Sustained Effects of Different Exercise Modalities on Physical and Mental Health in Patients With Coronary Artery Disease: A Randomized Clinical Trial

Exercise Modalities and Intensity to Improve Functional Capacity and Psychological/Mental Health in Cardiac Rehabilitation: A Role for Nordic Walking?

“…The study by Terada et al 19 reported in this issue of the Canadian Journal of Cardiology extends the previous work by comparing NW with different exercise modalities (HIIT and MICT groups) during and after supervised CR. The HIIT and MICT groups performed various types of aerobic exercise, including, but not limited to, walking.…”

“…The authors acknowledge that the greater improvement in 6MWT distance by NW may be a reflection of the similarity between testing and training methods (ie, walking), and specific improvements in parameters related to walking, such as posture and gait. 19 Nonetheless, NW was superior to HIIT and MICT for improving walking capacity during the 12-week CR program. The authors acknowledge the lack of cardiopulmonary exercise testing as a limitation of the study.…”

“…Very commendably, Terada et al 19 elaborate on the impact of CR not only on CRF but also on mental and emotional status. They present equally effective and positive acute effects of CR on the mental component of QoL and depressive symptoms regardless of exercise modality.…”

“…Nonetheless, Terada et al demonstrate that, unlike functional capacity, achieved improvements in mental and emotional status do not persist, or even reverse, during a 14-week observation period. 19 The authors speculate that this could be a consequence of increased physical activity level during the observation phase. However, there is still an unexplained incoherence between physical health and mental/ emotional status during this phase.…”

Impact of mental disorders on clinical outcomes of physical diseases: an umbrella review assessing population attributable fraction and generalized impact fraction

“…Furthermore, independent meta-analyses showed that psychotherapy/psychoeducation can have a preventive effect by reducing the severity of symptoms before the onset of depressive disorders [135][136][137] . Randomized controlled trials demonstrated that collaborative care, which includes patient preferences, cognitive intervention and/ or lifestyle advice, drug treatment management, and relapse prevention 138 , or physical exercise 139,140 , can specifically reduce depression in patients with cardiovascular diseases or diabetes, including low-and middle-income countries 141,142 . These interventions could, at the same time, have an impact on depressive disorders and improve self-management of physical diseases in patients with mental and physical multimorbidity 143 .…”