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. 2000 Jan;83(1):17–21. doi: 10.1136/heart.83.1.17

Relation between duration and intensity of first exercise and "warm up" in ischaemic heart disease

P Kay 1, J Kittelson 1, R Stewart 1
PMCID: PMC1729284  PMID: 10618328

Abstract

OBJECTIVE—To determine the importance of the duration and intensity of "warm up" exercise for reducing ischaemia during second exercise in patients with exertional angina.
DESIGN—Randomised crossover comparison of three warm up exercise protocols.
PATIENTS—18 subjects with stable ischaemic heart disease and > 0.1 mV ST segment depression on treadmill exercise testing.
INTERVENTIONS—The warm up protocols were 20 minutes of slow exercise at 2.7 km/h, symptom limited graded exercise for a mean of 7.4 (range 5.0 to 10.5) minutes, and three minutes of symptom limited fast exercise of similar maximum intensity.
MAIN OUTCOME MEASURES—ST segment depression during graded treadmill exercise undertaken 10 minutes after each warm up protocol or no warm up exercise.
RESULTS—Compared with exercise with no warm up, the duration of graded exercise after earlier slow warm up increased by 4.9% (95% confidence interval (CI), −3.3% to 13.7%), after graded warm up by 10.3% (95% CI, 5.6% to 15.2%), and after fast warm up by 16% (95% CI, 6.2% to 26.7%). ST segment depression at equivalent submaximal exercise decreased after slow warm up by 27% (95% CI, 5% to 44%), after graded warm up by 31% (95% CI, 17% to 44%), and after fast warm up by 47% (95% CI, 27% to 61%). Compared with slow warm up exercise, the more intense graded and fast warm up protocols significantly increased the duration of second exercise (p = 0.0072) and reduced both peak ST depression (p = 0.0026) and the rate of increase of ST depression (p = 0.0069).
CONCLUSIONS—In patients with exertional angina the size of the warm up response is related to the maximum intensity rather than the duration of first exercise.


Keywords: exercise; angina; warm up; preconditioning

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Figure 1  .

Figure 1  

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Mean percentage difference with 95% confidence intervals for graded exercise after slow, graded, and fast warm up protocols compared with graded exercise with no preceding warm up exercise.

Figure 2  .

Figure 2  

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Relation between ST segment depression on graded exercise with no warm up and the magnitude of warm up induced by the slow exercise protocol. Warm up is measured as the reduction in ST depression at an equivalent submaximal stage of exercise; p values test if the slope of the regression line through the points on the plot is significantly different from zero.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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