title: Eccentric exercise in ischemic cardiac patients and functional capacity: A systematic review and meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Eccentric (ECC) exercise is an "economical" type of exercise with low energy requirements and does not cause early fatigue. Therefore, it is used for cardiac patients, who have low physical activity and exercise intolerance, as an easier kind of training.
  
  
  OBJECTIVE
  This systematic review aimed to investigate the efficacy of ECC exercise for functional capacity (FC) in patients with ischemic heart disease.
  
  
  METHODS
  Systematic review.
  
  
  METHODS
  MEDLINE via PubMed and EBSCO databases were searched for articles of randomized controlled trials of adults with ischemic heart disease who underwent ECC training as compared with other forms of exercise (concentric exercise) or no exercise and assessed FC. The methodologic quality of studies was assessed by the PEDro scale. A meta-analysis was performed with sufficient homogeneity between at least 2 studies in the pre-defined comparisons.
  
  
  RESULTS
  Four studies, investigating a total of 99 subjects, met the inclusion criteria. The results of the studies did not clearly indicate whether ECC exercise could improve FC better than traditional forms of exercise. However, the small number of studies and their methodologic weaknesses do not allow for drawing firm conclusions.
  
  
  CONCLUSIONS
  We found contradictory results about the effectiveness of ECC as compared with concentric exercise in terms of FC in ischemic cardiac patients. Further investigation with well-designed randomized trials is needed to determine the effectiveness of this kind of exercise for FC in such patients.
authors.affiliation: European University of Cyprus, School of Sciences, Department of Health Sciences, Nicosia, Cyprus. Electronic address: C.karayiannis@euc.ac.cy.
authors.forename: C
authors.initials: C
authors.lastname: Karagiannis
authors.affiliation: European University of Cyprus, School of Sciences, Department of Health Sciences, Nicosia, Cyprus.
authors.forename: C
authors.initials: C
authors.lastname: Savva
authors.affiliation: European University of Cyprus, School of Sciences, Department of Health Sciences, Nicosia, Cyprus.
authors.forename: I
authors.initials: I
authors.lastname: Mamais
authors.affiliation: University of Nicosia, Department of Life and Health Sciences, Nicosia, Cyprus.
authors.forename: M
authors.initials: M
authors.lastname: Efstathiou
authors.affiliation: University of Cagliari, Department of Public Health, Clinical and Molecular Medicine, Cagliari, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Monticone
authors.affiliation: European University of Cyprus, School of Medicine, Nicosia, Cyprus.
authors.forename: T
authors.initials: T
authors.lastname: Xanthos
mesh_terms: D000368:Aged; D000072038:Cardiac Rehabilitation / Q000379:methods*; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000503:physiopathology / Q000534:rehabilitation*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
keywords: Eccentric exercise; Functional capacity; Ischemic heart disease; Systematic review