to compare the effect of low intensity resistance training with vascular occlusion vs. normal physical activity on: 1. muscle hypertrophy, strength and neuromuscular parameters; 2. vascular function; 3. and blood parameters (anabolic and catabolic hormones, catecholamines, inflammations factors, parameters of oxidative stress etc.)
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
30
Patients will perform unilateral leg extension resistance training with vascular occlusion 2 times per week for a period of 8 weeks. Each training session will consist of 3 sets of 15 repetitions at the intensity of 30% 1 RM with 30 s of rest period between sets.
University Medical Centre
Ljubljana, Slovenia
RECRUITINGChange in maximal strength
Determined with one repetition maximum test on leg extension machine (kg)
Time frame: 4 weeks, 8 weeks
Change in maximal voluntary contraction (MVC)
Determined with modified interpolated twitch protocol
Time frame: 4 and 8 weeks
Changes of flow-mediated dilatation of the brachial artery
Measured with ultrasound in %
Time frame: 4 weeks, 8 weeks
Change in muscle hypertrophy (muscle thickness)
Measured with ultrasound in mm
Time frame: 4 and 8 weeks
Change of the value of blood human growth hormon (HGH)
measured in ng/mL
Time frame: 4 and 8 weeks
Change of the value of testosterone
measured in ng/dL
Time frame: 4 and 8 weeks
Change of the value of myostatin
measured in ng/mL
Time frame: 4 and 8 weeks
Change of the value of mechano growth factor (MGF)
measured in ng/mL
Time frame: 4 and 8 weeks
Change of the value of insulin-like growth factor (IGF-1)
measured in ng/mL
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Time frame: 4 and 8 weeks
Change of the value of epinephrine
measured in pg/mL
Time frame: 4 and 8 weeks
Change of the value of norepinephrine
measured in pg/mL
Time frame: 4 and 8 weeks
Change of the value of cortisol
measured in mcg/dL
Time frame: 4 and 8 weeks
Change in C-reactive protein
measured in mg/L
Time frame: 4 and 8 weeks
Change in blood pressure prior and after exercise
measured in mmHg
Time frame: 1-8 week
Change in heat-shock protein (HSP-72)
measured in ng/mL
Time frame: 4 and 8 weeks
Change in resting and post-exercise heart rate
Measured in beats per min
Time frame: 4 and 8 weeks
Change of from-the-questionnaire-obtained quality of life
Measured in points
Time frame: 4 and 8 weeks