Resistance training is an effective exercise therapy in cardiac rehabilitation program for patients with coronary artery disease: a systematic review

Salwa B El-Sobkey

doi:10.1186/s43088-022-00206-2

Abstract

BackgroundExercise-based cardiac rehabilitation program is a comprehensive intervention for the rehabilitation of coronary artery disease patients. Exercise therapy is a valuable, effective, and integral intervention of cardiac rehabilitation. Aerobic training is the gold standard exercise therapy in cardiac rehabilitation programs. In addition, combined training with added resistant training is also used. This systematic review aimed to provide the physical therapy clinicians with a consensus regarding the effect of resistant training by answering the question of what is the cardiovascular and non-cardiovascular effect (s) of resistant training in the cardiac rehabilitation program for patients with coronary artery disease?Main bodyThe Physiotherapy evidence database (PEDro) was used as a search engine to select articles through study eligibility criteria. Adult or adult and old stable coronary artery disease patients engaged in a site-based (Phase II) exercise-based cardiac rehabilitation program that includes aerobic and resistant training. Selected articles applied cardiovascular and non-cardiovascular outcome measures to measure the effectiveness of resistant training. The author reviewed the selected articles and applied quantitative non-statistical analysis and appraisal for these articles. The systematic selection process resulted in 10 studies with a total participants number of 3877. Analyzing the articles revealed that adding resistant training to aerobic training resulted in a favorable improvement in outcome measures for coronary artery disease patients. Resistant training produced improvement in the exercise capacity (VO2 peak), blood pressure, skeletal muscle strength, endurance, body composition, sleep quality, depression, and health-related quality of life.Short conclusionsThe addition of resistant training to aerobic training in cardiac rehabilitation induces more positive cardiovascular and non-cardiovascular effects for stable coronary artery disease patients.

Highlights

The study protocol and information source used the PRISMA items, including the PRISMA 2009 checklist, were the reference of the current systematic review reporting [35] and the physiotherapy evidence database (PEDro) was the search engine for it
In addition to Aerobic training (AT) and resistance training (RT), the exercise-based Cardiac rehabilitation program (CRP) consists of combined training (CT) in which the RT is added to the AT and showed to be an effective intervention to restore physical function and exercise capacity and to improve coronary risk factors including hypertension, hyperglycemia, and dyslipidemia in coronary artery disease (CAD) patients [2]
Eligibility Criteria: The following inclusion criteria were considered for records selection: 1- Type of records: randomized controlled trials (RCTs), systemic review (SR), and meta-analysis (MA) 2- Time frame: records published within the last 10 years (2010 to 2019), 3Age of participants: Adult (18–60 years) or adult and old. 4- Diagnosis: patients with stable CAD (e.g., myocardial infarction (MI), coronary artery bypass graft (CABG) surgery), 5- Type of CRP: Sitebased supervised CRP (Phase II cardiac rehabilitation, 5–9 days post-cardiac event or cardiac revascularization), 6- Objective of the records: to measure the effects of RT, 7- Language of the records: English language, 8- Type of intervention: RT or CT, 9- Type of outcome measures: cardiovascular and non-cardiovascular, 10- Publication status: Free access to the full record

Summary

Background

Cardiac rehabilitation program (CRP) is a comprehensive useful and effective program for prevention and rehabilitation which is recommended by the American Heart Association and the American College of Cardiology for treatment and management of patients with coronary artery disease (CAD) [1–7]. In addition to AT and RT, the exercise-based CRP consists of combined training (CT) in which the RT is added to the AT and showed to be an effective intervention to restore physical function and exercise capacity and to improve coronary risk factors including hypertension, hyperglycemia, and dyslipidemia in CAD patients [2]. Complications of CRP in general and exercise therapy specific for CAD patients include major adverse cardiovascular events and even death [34]. These serious complications raise the importance of depending on evidence-based practice for the implementation of exercise-based CRP for CAD patients. The purpose of the current systematic review is to provide the physical therapy clinicians with a consensus regarding the effects of RT by answering the question of what is the cardiovascular and non-cardiovascular effect (s) of resistant training in the cardiac rehabilitation programs for stable CAD patients?

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