1. An evaluation of the role of the exercise training dose for changes in exercise capacity following a standard cardiac rehabilitation program.
- Author
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Iannetta D, Rouleau CR, Chirico D, Fontana FY, Hauer T, Wilton SB, Aggarwal S, Austford LD, Arena R, and Murias JM
- Subjects
- Humans, Retrospective Studies, Exercise Tolerance, Exercise physiology, Exercise Therapy, Cardiac Rehabilitation
- Abstract
Background: To retrospectively characterize and compare the dose of exercise training (ET) within a large cohort of patients demonstrating different levels of improvement in exercise capacity following a cardiac rehabilitation (CR) program., Methods: A total of 2310 patients who completed a 12-week, center-based, guidelines-informed CR program between January 2018 and December 2019 were included in the analysis. Peak metabolic equivalents (MET
peak ) were determined pre- and post-CR during which total duration (ET time) and intensity [percent of heart rate peak (%HRpeak )] of supervised ET were also obtained. Training responsiveness was quantified on the basis of changes in METpeak from pre- to post-CR. A cluster analysis was performed to identity clusters demonstrating discrete levels of responsiveness (i.e., negative, low, moderate, high, and very-high). These were compared for several baseline and ET-derived variables which were also included in a multivariable linear regression model., Results: At pre-CR, baseline METpeak was progressively lower with greater training responsiveness (F(4,2305) = 44.2, P < 0.01, η2 p = 0.71). Likewise, average training duration (F(4,2305) = 10.7 P < 0.01, η2 p = 0.02) and %HRpeak (F(4,2305) = 25.1 P < 0.01, η2 p = 0.042) quantified during onsite ET sessions were progressively greater with greater training responsiveness. The multivariable linear regression model confirmed that baseline METpeak , training duration and intensity during ET, BMI, and age (P < 0.001) were significant predictors of METpeak post-CR., Conclusions: Along with baseline METpeak , delta BMI, and age, the dose of ET (i.e., training duration and intensity) predicts METpeak at the conclusion of CR. A re-evaluation of current approaches for exercise intensity prescription is recommended to extend the benefits of completing CR to all patients., Competing Interests: Declaration of Competing Interest The authors report no relationships that could be construed as a conflict of interest., (Copyright © 2023 Elsevier B.V. All rights reserved.)- Published
- 2023
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