TY - JOUR
T1 - Training intensity and improvements in exercise capacity in elderly patients undergoing European cardiac rehabilitation - the EU-CaRE multicenter cohort study
AU - Marcin, Thimo
AU - Eser, Prisca
AU - Prescott, Eva
AU - Prins, Leonie F.
AU - Kolkman, Evelien
AU - Bruins, Wendy
AU - van der Velde, Astrid E.
AU - Pena Gil, Carlos
AU - Iliou, Marie-Christine
AU - Ardissino, Diego
AU - Zeymer, Uwe
AU - Meindersma, Esther P.
AU - Van't Hof, Arnoud W. J.
AU - de Kluiver, Ed P.
AU - Wilhelm, Matthias
N1 - Publisher Copyright:
Copyright: © 2020 Marcin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2020/11/13
Y1 - 2020/11/13
N2 - ObjectivesGuidelines for exercise intensity prescription in Cardiac Rehabilitation (CR) are inconsistent and have recently been discussed controversially. We aimed (1) to compare training intensities between European CR centres and (2) to assess associations between training intensity and improvement in peak oxygen consumption (VO2) in elderly CR patients.MethodsPeak VO2, heart rate and work rate (WR) at the first and second ventilatory thresholds were measured at start of CR. Training heart rate was measured during three sessions spread over the CR. Multivariate models were used to compare training characteristics between centres and to assess the effect of training intensity on change in peak VO2.ResultsTraining intensity was measured in 1011 out of 1633 EU-CaRE patients in 7 of 8 centers and the first and secondary ventilatory threshold were identified in 1166 and 817 patients, respectively. The first and second ventilatory threshold were found at 44% (SD 16%) and 78% (SD 9%) of peak WR and 78% (SD 9%) and 89% (SD 5%) of peak heart rate, respectively. Training intensity and session duration varied significantly between centres but change in peak VO2 over CR did not. Training above the first individual threshold (beta 0.62, 95% confidence interval [0.25-1.02]) and increase in training volume per hour (beta 0.06, 95%CI [0.01-0.12]) were associated with a higher change in peak VO2.ConclusionWhile training intensity and volume varied greatly amongst current European CR programs, changes in peak VO2 were similar and the effect of training characteristics on these changes were small.
AB - ObjectivesGuidelines for exercise intensity prescription in Cardiac Rehabilitation (CR) are inconsistent and have recently been discussed controversially. We aimed (1) to compare training intensities between European CR centres and (2) to assess associations between training intensity and improvement in peak oxygen consumption (VO2) in elderly CR patients.MethodsPeak VO2, heart rate and work rate (WR) at the first and second ventilatory thresholds were measured at start of CR. Training heart rate was measured during three sessions spread over the CR. Multivariate models were used to compare training characteristics between centres and to assess the effect of training intensity on change in peak VO2.ResultsTraining intensity was measured in 1011 out of 1633 EU-CaRE patients in 7 of 8 centers and the first and secondary ventilatory threshold were identified in 1166 and 817 patients, respectively. The first and second ventilatory threshold were found at 44% (SD 16%) and 78% (SD 9%) of peak WR and 78% (SD 9%) and 89% (SD 5%) of peak heart rate, respectively. Training intensity and session duration varied significantly between centres but change in peak VO2 over CR did not. Training above the first individual threshold (beta 0.62, 95% confidence interval [0.25-1.02]) and increase in training volume per hour (beta 0.06, 95%CI [0.01-0.12]) were associated with a higher change in peak VO2.ConclusionWhile training intensity and volume varied greatly amongst current European CR programs, changes in peak VO2 were similar and the effect of training characteristics on these changes were small.
KW - ASSOCIATION
KW - CARDIOVASCULAR PREVENTION
KW - CORONARY-ARTERY-DISEASE
U2 - 10.1371/journal.pone.0242503
DO - 10.1371/journal.pone.0242503
M3 - Article
C2 - 33186408
SN - 1932-6203
VL - 15
JO - PLOS ONE
JF - PLOS ONE
IS - 11
M1 - 0242503
ER -