Table 2.
Presentation of articles in line with objectives and main findings regarding exercise therapy in coronary heart disease patients.
| Author/Year | Objective of the Study | Intervention | Outcome Measures | Results | Conclusion |
|---|---|---|---|---|---|
| Hansen, D. et al. [10] 2011 |
Evaluate the efficacy of aerobic training in combination of lower limb low intensity resistance training in patients with coronary artery disease. | Aerobic training group = Aerobic training for 3 times in a week for 8 weeks. Combined group = Limbs along with aerobic exercises 3 times a week for 8 weeks. |
|
In comparison to AET, RT tends to increase the total body lean tissue mass with a higher magnitude (p = 0.07), and blood high-density lipoprotein cholesterol content with a considerably greater magnitude (p < 0.05). | Low-intensity RT during early aerobic endurance training in individuals with coronary artery disease accounts for a substantial increase in blood high-density lipid cholesterol content, along with tends to alter lean tissue mass. |
| Caruso, F.R. et al. [11] 2015 |
The effect of resistance training on improving heart variability in patients with coronary heart disease. | Resistance training group = Session of resistance training along with aerobic training for a total duration of 1 h, 2 times a week for 8 weeks. Usual care group = In this group patients were provided with a session composed of warm-up, aerobic exercises, stretching and cool-down of 1 h, 2 times a week for 8 weeks. |
|
Significantly increase in RMSSD and SD1 indices in the resistance training group after 8 weeks of training session. | Significant improvement in heart rate volume, muscle strength and endurance in coronary artery disease patients. |
| Scheer, A. et al. [12] 2021 | Effect of water-based circuit training on body fat, fitness and leg strength in patients with stable coronary artery disease. | Water based exercise group = Circuit of light aerobic and stretching exercises, with an alternative session of aerobic exercises with resistance exercises 60 min, 3 times a week 12 weeks. Gym based exercise group = Aerobic exercises and resistance exercises were given to the patients 60 min, 3 times a week for 12 weeks. Control group = Usual activities of daily living |
|
VO2 peak significantly increased in both training groups as compared to controls: WEX by 2.5 mL/kg/min (95 % CI 0.6 to 4.4) and GEX by 2.3 mL/kg/min (95 % CI 0.6 to 4.0). When compared to the control, both WEX and GEX increased hamstring strength: WEX by 6.3 kg (95 % CI 1.2 to 11.3) and GEX by 7.6 kg (95 % CI 2.9 to 12.2). GEX enhanced leg press strength by 15.5 kg (95% CI 5.7 to 25.3) in comparison to control. Latissimus dorsi pulldown strength was only increased with GEX. | WEX was well tolerated. It enhanced body composition, leg strength, and aerobic ability. Data suggest WEX as a useful exercise training substitute for GEX for individuals with coronary heart disease. |
| Reed, J.L. et al. [13] 2021 | Effect of high intensity interval training, walking on cardiovascular system in patients with coronary artery disease. | High intensity interval training = Session of 45 min was given to the patients that consist of warm-up high intensity training and cool-down. Moderate to vigorous intensity continuous training = A session of 60 min was given that consist of 10–15 min of warm-up, 10–15 min aerobic exercises and 15 min cool-down. Nordic walking = Session of 60 min was given to the patients that included 15 min warm-up, 10–15 min walking and 15 min cool-down. |
|
There was a higher increase in 6 MWT distance (m) for NW (77.2–60.9) than HIIT (51.4–47.8) and MICT (48.3–47.3), according to a significant time–group interaction (p = 0.042). BDI-II considerably improved (HIIT: 1.4 3.7, NW: 1.6 4.0, MICT: 2.3 6.0 points, main effect of time p < 0.001). Values for the SF-36 and Heart QoL significantly improved (main effects of time: p < 0.05). |
All exercise programs (HIIT, NW, and MICT) were well-attended, secure, and helpful for enhancing physical and emotional health in patients with CAD. |
| Marzolini, S. et al. [15] 2008 |
Determine the effect of aerobic and resistance training in patients with coronary artery disease. | Aerobic training group = 30 to 60 min of walking and jogging AT/RT1 and AT/RT3 = Within a 24-week period, attended 6 RT exercise training sessions during their regularly scheduled weekly classes, including follow-up sessions at weeks 12, 16, and 22 |
