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Canadian Journal of Cardiology

Sustained Effects of Different Exercise Modalities on Physical and Mental Health in Patients With Coronary Artery Disease: A Randomized Clinical Trial

  • Tasuku Terada
    Affiliations
    Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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  • Lisa M. Cotie
    Affiliations
    Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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  • Heather Tulloch
    Affiliations
    Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada

    Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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  • Matheus Mistura
    Affiliations
    Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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  • Sol Vidal-Almela
    Affiliations
    Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada

    School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
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  • Carley D. O’Neill
    Affiliations
    Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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  • Robert D. Reid
    Affiliations
    Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada

    Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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  • Andrew Pipe
    Affiliations
    Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada

    Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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  • Jennifer L. Reed
    Correspondence
    Corresponding author: Dr Jennifer L. Reed, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, Ontario K1Y 4W7, Canada. Tel.: +1-613-696-7392.
    Affiliations
    Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada

    Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada

    School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
    Search for articles by this author

      Abstract

      Background

      Twelve-week high-intensity interval training (HIIT), moderate-to-vigorousintensity continuous training (MICT), and Nordic walking (NW) have been shown to improve functional capacity, quality of life (QoL), and depression symptoms in patients with coronary artery disease. However, their prolonged effects or whether the improvements can be sustained remains unknown. In this study we compared the effects of 12 weeks of HIIT, MICT, and NW on functional capacity, QoL, and depression symptoms at week 26.

      Methods

      Patients with coronary artery disease were randomized to a 12-week HIIT, MICT, or NW program followed by a 14-week observation phase. At baseline, and at weeks 12 and 26, functional capacity was measured with a 6-minute walk test (6MWT); QoL was assessed using the HeartQoL and Short Form-36; and depression severity using the Beck Depression Inventory-II. Prolonged (between baseline and week 26) and sustained (between weeks 12 and 26) effects were assessed using linear mixed models with repeated measures.

      Results

      Of 130 participants randomized, 86 (HIIT: n = 29; MICT: n = 27; NW: n = 30) completed week 26 assessments. There were significant improvements in 6MWT distance, QoL, and depression symptoms from baseline to week 26 (P < 0.05); NW increased 6MWT distance (+94.2 ± 65.4 m) more than HIIT (+59.9 ± 52.6 m; interaction effect P = 0.025) or MICT (+55.6 ± 48.5 m; interaction effect P = 0.010). Between weeks 12 and 26, 6MWT distance and physical QoL increased significantly (P < 0.05).

      Conclusions

      Twelve weeks of HIIT, MICT, and NW have positive prolonged effects on functional capacity, QoL, and depression symptoms. However, NW conferred additional benefits in increasing functional capacity. The effects of the 12-week exercise programs were sustained at week 26.

      Résumé

      Contexte

      Il a été démontré que l’entraînement fractionné de haute intensité (EFHI), l’entraînement continu d’intensité modérée à élevée (ECIME) et la marche nordique (MN) pratiqués durant 12 semaines améliorent la capacité fonctionnelle et la qualité de vie (QdV), en plus d’atténuer les symptômes de dépression chez les patients atteints de coronaropathie. Toutefois, leurs effets à long terme et la persistance de leurs bienfaits restent à confirmer. Notre étude nous a permis de comparer les effets que l’EFHI, l’ECIME et la MN pratiqués durant 12 semaines avaient au bout de 26 semaines sur la capacité fonctionnelle, la QdV et les symptômes de dépression.

      Méthodologie

      Des patients atteints de coronaropathie ont été répartis de façon aléatoire pour suivre un programme d’EFHI, d’ECIME ou de MN de 12 semaines, suivi d’une phase d’observation de 14 semaines. Au début de l’étude et aux semaines 12 et 26, la capacité fonctionnelle a été mesurée au moyen d’un test de marche de six minutes (TDM6); la QdV a été évaluée à l’aide des questionnaires HeartQoL et Short Form-36; la gravité de la dépression a été établie à l’aide de l’inventaire de dépression de Beck II. Les effets à long terme (entre le début de l’étude et la semaine 26) et la persistance des effets (entre les semaines 12 et 26) ont été évalués à l’aide de modèles linéaires mixtes à mesures répétées.

      Résultats

      Sur les 130 participants répartis de façon aléatoire, 86 (EFHI : n = 29; ECIME : n = 27; MN : n = 30) ont terminé les évaluations de la semaine 26. Des améliorations significatives de la distance parcourue au TDM6, de la QdV et des symptômes de dépression ont été observées entre le début de l’étude et la semaine 26 (P < 0,05); la MN a permis d’augmenter davantage la distance parcourue au TDM6 (+94,2 ± 65,4 m) que l’EFHI (+59,9 ± 52,6 m; valeur P de l’effet d’interaction = 0,025) ou que l’ECIME (+55,6 ± 48,5 m; valeur P de l’effet d’interaction = 0,010). Entre les semaines 12 et 26, la distance parcourue au TDM6 et la QdV physique ont augmenté de façon significative (P < 0,05).

      Conclusions

      L’EFHI, l’ECIME et la MN pratiqués durant 12 semaines ont des effets positifs prolongés sur la capacité fonctionnelle, la QdV et les symptômes de dépression. Toutefois, la MN s’est révélée plus bénéfique en matière d’augmentation de la capacité fonctionnelle. Les effets des programmes d’exercices de 12 semaines persistaient à la semaine 26.
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