Effect of Constant vs. Variable Moderate-Intensity Load on Peak Oxygen Uptake in Outpatient Cardiac Rehabilitation.

Circulation Reports Pub Date : 2023-03-31 eCollection Date: 2023-05-10 DOI:10.1253/circrep.CR-23-0024
Hajime Saeki, Miho Kuramoto, Yoshinori Iida, Kaori Yasumura, Yoh Arita, Nobuyuki Ogasawara
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Abstract

Background: In outpatient center-based cardiac rehabilitation (O-CBCR), moderate-intensity continuous training (MICT) based on the anaerobic threshold (AT) determined by cardiopulmonary exercise stress testing is recommended. However, it is unclear whether differences in exercise intensity within the MICT domain affect peak oxygen uptake (%peakV̇O2). Methods and Results: We retrospectively evaluated patients who underwent O-CBCR at Japan Community Healthcare Organization Osaka Hospital. Those treated with the constant-load method were designated as Group A (n=38), whereas those treated with the variable-load method were designated as Group B (n=48). Although the change in exercise intensity was significantly greater in Group B by approximately 4.5 W, the change in %peakV̇O2 was not significantly different between groups. Group A had a significantly longer exercise time than Group B (by approximately 4-5 min). No deaths or hospitalizations occurred in either group. The percentage of episodes with exercise cessation was similar between the 2 groups, but the percentage of episodes with load reduction was significantly higher in Group B, mostly because of the increased heart rate. Conclusions: In supervised MICT based on AT, the variable-load method increased exercise intensity more than the constant-load method without severe complications, but did not improve %peakV̇O2.

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恒定和可变中等强度负荷对门诊心脏康复患者峰值摄氧量的影响。
背景:在基于门诊中心的心脏康复(O-CBCR)中,建议基于心肺运动压力测试确定的无氧阈值(AT)的中等强度连续训练(MICT)。然而,目前尚不清楚MICT域内运动强度的差异是否会影响峰值摄氧量(%peakV̇O2)。方法 和 结果:我们回顾性评估了在日本社区医疗组织大阪医院接受O-CBCR的患者。用恒定负荷法治疗的患者被指定为A组(n=38),而用可变负荷法治疗者被指定为B组(n=48)。尽管B组运动强度的变化显著增加了约4.5W,但两组之间%peakV̇O2的变化没有显著差异。A组的运动时间明显长于B组(约4-5分钟)。两组均未发生死亡或住院。两组运动停止的发作百分比相似,但B组负荷减少的发作百分比显著较高,主要是因为心率增加。结论:在基于AT的监督MICT中,可变负荷法比恒定负荷法增加了运动强度,没有严重并发症,但没有改善%peakV̇O2。
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