|
The average increase in VO2 peak from baseline was 11% for AT (p < 0.05), 14% for AT/RT1, and 18% for AT/RT3, although there was no statistically significant difference between the groups. VAT dramatically increased in the AT/RT3 group (p < 0.05). Only the AT + RT groups showed a decrease in body fat (p < 0.05). In comparison to AT alone, endurance improved greater in the AT + RT groups (p < 0.05). Compliance with the number of sets completed was less in than AT/RT1 is AT/RT3 (p < 0.02). |
Despite of 28% reduction in the actual AT training stimulus, combination of RT and AT result in larger improvements in cardiovascular endpoints of exercise performance, skeletal muscle function, and body composition than AT alone. Findings strongly suggest use of multiple-set RT for patients requiring a higher RT stimulus and a combined training intervention in CAD patients. |
| Santa-Clara, H. et al. [16] 2002 |
The effect of a combined effect of aerobic and weight training program of 1 year in patients with coronary artery disease. |
Aerobic training group = Session of aerobic exercises for 50 min along with warm-up and cool-down phase. Combined exercise group = Aerobic activities along with weight training program. Control group = No intervention |
|
One-repetition maximum approach was used for each of the eight weight exercises to measure muscle strength exclusively in the combined exercise group. Strength in the arms and legs rose from pre- to post-tests by 21.9 and 27.8 percent, respectively (p < 0.0001). | VT was raised more by weight training in addition to aerobic exercise than by aerobic exercise alone. When compared to the no-exercise group, aerobic exercise, whether it included weight training or not, significantly increased VO2, peak, functional capacity, and VT. |
| Kambic, T. et al. [17] 2021 | The efficacy of high and low load resistance exercises on hemodynamic in patient with coronary artery disease. | Group 1 = Low load resistance exercises after 48–72 h rest then given high load resistance exercises. Group2 = High load resistance exercises after 48–72 h rest then given low load resistance exercises. |
|
During HL-RE or LL-RE, no clinically significant changes in HR, BP, or patient-reported symptoms were noted. When compared to baseline, HR and SBP increased during LL-RE (from 66 to 86 bpm; from 129 to 146 mmHg; time effect: p < 0.001; and HL-RE (from 68 to 86 bpm; from 130 to 146 mmHg; time effect: p < 0.001). The increase in HR was larger after the final set of LL-RE (32 percent vs. 28 percent, p = 0.015) than it was after HL-RE. | Both HL-RE and LL-RE were effective and well-tolerated in patients with CAD. |
| Caruso, F.R. et al. [18] 2017 |
Evaluate the after effect of resistance exercises in patients with coronary artery disease on hemodynamic, autonomic, ventilatory, and metabolic alterations. | Aerobic group = Cardiovascular rehabilitation program that consist of aerobic exercises, stretching, treadmill training for 50 min 2 times a week for 8 weeks. Combined group = Cardiovascular rehabilitation program along with resistance training program. Each session was of 40 min 2 times a week for 8 weeks. |
|
RT increased maximal and submaximal load tolerance (p < 0.01), reduced hemodynamic response (p < 0.01), and decreased blood lactate levels during the 45° leg press. During exercise on a cycle ergometer and a 45° leg press, during the 8-week RT program increased parasympathetic tone and increased the SDNN index (p < 0.05). | An 8-week program of resistance exercise combined with aerobic exercise may reduce hemodynamic stress and alters metabolic and autonomic responses and reflect significant benefits on heart and autonomic nervous system. |
| Ximenes, N.N. et al. [19] 2015 | Effect of early resistance exercises in patients with coronary artery disease. | Intervention group = Patients were provided with diaphragmatic breathing, resistance exercises and ambulation exercises 30 min twice a day. Control group = Patients were given diaphragmatic breathing exercises for 30 min twice a week. |
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When compared to the control group, resistance exercise had no impact on the pulmonary function of the intervention group. | Early implementation of RT in CAD disease patient’s artery surgery is more beneficial and does not alter pulmonary function. |
