Differential effects of high-frequency versus low-frequency exercise training in rehabilitation of patients with coronary artery disease.
OBJECTIVE
We sought to study the influence of frequency of exercise training during cardiac rehabilitation on functional capacity (i.e., peak oxygen consumption [VO2] and ventilatory anaerobic threshold [VAT]) and quality of life (QoL).


BACKGROUND
Although the value of cardiac rehabilitation is now well established, the influence of the different program characteristics on outcome has received little attention, and the effect of frequency of exercise training is unclear. Functional capacity is regularly evaluated by peak VO2 but parameters of submaximal exercise capacity such as VAT should also be considered because submaximal exercise capacity is especially important in daily living.


METHODS
Patients with coronary artery disease (n = 130, 114 men; mean age 52 +/- 9 years) were randomized to either a high- or low-frequency program of six weeks (10 or 2 exercise sessions per week of 2 h, respectively). Functional capacity and QoL were assessed before and after cardiac rehabilitation. Global costs were also compared.


RESULTS
Compared with baseline, mean exercise capacity increased in both programs: for high- and low-frequency, respectively: peak VO2 = 15% and 12%, Wmax = 18% and 12%, VAT = 35% and 12% (all p < 0.001). However, when the programs were compared, only VAT increased significantly more during the high-frequency program (p = 0.002). During the high-frequency program, QoL increased slightly more, and more individuals improved in subjective physical functioning (p = 0.014). We observed superiority of the high-frequency program, especially in younger patients. Mean costs were estimated at 4,455 and 2,273 Euro, respectively, for the high- and low-frequency programs.


CONCLUSIONS
High-frequency exercise training is more effective in terms of VAT and QoL, but peak VO2 improves equally in both programs. Younger patients seem to benefit more from the high-frequency training.
Nieuwland
W
W
Department of Cardiology/Thoraxcenter, University Hospital Groningen, The Netherlands.
Berkhuysen
M A
MA
van Veldhuisen
D J
DJ
Brügemann
J
J
Landsman
M L
ML
van Sonderen
E
E
Lie
K I
KI
Crijns
H J
HJ
Rispens
P
P
D000328:Adult; D000368:Aged; D015308:Anaerobic Threshold / Q000502:physiology; D001944:Breath Tests; D003327:Coronary Disease / Q000378:metabolism / Q000503:physiopathology / Q000534:rehabilitation*; D003365:Costs and Cost Analysis; D005081:Exercise Therapy / Q000191:economics / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000032:analysis; D016896:Treatment Outcome
D010100:Oxygen