Table 3 Effects of exercise therapy in cardiac rehabilitation program for coronary artery disease patients on different outcome measures
Study | Outcome measures | Resistance training (RT) | Aerobic training (AT) | Combined training (CT) | Â |
|---|---|---|---|---|---|
Zhang et al. [1]/2018/MA | Central blood pressure, ASP | Pre-post significant ↓ | Pre-post significant ↓ | (CT = RT + AT) No change |  |
|  | Central blood pressure, ADP | Pre-post significant ↓ | No change | No change |  |
| Â | Central arterial stiffness, cf-PWV | Pre-post controversial effect | Pre-post significant improvement | Significant improvement | Â |
| Â | Mechanical cardiac function, LVEF | No effect | Pre-post significant improvement | Significant improvement | Â |
| Â | Mechanical cardiac function, CO | No effect | Pre-post significant improvement | Significant improvement | Â |
Yamamoto et al. [2]/2016/MA | Upper and lower extremities skeletal muscles strength |  |  | Results of middle-aged patients: ↑ and RT or CT (RT + AT) had a significantly greater favorable effect than the control group (usual care or AT alone) |  |
| Â | Exercise capacity, VO2 peak | Â | Â | Â | Â |
| Â | Exercise capacity, exercise time | Â | Â | Â | Â |
| Â | Mobility, household physical activity and functional mobility scores from continuous-scale physical performance tests | Â | Â | No significant difference between RT or CT and the usual care or AT alone | Â |
Marzolini et al. [37]/2011/meta-analysis of RCTs | Body composition: Percent body fat | Not measured |  | (CT = RT + AT) CT is favorable than AT alone in decreasing the percentage of body fat |  |
| Â | Body composition: Trunk fat | Not measured | Â | CT is more favorable than AT alone in decreasing trunk fat | Â |
| Â | Body composition: Fat-free mass | Not measured | Â | CT is more favorable than AT alone in increasing fat-free mass | Â |
| Â | Lower and upper body skeletal muscle strength | Not measured | Â | CT is associated with a larger increase in lower and upper body strength than AT alone | Â |
| Â | Exercise capacity (VO2 peak) | Not measured | Â | There was a trend for CT to increase VO2 peak and was more favorable than AT alone | Â |
| Â | HRQOL | Not measured | Â | CT is more favorable than AT alone in increasing HRQOL | Â |
Gremeaux Pole et al. [39]/2010/RCT | Symptom-limited Vo2 | Not measured | Not measured | CT = AT + RT (RT = eccentric group and concentric group) A significant pre-post training effect was found in concentric and eccentric groups with a tendency for a better improvement of symptom limited Vo2 and ankle plantar flexor maximal isometric voluntary contraction in the eccentric group |  |
| Â | Peak workload | Â | Â | Â | Â |
| Â | Walked distance of 6-min walk test | Â | Â | Â | Â |
| Â | Knee extensor maximal isometric voluntary contraction | Â | Â | Â | Â |
| Â | Ankle plantar flexor maximal isometric voluntary contraction | Â | Â | Â | Â |
| Â | Time of 200-m fast walk test | Â | Â | Showed a strong but not significant decrease in concentric and eccentric groups | Â |
| Â | Observed adverse events | Â | Â | No, in both training groups | Â |
Dor-Haim et al. [10]/2018/RCT | LVEF | Not measured | AT = CAT No significant changes from pre- to post-training | CT (SCT) = (AT + RT in interval circuits) Significant Pre-post training ↑ with no significant difference between post-training of CAT and SCT |  |
|  | Aerobic fitness (maximal MET) | Not measured | No significant changes from pre- to post-training | Significant Pre-post training ↑ |  |
|  | HRQOL (physical component) | Not measured | Significant Pre-post training ↑ | Significant Pre-post training ↑. The improvement in SCT is more than in the CAT |  |
| Â | Observed adverse events | Not measured | No | No, The SCT was also found to be safe as, throughout the 12-weeks program, no major and/or minor adverse events such as syncope, hospitalization, severe arrhythmia, or disturbances in autonomic nervous system function were observed | Â |
| Â | The attrition rate | Not measured | Like SCT | Like CAT. the main cause of attrition in the SCT program was from non-program-related factors such as transportation to the CR facility, difficulties in maintaining the training schedule etc., factors not related to the training program itself | Â |
