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Resistance Training in Cardiovascular Disease Patients

Not Applicable
Conditions
Coronary Artery Disease
Heart Failure With Reduced Ejection Fraction
Interventions
Other: Aerobic interval training combined with high intensity resistance training
Other: Aerobic interval training combined with low intensity resistance training
Other: Aerobic interval training
Registration Number
NCT04638764
Lead Sponsor
General Hospital Murska Sobota
Brief Summary

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.

Detailed Description

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.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
72
Inclusion Criteria
  • Stable patients with documented CAD with clinical event (>1 month after acute coronary syndrome and/or percutaneous coronary intervention) or coronarography and/or
  • Stable Heart Failure patients with documented reduced ejection fraction (>40-45 %)
  • age >18 years
  • NYHA class I-III
  • Cardiopulmonary exercise test without ECG abnormalities
Exclusion Criteria
  • Unstable CHD
  • Decompensated HF
  • Uncontrolled arrhythmias
  • Severe and symptomatic aortic stenosis
  • Acute myocarditis, endocarditis, or pericarditis
  • Aortic dissection
  • Marfan syndrome
  • Musculoskeletal limitations

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Aerobic interval training with high loads resistance trainingAerobic interval training combined with high intensity resistance trainingPatient to be randomised into "combined aerobic training with high loads resistance training group".
Aerobic interval training with low loads resistance trainingAerobic interval training combined with low intensity resistance trainingPatient to be randomised into "combined aerobic training with low loads resistance training group".
Aerobic interval trainingAerobic interval trainingPatient to be randomised into "aerobic training training group".
Primary Outcome Measures
NameTimeMethod
Change in Maximal aerobic capacityChange in maximal aerobic capacity at 12 weeks compared to baseline

Measured as change in VO2 max (ml/kg/min)

Change in Maximal voluntary contraction of knee extensorsChange in maximal isometric torque at 12 weeks compared to baseline

Measured as change in maximal isometric torque of knee extensors

Secondary Outcome Measures
NameTimeMethod
Change in Homeostatic Model Assessment for Insulin Resistance (HOMA-IR)Change in HOMA-IR at 12 weeks compared to baseline

Measured as change in HOMA IR (%)

Change in glucose levelsChange in glucose levels at 12 weeks compared to baseline

Measured as change in glucose levels (mmol/L)

Change in insulin levelsChange in insulin levels at 12 weeks compared to baseline

Measured as change in insulin levels

Change in heart rate during high and low load resistance exerciseChange of heart rate during resistance exercise compared to baseline (pre-exercise) within the first and the last week of the intervention

Measured as change in heart rate during resistance exercise compared to baseline (pre-exercise)

Change in systolic blood pressure during high and low load resistance exerciseChange of systolic blood pressure during resistance exercise compared to baseline (pre-exercise) within the first and the last week of the intervention

Measured as change in systolic blood pressure during resistance exercise compared to baseline (pre-exercise) values

Change in diastolic blood pressure during high and low load resistance exerciseChange of diastolic blood pressure during resistance exercise compared to baseline (pre-exercise) within the first and the last week of the intervention

Measured as change in diastolic blood pressure during resistance exercise compared to baseline (pre-exercise)

Change in Short Physical Performance Battery (SPPB) total scoreChange in the Short Physical Performance battery test total score (0-the worse outcome, 12- the best outcome) after 12 weeks compared to baseline

Measured as change in points of the SPPB after 12 weeks compared to baseline

Change in time of the "Up and Go" testChange in seconds of the "Up and Go" test after 12 weeks compared to baseline

Measured as change of time (s) in "Up and Go" test

Change in Grip strength test (kg)Change in kg of Grip strength test after 12 weeks compared to baseline

Measured as change of kg in Grip strength test

Change in rating of perceived exertion during high and low load resistance exerciseChange 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

Measured as change of rating of perceived exertion (0-10) during resistance exercise compared to baseline (pre-exercise)

Change in total energy expenditureChange in kcal after 12 weeks compared to baseline

Measured as change in kcal using accelerometry data

Change in the Back Scratch testChange in cm of the Back Scratch test after 12 weeks compared to baseline

Measured as change in cm of the Back Scratch test

Change in Ve/VCO2 slope ratioChange in ratio of VE/VCO2 slope after 12 weeks compared to baseline

Measured as change in VE/VCO2 slope

Change in Arm curl test (number of repetitions)Change in number of repetitions of the Arm curl test after 12 weeks compared to baseline

Measured as change of number of repetitions in Arm curl test

Change in sedentary activity levelChange in minutes of sedentary activity after 12 weeks compared to baseline

Measured as change in minutes spent in sedentary activity level using accelerometry data

Change in moderate to vigorous physical activity levelChange in minutes of moderate to vigorous physical activity after 12 weeks compared to baseline

Measured as change in minutes spent in moderate to vigorous physical activity level using accelerometry data

Change in the Chair Sit and Reach testChange in cm of the Chair sit and Reach test after 12 weeks compared to baseline

Measured as change in cm of the Chair Sit and Reach test

Change in Respiratory Exchange Ratio (RER)Change in % after 12 weeks compared to baseline

Measured as percent change of RER during cardiopulmonary exercise test

Change in Tumor necrosis factor alpha (TNF-alpha) levelChange in TNF-alpha level after 12 weeks compared to baseline

Measured as change in TNF-alpha

Change in time of the Sit to stand testChange in seconds of the Sit to stand test after 12 weeks compared to baseline

Measured as change in time (s) of the Sit and stand test

Change in One Leg Heel Raise test (number of repetitions)Change in number of repetitions of One leg heel raise test after 12 weeks compared to baseline

Measured as change of number of repetitions in One leg heel raise test

Change in Short form Health related quality of life questionnaire (SF-12)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

Measured as change in score of the SF-12

Change in Stork balance testChange in seconds of the Stork balance test after 12 weeks compared to baseline

Measured as change in seconds of the Stork balance test

Change in Patients health questionnaire score (PHQ-9)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

Measured as change in points of PHQ-9 questionnaire

Change in Interleukin 6 (IL-6) levelChange in IL-6 level after 12 weeks compared to baseline

Measured as change in IL-6 level

Change in Human Growth hormone (hGH) levelChange in hGH level after 12 weeks compared to baseline

Measured as change in hGH level

Change in Insulin like Growth Factor 1 (IGF-1)Change in IGF-1 level after 12 weeks compared to baseline

Measured as change in IGF-1 level

Change in N-terminal-pro brain natriuretic peptide (NT-proBNP)Change in NT-proBNP level after 12 weeks compared to baseline

Measured as change in NT-proBNP level

Trial Locations

Locations (1)

Division of Cardiology, General Hospital Murska Sobota

🇸🇮

Murska Sobota, Slovenia

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