In this study coronary artery disease patients and patients with heart failure will be randomly assigned to three training groups: combined aerobic interval training with high intensity resistance training, combined aerobic interval training with low intensity resistance training and aerobic interval training.
Exercise-based cardiac rehabilitation programmes have predominantly used aerobic-dynamic exercise modalities, whereas resistance training have been discouraged in patients with cardiovascular disease, due to safety concerns related to cardiovascular response (heart rate and blood pressure) during the exertion. Contrary to such concerns, recent hemodynamic studies have reported lower blood pressure and heart rate during higher intensity resistance training (\>70 % 1-RM) compared to lower intensity resistance training (\>40 % 1-RM). Furthermore, the latest meta analysis have demonstrated that combined resistance training with standard aerobic interval training has been superior than aerobic training alone in several aspects of health. However, there is still huge heterogeneity in training intervention design, also there still lacks studies to further elucidate the effects of high intensity resistance training combined with aerobic training on physical performance (aerobic capacity, muscle strength, balance), body composition, quality of life, morbidity, mortality, etc. Therefore, the aim of this study was to examine the effects of high (70%-80 % 1-RM) versus low loads (30%- 40 % 1-RM) resistance training in combination with aerobic interval cycling (50 % -80% of baseline peak Power output) in coronary artery disease patients and patients with heart failure.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
72
Patients enrolled in arm of the study will perform 12 weeks of combined aerobic interval training (5 intervals of cycling at the intensity of 50 %-80% of peak power obtained at baseline cardiopulmonary testing) combined with high intensity resistance training (3 sets of leg press at the intensity of 70 %- 80 % of one repetition maximum (1-RM)).
Patients enrolled in arm of the study will perform 12 weeks of combined aerobic interval training (5 intervals of cycling at the intensity of 50 %-80% of peak power obtained at baseline cardiopulmonary testing) combined with high intensity resistance training (3 sets of leg press at the intensity of 30 %- 40 % 1-RM).
Division of Cardiology, General Hospital Murska Sobota
Murska Sobota, Slovenia
RECRUITINGChange in Maximal aerobic capacity
Measured as change in VO2 max (ml/kg/min)
Time frame: Change in maximal aerobic capacity at 12 weeks compared to baseline
Change in Maximal voluntary contraction of knee extensors
Measured as change in maximal isometric torque of knee extensors
Time frame: Change in maximal isometric torque at 12 weeks compared to baseline
Change in Homeostatic Model Assessment for Insulin Resistance (HOMA-IR)
Measured as change in HOMA IR (%)
Time frame: Change in HOMA-IR at 12 weeks compared to baseline
Change in glucose levels
Measured as change in glucose levels (mmol/L)
Time frame: Change in glucose levels at 12 weeks compared to baseline
Change in insulin levels
Measured as change in insulin levels
Time frame: Change in insulin levels at 12 weeks compared to baseline
Change in systolic blood pressure during high and low load resistance exercise
Measured as change in systolic blood pressure during resistance exercise compared to baseline (pre-exercise) values
Time frame: Change of systolic blood pressure during resistance exercise compared to baseline (pre-exercise) within the first and the last week of the intervention
Change in diastolic blood pressure during high and low load resistance exercise
Measured as change in diastolic blood pressure during resistance exercise compared to baseline (pre-exercise)
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Patients enrolled in arm of the study will perform 12 weeks of aerobic interval training (5 intervals of cycling at the intensity of 50 %-80% of peak power obtained at baseline cardiopulmonary testing).
Time frame: Change of diastolic blood pressure during resistance exercise compared to baseline (pre-exercise) within the first and the last week of the intervention
Change in heart rate during high and low load resistance exercise
Measured as change in heart rate during resistance exercise compared to baseline (pre-exercise)
Time frame: Change of heart rate during resistance exercise compared to baseline (pre-exercise) within the first and the last week of the intervention
Change in rating of perceived exertion during high and low load resistance exercise
Measured as change of rating of perceived exertion (0-10) during resistance exercise compared to baseline (pre-exercise)
Time frame: Change of rating of perceived exertion (score 0-10, 0-no exertion, 10-maximal exertion) during resistance exercise compared to baseline (pre-exercise) within the first and the last week of the intervention
Change in Short Physical Performance Battery (SPPB) total score
Measured as change in points of the SPPB after 12 weeks compared to baseline
Time frame: Change in the Short Physical Performance battery test total score (0-the worse outcome, 12- the best outcome) after 12 weeks compared to baseline
Change in time of the "Up and Go" test
Measured as change of time (s) in "Up and Go" test
Time frame: Change in seconds of the "Up and Go" test after 12 weeks compared to baseline
Change in Grip strength test (kg)
Measured as change of kg in Grip strength test
Time frame: Change in kg of Grip strength test after 12 weeks compared to baseline
Change in Arm curl test (number of repetitions)
Measured as change of number of repetitions in Arm curl test
Time frame: Change in number of repetitions of the Arm curl test after 12 weeks compared to baseline
Change in time of the Sit to stand test
Measured as change in time (s) of the Sit and stand test
Time frame: Change in seconds of the Sit to stand test after 12 weeks compared to baseline
Change in One Leg Heel Raise test (number of repetitions)
Measured as change of number of repetitions in One leg heel raise test
Time frame: Change in number of repetitions of One leg heel raise test after 12 weeks compared to baseline
Change in total energy expenditure
Measured as change in kcal using accelerometry data
Time frame: Change in kcal after 12 weeks compared to baseline
Change in sedentary activity level
Measured as change in minutes spent in sedentary activity level using accelerometry data
Time frame: Change in minutes of sedentary activity after 12 weeks compared to baseline
Change in moderate to vigorous physical activity level
Measured as change in minutes spent in moderate to vigorous physical activity level using accelerometry data
Time frame: Change in minutes of moderate to vigorous physical activity after 12 weeks compared to baseline
Change in the Back Scratch test
Measured as change in cm of the Back Scratch test
Time frame: Change in cm of the Back Scratch test after 12 weeks compared to baseline
Change in the Chair Sit and Reach test
Measured as change in cm of the Chair Sit and Reach test
Time frame: Change in cm of the Chair sit and Reach test after 12 weeks compared to baseline
Change in Stork balance test
Measured as change in seconds of the Stork balance test
Time frame: Change in seconds of the Stork balance test after 12 weeks compared to baseline
Change in Short form Health related quality of life questionnaire (SF-12)
Measured as change in score of the SF-12
Time frame: Change in score of the Short form 12 items health related questionnaire (12 points -the lowest score, 47 points the highest score) after 12 weeks compared to baseline
Change in Patients health questionnaire score (PHQ-9)
Measured as change in points of PHQ-9 questionnaire
Time frame: Change in score of the Patients health 9-item questionnaire (0 points-the best outcome, 27 points-the worse outcome) after 12 weeks compared to baseline
Change in Respiratory Exchange Ratio (RER)
Measured as percent change of RER during cardiopulmonary exercise test
Time frame: Change in % after 12 weeks compared to baseline
Change in Ve/VCO2 slope ratio
Measured as change in VE/VCO2 slope
Time frame: Change in ratio of VE/VCO2 slope after 12 weeks compared to baseline
Change in Tumor necrosis factor alpha (TNF-alpha) level
Measured as change in TNF-alpha
Time frame: Change in TNF-alpha level after 12 weeks compared to baseline
Change in Interleukin 6 (IL-6) level
Measured as change in IL-6 level
Time frame: Change in IL-6 level after 12 weeks compared to baseline
Change in Human Growth hormone (hGH) level
Measured as change in hGH level
Time frame: Change in hGH level after 12 weeks compared to baseline
Change in Insulin like Growth Factor 1 (IGF-1)
Measured as change in IGF-1 level
Time frame: Change in IGF-1 level after 12 weeks compared to baseline
Change in N-terminal-pro brain natriuretic peptide (NT-proBNP)
Measured as change in NT-proBNP level
Time frame: Change in NT-proBNP level after 12 weeks compared to baseline