Abstract
Exercise-induced improvements in the VO2peak of cardiac rehabilitation participants are well documented. However, optimal exercise intensity remains doubtful. This study aimed to identify the optimal exercise intensity and program length to improve VO2peak in patients with cardiovascular diseases (CVDs) following cardiac rehabilitation. Randomized controlled trials (RCTs) included a control group and at least one exercise group. RCTs assessed cardiorespiratory fitness (CRF) changes resulting from exercise interventions and reported exercise intensity, risk ratio, and confidence intervals (CIs). The primary outcome was CRF (VO2peak or VO2 at anaerobic threshold). Two hundred and twenty-one studies were found from the initial search (CENTRAL, MEDLINE, CINAHL and SPORTDiscus). Following inclusion criteria, 16 RCTs were considered. Meta-regression analyses revealed that VO2peak significantly increased in all intensity categories. Moderate-intensity interventions were associated with a moderate increase in relative VO2peak (SMD = 0.71 mL-kg−1-min−1; 95% CI = [0.27–1.15]; p = 0.001) with moderate heterogeneity (I2 = 45%). Moderate-to-vigorous-intensity and vigorous-intensity interventions were associated with a large increase in relative VO2peak (SMD = 1.84 mL-kg−1-min−1; 95% CI = [1.18–2.50], p < 0.001 and SMD = 1.80 mL-kg−1-min−1; 95% CI = [0.82–2.78] p = 0.001, respectively), and were also highly heterogeneous with I2 values of 91% and 95% (p < 0.001), respectively. Moderate-to-vigorous and vigorous-intensity interventions, conducted for 6–12 weeks, were more effective at improving CVD patients’ CRF.
Highlights
Cardiovascular diseases (CVDs) are the leading cause of mortality in today’s society, being responsible for up to one-third of all deaths worldwide and 50% of all deaths in Europe, and this scenario is expected to worsen in the coming years [1].The concept of cardiac rehabilitation (CR) has been defined as the effort towards cardiovascular risk factor reduction, designed to lessen the chance of a subsequent cardiac event, and to slow and perhaps stop the progression of the disease process
All data were extracted by the principal investigator and their accuracy was assessed by a second author
Based on the sensitivity analysis, the results suggest that interventions conducted bidirectionally six times a week resulted in more significant gains of cardiorespiratory fitness (CRF) favoring vigorous intensity, the analysis only included two studies and may not be practical to implement
Summary
Cardiovascular diseases (CVDs) are the leading cause of mortality in today’s society, being responsible for up to one-third of all deaths worldwide and 50% of all deaths in Europe, and this scenario is expected to worsen in the coming years [1].The concept of cardiac rehabilitation (CR) has been defined as the effort towards cardiovascular risk factor reduction, designed to lessen the chance of a subsequent cardiac event, and to slow and perhaps stop the progression of the disease process. In the context of CR programs, exercise training has been recognized as one of the main components, combined with education, control, pharmacological adherence and lifestyle changes of cardiovascular risk factors [2]. Physical exercise inclusion in CR programs resulted in several beneficial effects on cardiovascular functional capacity, quality of life, risk factor modification, psychological profile, hospital readmissions, and mortality [3,4]. Such benefits can be justified by a 20% reduction in mortality from all causes and in the levels of.
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