title: Effects of exercise prescription on daily physical activity and maximal exercise capacity in coronary artery disease patients with and without type 2 diabetes.
abstract: BACKGROUND
  Promotion of and adherence to increased physical activity (PA) is an important part of the prevention and treatment of coronary artery disease (CAD). We hypothesized that individually tailored home-based exercise prescriptions will increase long-term PA and maximal exercise capacity among CAD patients without and with type 2 diabetes (CAD+T2D).
  
  
  METHODS
  Physical activity of patients with CAD (n = 44) and CAD+T2D (n = 39), matched by age, sex and ejection fraction, was measured over 5 days with an accelerometer pre- and postexercise prescription. PA was assessed as the average time per day of moderate (METs = 2-5) and high (METs > 5) intensities. Six-month exercise prescriptions were introduced based on individual maximal heart rate reserve.
  
  
  RESULTS
  At the baseline, patients with CAD+T2D engaged in less moderate-intensity PA (2:40 ± 1:23 versus 3:24 ± 1:17 h, P = 0·014) and exhibited a non-significant trend to reduced high-intensity PA (2:08 ± 2:57 versus 5:02 ± 9:19 min, P = 0·091) compared with patients with CAD. High-intensity PA increased markedly in CAD (5:02 ± 9:19 versus 9:59 ± 15:03 min) and patients with CAD+T2D (2:08 ± 2:57 versus 6:14 ± 10:18 min) after exercise prescription (main effect for time P = 0·001). Also maximal exercise capacity increased in both groups (main effect for time P< 0·001).
  
  
  CONCLUSIONS
  Patients with CAD with T2D are physically less active than CAD patients without diabetes in their daily life. Individually tailored home-based exercise prescriptions are an effective way to promote more active lifestyles and improve fitness in both patient groups.
authors.affiliation: Department of Exercise and Medical Physiology, Verve Research, Oulu, Finland.
authors.forename: Jaana J
authors.initials: JJ
authors.lastname: Karjalainen
authors.forename: Antti M
authors.initials: AM
authors.lastname: Kiviniemi
authors.forename: Arto J
authors.initials: AJ
authors.lastname: Hautala
authors.forename: Jarkko
authors.initials: J
authors.lastname: Niva
authors.forename: Samuli
authors.initials: S
authors.lastname: Lepojärvi
authors.forename: Timo H
authors.initials: TH
authors.lastname: Mäkikallio
authors.forename: Olli-Pekka
authors.initials: OP
authors.lastname: Piira
authors.forename: Heikki V
authors.initials: HV
authors.lastname: Huikuri
authors.forename: Mikko P
authors.initials: MP
authors.lastname: Tulppo
mesh_terms: D056044:Actigraphy / Q000295:instrumentation; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology; D005080:Exercise Test; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D005387:Finland; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010809:Physical Fitness; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016276:Ventricular Function