An innovative cardiac rehabilitation based on the power-force-velocity profile to further improve cardiorespiratory capacities in coronary artery disease patients

Abstract

Abstract Background Several studies have shown the importance of the relationship between the power-force-velocity profile (PFVP) and sport performance in elite athletes through optimised exercise training [1]. Optimising the training programme is constantly sought in rehabilitation among patients always younger with coronary artery disease. To adapt the exercise training to each patient, we rely mainly on the results of the cardiopulmonary exercise test [2]. However, the nature of the training is the same for all patients. We hypothesized that the assessment of the PFVP at the beginning of the cardiac rehabilitation (CR) would allow to better adapt the CR training programme for each patient. Purpose The aim of this study was to compare the effects of two exercise training programmes: a traditional CR versus a new CR relied on patient's PFVP on cardiorespiratory system and functional capacities in coronary patients. Methods This prospective randomized controlled trial was conducted from May 2020 to July 2021. A total of 89 patients were randomly assigned (1:1) to test or control group. Before starting CR, participants performed two sprints of 8 s on a cycle ergometer to define the PFVP. The PFVP was analysed to determine whether the participant had a force or velocity deficit. Patients included in test group followed a specific cycling training programme based on their weak point (i.e., specific force training with high resistance and low pedalling frequency on the cycle if the PFVP was oriented in velocity and reversely). While control patients attended a conventional CR programme. The 3-week training intervention consisted of 40 min of cycling, 30 min of walking on treadmill and 20 min of strength training (4/week). Cardiopulmonary exercise test (VO2 at the first ventilatory threshold, SV1 and VO2 peak in ml/min/kg), functional assessments (distance of 6-min walk test, handgrip strength, 10 sit-to-stand repetitions, cholesterol levels, LDL-C and quality of life) were performed at the baseline and after CR. A two-way ANOVA with one repeated measure (pre vs. post) and one independent factor (test vs. control) was realized. Results The mean age was 61.0±9.6 years, 18% were women. A significant difference was observed in VO2 peak (test: +22.0±19.1% vs. control: +10.2±15.8%, p=0.003) and VO2 SV1 (test: +35.9±33.9% vs. control: +11.9±34.4%, p<0.001), LDL-C (p=0.016) and quality of life (p<0.001). No significant change between groups in other functional tests occurred after CR programme. Conclusion Cardiopulmonary activity, cholesterol and quality of life were improved after 3-week exercise programme. The novel CR depending on initial PFVP showed greater cardiorespiratory benefits than a conventional CR. Therefore, the PFVP can be used in CR to adapt specifically the content of training sessions. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): DRCI University Hospital Saint-Etienne