What is the effect of aerobic exercise intensity on cardiorespiratory fitness in those undergoing cardiac rehabilitation? A systematic review with meta-analysis
Date
2019
Authors
Mitchell, B.L.
Lock, M.J.
Davison, K.
Parfitt, G.
Buckley, J.P.
Eston, R.G.
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Journal article
Citation
British Journal of Sports Medicine, 2019; 53(21):1341-1352
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Abstract
Objective: Assess the role of exercise intensity on changes in cardiorespiratory fitness (CRF) in patients with cardiac conditions attending exercise-based cardiac rehabilitation. Design: Systematic review with meta-analysis. Data sources: MEDLINE, Embase, CINAHL, SPORTDiscus, PsycINFO and Web of Science. Eligibility criteria for selection: Studies assessing change in CRF (reported as peak oxygen uptake; VO2peak) in patients post myocardial infarction and revascularisation, following exercise-based cardiac rehabilitation. Studies establishing VO2peakvia symptom-limited exercise test with ventilatory gas analysis and reported intensity of exercise during rehabilitation were included. Studies with mean ejection fraction <40% were excluded. Results: 128 studies including 13 220 patients were included. Interventions were classified as moderate, moderate-to-vigorous or vigorous intensity based on published recommendations. Moderate and moderate-to-vigorous-intensity interventions were associated with a moderate increase in relative VO2peak(standardised mean difference±95% CI=0.94±0.30 and 0.93±0.17, respectively), and vigorous-intensity exercise with a large increase (1.10±0.25). Moderate and vigorous-intensity interventions were associated with moderate improvements in absoluteVO2peak(0.63±0.34 and 0.93±0.20, respectively), whereas moderate-to-vigorous-intensity interventions elicited a large effect (1.27±0.75). Large heterogeneity among studies was observed for all analyses. Subgroup analyses yielded statistically significant, but inconsistent, improvements in CRF. Conclusion: Engagement in exercise-based cardiac rehabilitation was associated with significant improvements in both absolute and relative VO2peak. Although exercise of vigorous intensity produced the greatest pooled effect for change in relative VO2peak, differences in pooled effects between intensities could not be considered clinically meaningful.
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Data source: Supplementary data, https://bjsm.bmj.com/content/bjsports/early/2018/08/18/bjsports-2018-099153/DC1/embed/inline-supplementary-material-1.pdf?download=true
Link to a related website: https://chesterrep.openrepository.com/bitstream/10034/622490/1/BJSM_SysRev_AcceptedManuscript_2018.pdf, Open Access via Unpaywall
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Copyright 2018 Author(s) (or their employer(s))