The effects of resistance training in patients with coronary disease : doktorska disertacija

Kambič, Tim (author), Lainščak, Mitja (mentor), Hadžić, Vedran (comentor)

Resistance training (RT) in combination to aerobic training (AT) was shown to be superior when compared with AT alone, however, it remains unknown whether high load (HL-) RT provides more benefits than low load (LL-) RT in patients with coronary artery disease (CAD). This study aimed to compare the effects of HL-RT or LL-RT combined with AT versus AT alone on maximal aerobic capacity (VO2max) and maximal voluntary contraction (MVC), body composition, physical performance and physical activity, glucose metabolism, quality of life and acute hemodynamic response (heart rate and blood pressure) to resistance exercise (RE). We randomised 79 patients with CAD to HL-RT+AT (70%-80% of one repetition maximum [1-RM]), LL-RT+AT (35%–40% of 1-RM) or AT alone. Fifty-nine patients, predominately males (75%), mean (SD), 61(8) years old and mostly with preserved left ventricular ejection fraction (53 (9) %) completed the study. Measurements were performed at baseline and post-training. All training modalities were safe and improved VO2max (p <0.01), whereas only HL-RT and LL-RT modalities improved MVC (both p <0.001). HL-RT improved VO2 max to a greater extent than AT (+18%, p = 0.032). There was a greater increase in MVC following HL-RT compared with LL-RT (+7%, p = 0.018) and AT (+16 %, p <0.001), and following LL-RT compared with AT (+10%, p = 0.001). All training modalities improved most of the physical abilities, but HL-RT and LL-RT were superior to AT in gait speed, and upper and lower limb muscle strength parameters. There was no between-modalities difference in body composition, physical activity, blood lipids, insulin resistance and quality of life. The acute hemodynamic response to RE was within physiological ranges, and similar between HL-RE and LL-RE. Our findings support the implementation of HL-RT in addition to AT in cardiac rehabilitation for patients with CAD.

• Language: English
• Keywords: resistance training, aerobic training, cardiac rehabilitation, coronary artery disease
• Work type: Doctoral dissertation
• Typology: 2.08 - Doctoral Dissertation
• Organization: FŠ - Faculty of Sport
• Year: 2023
• PID: 20.500.12556/RUL-144991
• COBISS.SI-ID: 148064259
• Publication date in RUL: 29.03.2023

Secondary language

• Language: Slovenian
• Title: Učinki vadbe za moč pri bolnikih s koronarno boleznijo

Abstract

Vadba za moč (VM) v kombinaciji z aerobno vadbo (AV) je učinkovitejša kot AV, vendar pri bolnikih s koronarno arterijsko boleznijo (KAB) še vedno ostaja nepojasnjen potencial VM z velikimi bremeni (VB) v primerjavi z majhnimi bremeni (MB). Cilj raziskave je bil primerjati učinke AV s kombinacijo AV in VM-VB ali VM-MB na maksimalno aerobno zmogljivost (VO2max) in maksimalno hoteno kontrakcijo (MHK), telesno sestavo, zmogljivost in aktivnost, metabolizem glukoze, kakovost življenja in akutni hemodinamski odziv na VM. Devetinsedemdeset bolnikov s KAB smo randomizirali v VM-VB + AV (70-80 % maksimalnega bremena, ki se ga premaga enkrat [1-RM]), VM-MB + AV (35–40 % 1-RM) ali intervalno AV. Raziskavo je zaključilo 59 bolnikov, ki so bili večinoma moški (75 %), stari 61 (8) let [povprečje (standardni odklon)], s pretežno ohranjenim iztisnim deležem levega ventrikla (53 (9)%). Meritve smo izvedli na začetku in po koncu vadbene intervencije. Vse vadbene oblike so bile varne in so izboljšale VO2max (p < 0,01), medtem ko sta zgolj VM-VB in VM-MB izboljšali MHK (obe p < 0,001). VM-VB je VO2max izboljšala v večji meri kot AV (+18 %, p = 0,032). MHK se je v večji meri izboljšala po VM-VB v primerjavi z VM-MB (+7 %, p = 0,018) in AV (+16 %, p <0,001) ter po VM-MB v primerjavi z AV (+10 %, p = 0,001). Vse vadbene oblike so izboljšale večino motoričnih sposobnosti, vendar sta bili VM-VB in VM-MB učinkovitejši kot AV v izboljšanju hitrosti hoje in mišični jakosti zgornjih ter spodnjih okončin. Med vadbenimi oblikami nismo ugotovili razlik na področjih telesne sestave in aktivnosti, krvnih maščob, občutljivosti na inzulin in kakovosti življenja. Akutni hemodinamski odziv na VM je bil varen, znotraj mej fiziološkega odziva in podoben pri VM-VB in VM-MB. Izsledki naše raziskave podpirajo implementacijo VM-VB v kombinaciji z AV v kardiološki rehabilitaciji bolnikov s KAB.

• Keywords: Vadba za moč, aerobna vadba, kardiološka rehabilitacija, koronarna bolezen