NON-LINEAR IS NOT SUPERIOR TO LINEAR AEROBIC PERIODIZATION IN CORONARY PATIENTS

Abstract

A greater training load variation (non-linear periodization [NLP]) is often suggested to bring greater training adaptation in athletes compared to the traditional linear periodization (LP) proposed in most of the guidelines. Recently, NLP was used in patients with chronic obstructive pulmonary disease but was never studied in coronary artery disease (CAD) patients. First, we aimed to compare two different periodized aerobic training protocols (linear [LP] vs. non-linear [NLP]) on the cardiopulmonary and hemodynamic exercise response in CAD patients; Moreover, CAD patients could have different response to exercise training (non- vs. low- vs. high-response). Second, we aimed to measure the proportion of responders between both training protocols. We randomized 39 CAD patients to either LP (n=20, 65±10 years) or NLP (n=19, 66±5 years). All patients completed a cardiopulmonary exercise testing (CPET) with gas exchange and hemodynamic measurements (impedance cardiography). Patients underwent a 12-week supervised exercise program including an isoenergetic aerobic periodized training and a similar resistance training program, 3 times/week. Weekly energy expenditure was constantly increased in the LP group for the aerobic training, while it was increased during the first 3-weeks and decreased the fourth week in the NLP group. This cycle was repeated until the end of the intervention. Cardiorespiratory fitness (peak V ̇O2), oxygen uptake efficiency slope (OUES), ventilatory efficiency slope (V ̇E/V ̇CO2 slope), V ̇O2 at the first (VT1) and second (VT2) ventilatory thresholds, cardiac output (Q ̇c), and oxygen pulse (O2 pulse) were measured. Responders were determined according the median value of the Δ peak V ̇O2 (in mL.kg-1.min-1). We found similar improvement for peak V ̇O2 (LP: +8.1%, NLP: +5.3%, interaction: p=0.37; time: p < 0.001), and for OUES, VT1, VT2, and O2 pulse in both groups (interaction: p>0.05; time: p < 0.05) with a greater effect size in the LP group. The proportion of non, low and high-responders was similar between groups (p=0.39). More variation (NLP) does not seem necessary for greater cardiopulmonary and hemodynamic adaptations in CAD patients. Moreover, greater effect size in the LP group allows us to consider the linear periodization as an optimal approach for exercise training in CAD patients.