Guiraud et al. [40]/2017/RCT | Â | Isometric (HML) Vs. Dynamic (TST) | Not measured | Not measured | Â |
|  | Cardiopulmonary exercise test (CPET): peak power output, PPO | Pre-post training was significant ↑ in both groups. Between-group favors isometric group |  |  |  |
|  | (CPET): maximal HR | Pre-post training was significant ↑ in both groups. No significant difference between groups |  |  |  |
|  | (CPET): maximal SBP | Pre-post training was significant ↑ in both groups. No significant difference between groups |  |  |  |
|  | (CPET): maximal DBP | Pre-post training ↓in an isometric group. pre-post training significant ↑ in the dynamic group |  |  |  |
|  | Upper and lower extremities strength (MVIC) | Pre-post training was significant ↑ in both groups. No significant difference between groups |  |  |  |
| Â | Endothelial function RHI | No pre-post training effect | Â | Â | Â |
| Â | Anthropometric variables (BMI, waist circumference) | No pre-post training effect | Â | Â | Â |
| Â | body composition (bioelectrical impedance) | No pre-post training effect | Â | Â | Â |
| Â | HRQOL | Beneficial in the entire group with no difference between groups | Â | Â | Â |
| Â | Pittsburgh Sleep Quality Index | Beneficial in the entire group with no difference between groups | Â | Â | Â |
| Â | Observed adverse events | No adverse event was observed in either group as both protocols appeared to be well-tolerated, safe and feasible for CAD patients | Â | Â | Â |
Caruso [38]/2015/RCT | HRV | Not measured | No significant improvement in any outcome | CT = AT + HR/LL-RT Significant improvement in all outcomes compared to AT alone |  |
| Â | Skeletal muscle strength (Leg press) | Â | Â | Â | Â |
| Â | Skeletal muscle endurance (Leg press) | Â | Â | Â | Â |
Berent et [34]/2011/RCT |  |  |  | CT = AT + RT (2 sets X 12 Repetitions) | CT = AT + RT (3 sets X 15 Repetitions) |
|  | Exercise capacity (VO2 max) | Not measured | Not measured | Pre-post training was significant ↑ in both groups. No significant difference between groups |  |
|  | Skeletal muscle strength (leg press, leg curl, rowing, and pull-down exercises) | Not measured | Not measured | Pre-post training was significant ↑ in both groups. No significant difference between groups |  |
|  | Blood chemistries (Lipids) | Not measured | Not measured | Pre-post training was significant ↑ in both groups. No significant difference between groups |  |
|  | Hemodynamics (HR, SBP, DBP) | Not measured | Not measured | Pre-post training was significant ↑ in both groups. No significant difference between groups |  |
| Â | Bodyweight and BMI | Not measured | Not measured | Not significantly reduced | Â |
| Â | Observed side-effects | Not measured | Not measured | No | Â |
Marzolini et al. [52]/2015/RCT | HRQOL (self-efficacy of lower-body physical activity tasks) | Not measured | Pre-post significant ↑ | CT = AT + RT (1 set) | CT = AT + RT (3 sets) |
|  |  |  |  | Pre-post significant ↑↑ | Pre-post significant ↑↑↑ |
|  | HRQOL (self-efficacy for upper body physical activity tasks) | Not measured | No improvement | Pre-post significant ↑ | Pre-post significant ↑↑ |
|  | Physical component of HRQOL | Not measured | Pre-post significant ↑ | Pre-post significant ↑ | Pre-post significant ↑ |
|  | Psychological (depression score) | Not measured | No improvement | Pre-post significant↓ | Pre-post significant↓ |
| Â | Injuries or cardiovascular complications | Not measured | No significant injuries or cardiovascular complications related to RT or AT were included | Â | Â |
Currie et al. [33]/2015/RCT |  |  | Low volume HIIT | MICT | CT = RT + AT (low-volume HIIT) Vs. CT = RT + AT (MICT) |
|  | Exercise capacity (VO2 peak) | Not measured | Pre-post 3 months significant ↑ | No further increase post 6 months |  |
| Â | BP and HR | Not measured | Unchanged | Unchanged | Â |
|  | Lipid profiles (high-density lipoprotein) | Not measured | Unchanged | RT + low-volume HIIT: Unchanged |  |
|  |  |  |  | RT + MICT: increase |  |
|  | HRQOL (Self-evaluated health) | Not measured | Unchanged | RT + low-volume HIIT: Unchanged |  |
|  |  |  |  | RT + MICT: increase |  |
| Â | Exercise compliance | Â | Similar between groups | Â | Â |