| Deka, P. et al. [20] 2022 | The effect of high intensity interval and resistance exercise training in patients with coronary artery disease. | Intervention group = In this group high intensity interval training along with resistance training of 50–60 min, 1 session per week for 8 weeks were given. Usual care group = Conventional medical treatment was given in this group to the patients. |
|
In comparison to the usual care group, there was a significant group and time interaction for the participants in the HIIT + R Group for BMI (p < 0.001), body fat percentage (p < 0.001), waist circumference (p = 0.001), physical activity (p < 0.001), functional capacity (p< 0.001), and QoL (p < 0.001). The HIIT + R group experienced a significant decrease in systolic blood pressure (p < 0.001). | To achieve desired health goals, elderly with CAD may benefit from a combined HIIT + R exercise strategy. |
| Arthur, H.M. [21] 2007 | Effect of aerobic and combined aerobic strength training in women after an event of coronary artery by-pass grafting as post-surgery cardiac rehabilitation. | Intervention group = Aerobic exercises and aerobic plus strength training for a period of 6 months, 2 times in a week. Usual care group = Aerobic exercises for a duration of 6 months for 2 times in a week. |
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Both groups demonstrated statistically significant improvements in physical quality of life (p = 0.0002), peak VO2 (19% in aerobic/strength training vs. 22% in aerobic training alone), strength (p = 0.0001), and self-efficacy for stair climbing (p = 0.0024), lifting (p = 0.0001), and walking (p = 0.0012) after 6 months of supervised exercise training. Aerobic/strength training group had a statistically significant change in physical quality of life at the 1-year follow-up (p = 0.05). | Aerobic training alone and both aerobic/strength training are both beneficial in women with coronary artery disease. Combining strength and aerobic exercise maintains physical quality of life. |
| Schmid, J.P. et al. [22] 2007 | The effect of endurance and resistance exercises after myocardial infarction in patients with coronary artery disease. | Combined group = endurance training and resistance training was given to patients for 4 times and 2 times respectively in a week. Endurance training group = In these group 6 sessions per week of endurance training of lower limb and abdominal muscles were given to the patients. |
|
Over the course of a year, the end-diastolic volume increased from 206 ± 41 to 210 ± 48 mL (p = 0.379) compared to 183 ± 44 to 186 ± 52 mL (p = 0.586), the Left Ventricular mass increased from 149 ± 28 to 155 ± 31 g (p = 0.408) compared to 144 ± 36 to 149 ± 42 g (p = 0.227), and peak oxygen consumption and muscle strength both increased dramatically in both groups. | For three months, either an ET/RT combination or an ET alone can dramatically raise peak VO2 and muscle strength. |
| Pimenta, N.M. et al. [23] 2013 | Effect of combined exercise training on body fat response in male coronary artery disease patients. | Combined exercise training group = Aerobic training and resistance training on 3 non-consecutive days in a week for 12 months. Control group = Aerobic training was given to the patients. |
|
Both groups’ body mass and BMI did not differ between the start of the study and the end of the follow-up, but in the CET group, a significant decrease in all the outcome measures were observed. | Despite no changes in body mass or BMI, CET has positive impact on the body composition in CAD patients. No changes in BF distribution, which indicates that the rate of fat loss was identical across all BF depots that were evaluated. |
Abbreviations: VO2 = Maximum Oxygen Consumption, RMSSD = Root Mean Square of Successive Difference, SD = Standard Deviation, SDNN = Standard Deviation of Normal Intervals UC = Usual Care, MWT = Minute Walk Test, AT—Aerobic Training, RT = Resistance Training, BMI = Body Mass Index, VT = Ventilatory Threshold, LV = Left Ventricle, ET = Endurance Training, HL-RE = High Load Resistance Exercise, LL-RE = Low Load Resistance Exercise, HR = Heart Rate, SB P= Systolic Blood Pressure, WEX = Water based Exercise, GEX = Gym based Exercise, CET = Combined aerobic and resistance Training, HIIT + R = High Intensity Interval Training+ Resistance, MICT = Moderate Intensity Continuous Training, NW = Nordic Walking BF = Body Fat, BP = Blood Pressure, HIIT = High Intensity Interval Training.