TY - JOUR
T1 - The influence of training characteristics on the effect of exercise training in patients with coronary artery disease
T2 - Systematic review and meta-regression analysis
AU - Kraal, Jos J.
AU - Vromen, Tom
AU - Spee, Ruud
AU - Kemps, Hareld M.C.
AU - Peek, Niels
PY - 2017/10/15
Y1 - 2017/10/15
N2 - Background Although exercise-based cardiac rehabilitation improves exercise capacity of coronary artery disease patients, it is unclear which training characteristic determines this improvement. Total energy expenditure and its constituent training characteristics (training intensity, session frequency, session duration and programme length) vary considerably among clinical trials, making it hard to compare studies directly. Therefore, we performed a systematic review and meta-regression analysis to assess the effect of total energy expenditure and its constituent training characteristics on exercise capacity. Methods We identified randomised controlled trials comparing continuous aerobic exercise training with usual care for patients with coronary artery disease. Studies were included when training intensity, session frequency, session duration and programme length was described, and exercise capacity was reported in peakVO2. Energy expenditure was calculated from the four training characteristics. The effect of training characteristics on exercise capacity was determined using mixed effects linear regression analyses. The analyses were performed with and without total energy expenditure as covariate. Results Twenty studies were included in the analyses. The mean difference in peakVO2 between the intervention group and control group was 3.97 ml·min− 1·kg− 1 (p < 0.01, 95% CI 2.86 to 5.07). Total energy expenditure was significantly related to improvement of exercise capacity (effect size 0.91 ml·min− 1·kg− 1 per 100 J·kg, p < 0.01, 95% CI 0.77 to 1.06), no effect was found for its constituent training characteristics after adjustment for total energy expenditure. Conclusions We conclude that the design of an exercise programme should primarily be aimed at optimising total energy expenditure rather than on one specific training characteristic.
AB - Background Although exercise-based cardiac rehabilitation improves exercise capacity of coronary artery disease patients, it is unclear which training characteristic determines this improvement. Total energy expenditure and its constituent training characteristics (training intensity, session frequency, session duration and programme length) vary considerably among clinical trials, making it hard to compare studies directly. Therefore, we performed a systematic review and meta-regression analysis to assess the effect of total energy expenditure and its constituent training characteristics on exercise capacity. Methods We identified randomised controlled trials comparing continuous aerobic exercise training with usual care for patients with coronary artery disease. Studies were included when training intensity, session frequency, session duration and programme length was described, and exercise capacity was reported in peakVO2. Energy expenditure was calculated from the four training characteristics. The effect of training characteristics on exercise capacity was determined using mixed effects linear regression analyses. The analyses were performed with and without total energy expenditure as covariate. Results Twenty studies were included in the analyses. The mean difference in peakVO2 between the intervention group and control group was 3.97 ml·min− 1·kg− 1 (p < 0.01, 95% CI 2.86 to 5.07). Total energy expenditure was significantly related to improvement of exercise capacity (effect size 0.91 ml·min− 1·kg− 1 per 100 J·kg, p < 0.01, 95% CI 0.77 to 1.06), no effect was found for its constituent training characteristics after adjustment for total energy expenditure. Conclusions We conclude that the design of an exercise programme should primarily be aimed at optimising total energy expenditure rather than on one specific training characteristic.
KW - Aerobic exercise training
KW - Coronary artery disease
KW - Exercise capacity
KW - Meta-analysis
KW - Training characteristics
UR - http://www.scopus.com/inward/record.url?scp=85025463708&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2017.07.051
DO - 10.1016/j.ijcard.2017.07.051
M3 - Article
C2 - 28735757
AN - SCOPUS:85025463708
SN - 0167-5273
VL - 245
SP - 52
EP - 58
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -