Non-linear is not superior to linear aerobic training periodization in coronary heart disease patients

Abstract

Background We aimed to compare: (1) two different periodized aerobic training protocols (linear (LP) versus non-linear (NLP)) on the cardiopulmonary exercise response in patients with coronary heart disease; (2) the proportion of responders between both training protocols. Design A randomized controlled trial. Methods A total of 39 coronary heart disease patients completed either LP ( n = 20, 65 ± 10 years) or NLP ( n = 19, 66 ± 5 years). All patients completed a cardiopulmonary exercise testing with gas exchange measurements. 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 deeply increased and intercepted with a recovery week each fourth week in the NLP group. Peak oxygen uptake (peak V̇O2), oxygen uptake efficiency slope, ventilatory efficiency slope (V̇E/V̇CO2 slope), V̇O2 at the first (VT1) and second (VT2) ventilatory thresholds, and oxygen pulse (O2 pulse) were measured. Responders were determined according the median value of the Δpeak V̇O2 (mL.min−1.kg−1). Results We found similar improvement for peak V̇O2 (LP: +8.1%, NLP: +5.3%, interaction: p = 0.37; time: p < 0.001) and for oxygen uptake efficiency slope, 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 = 0.29). Conclusion In contrast to the athletes, more variation (NLP) does not seem necessary for greater cardiopulmonary adaptations in coronary heart disease patients.

Alternative aerobic training session in coronary artery disease patients in cardiac rehabilitation. A new stone thrown in the pond

“…Patients above the median (Á peak VO 2 > 1.3 mL.min -1 .kg -1 ) were considered as high-responders; patients under or equal to the median or with a decrease in peak VO 2 were considered as lowresponders or as non-responders. Boidin et al 11 found that, in the LP and NLP groups, five and three patients were considered as non-responders, respectively, three and seven patients as low-responders, and 12 and nine patients as high-responders; no significant statistically difference between the two exercise programme groups was observed. Boidin et al 11 provide an important contribution to test different individualized progressive exercise testing models to optimize adaptations in CAD patients.…”

“…In the present issue of this journal, Boidin et al. provide a meritorious paper 11 and they compare two different periodized aerobic sessions, linear (LP) versus non-linear (NLP), blindly randomized, in a 12-week supervised exercise programme on the cardiopulmonary exercise response in patients with CAD. All patients completed cardiopulmonary exercise testing (CPET): peak oxygen uptake (peak VO 2 ), oxygen uptake, efficiency slope, ventilatory efficiency slope (VE/VCO 2 slope), VO 2 at the first (VT1) and second (VT2) ventilatory thresholds, and oxygen pulse (O 2 pulse) were measured.…”

“…In the HIIT, the workloads reached 100% of peak power. Boidin’s paper 11 elicits also some points: Although the study was not planned to address the issue of safety of HIIT in CAD patients, as the population was limited (39 CAD patients were enrolled over two years), older and female CAD patients did not favour HIIT prescription. Patients’ preferences should be met in order to optimize adherence and increase intrinsic motivation to exercise (i.e.…”

“…14 Although CPETs were conducted in the same clinical and experimental conditions, maximality of tests is not explained in the text: nevertheless, a high respiratory exchange ratio can be detected at peak, after a careful inspect of Table 2. 11 Upgrading of CPET is influenced by time of intervention: this should be explained. Improvement of CPET parameters is influenced by age and gender (see above). Usually, women have a reduced first anaerobic ventilatory threshold (VT1) and they might not achieve the second one (VT2); 12,13 this unsteadiness might provide misleading results.…”

“…Although CPETs were conducted in the same clinical and experimental conditions, maximality of tests is not explained in the text: nevertheless, a high respiratory exchange ratio can be detected at peak, after a careful inspect of Table 2. 11…”