Effects of exercise prescription on daily physical activity and maximal exercise capacity in coronary artery disease patients with and without type 2 diabetes

Abstract

Summary Background Promotion of and adherence to increased physical activity (PA) is an important part of the prevention and treatment of coronary artery disease (CAD). We hypothesized that individually tailored home‐based exercise prescriptions will increase long‐term PA and maximal exercise capacity among CAD patients without and with type 2 diabetes (CAD+T2D). Methods Physical activity of patients with CAD (n = 44) and CAD+T2D (n = 39), matched by age, sex and ejection fraction, was measured over 5 days with an accelerometer pre‐ and postexercise prescription. PA was assessed as the average time per day of moderate (METs = 2–5) and high (METs > 5) intensities. Six‐month exercise prescriptions were introduced based on individual maximal heart rate reserve. Results At the baseline, patients with CAD+T2D engaged in less moderate‐intensity PA (2:40 ± 1:23 versus 3:24 ± 1:17 h, P = 0·014) and exhibited a non‐significant trend to reduced high‐intensity PA (2:08 ± 2:57 versus 5:02 ± 9:19 min, P = 0·091) compared with patients with CAD. High‐intensity PA increased markedly in CAD (5:02 ± 9:19 versus 9:59 ± 15:03 min) and patients with CAD+T2D (2:08 ± 2:57 versus 6:14 ± 10:18 min) after exercise prescription (main effect for time P = 0·001). Also maximal exercise capacity increased in both groups (main effect for time P<0·001). Conclusion Patients with CAD with T2D are physically less active than CAD patients without diabetes in their daily life. Individually tailored home‐based exercise prescriptions are an effective way to promote more active lifestyles and improve fitness in both patient groups.

Postprandial lipemia as a cardiometabolic risk factor

“…In nonobese subjects a high-fish diet decreased TRL apoB48 concentration by reducing the secretion rate and the fractional catabolic rate of apoB48 135 . Omega-3 fatty acid supplementation significantly reduced mean fasting and postprandial TG 136 and accelerated chylomicron TG clearance by increasing LPL-mediated lipolysis 137 . Two new formulations of omega-3 fatty acids (AMR101 and an ultrapure mixture of free fatty acid forms of eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) are under clinical development and may provide additional TG-lowering effects by reducing VLDL production and increasing their catabolism thus potentially affecting also postprandial lipemia.…”

Effects of the Swedish physical activity on prescription model on health-related quality of life in overweight older adults: a randomised controlled trial

“…Nevertheless, further scientific evaluation is called for in these reviews. There are different prescribed PA models from Denmark [ 16 ], the Netherlands [ 17 ], and Finland [ 18 ] and they all, just like the ERS’, vary in construct to some extent. The Swedish physical activity on prescription (PAP) model has five components: (a) patient-centred counselling, (b) written prescription of individualised PA using (c) the text book FYSS ( Physical Activity in the Prevention and Treatment of Disease ) for evidence-based prescriptions [ 19 ], (d) follow-up assessments, and (e) collaboration with societal organisations [ 20 ].…”

“…However, further scientific evaluation of effects on HRQoL of the Swedish PAP model is needed as the literature is scarce [ 25 ]. Additionally, evaluation of the effects on health of different models for prescribing PA is needed as the international literature is inconclusive [ 13 – 18 ].…”

Impact of Home- and Hospital-Based Exercise in Cardiac Rehabilitation on Hopelessness in Patients With Coronary Heart Disease

“…22 For those who do begin a CR program, predictors of not completing include increased baseline depression 23 and hopelessness. 24 As a supplement or alternative to phase 2 CR, home-based exercise prescriptions promote physical activity and improve exercise capacity in patients with CHD, 25 and have been found as effective as phase 2 CR in improving exercise capacity, risk factor control, and health-related quality of life. 26 A meta-analysis of 12 studies showed no differences in either short-or long-term outcomes between patients with stable CHD participating in home-or hospital-based CR.…”