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Does eccentric endurance training improve walking capacity in patients with coronary artery disease? A randomized
V Gremeaux1, J Duclay, G Deley
1Pôle Rééducation-Réadaptation, Centre Hospitalier Universitaire de Dijon, INSERM U887, Dijon, France. vincent.gremeaux@chu-dijon.fr
Objective:
To examine the effect of eccentric endurance training on exercise capacities in patients with coronary artery disease.
Design:
Randomized parallel group controlled study.
Setting:
Cardiac rehabilitation unit, Dijon University Hospital.
Participants:
Fourteen patients with stable coronary artery disease after percutaneous coronary intervention.
Intervention:
Patients followed 15 sessions of training (1 session per day, 3 days a week), either in the concentric group, following a standard programme, or in the eccentric group, performing eccentric resistance exercises using both lower limbs on a specifically designed ergometer.
Main Outcomes Measured:
Symptom-limited Vo2, peak workload, isometric strength of leg extensor and ankle plantar flexors, distance covered during the 6-minute walk test and time to perform the 200-m fast walk test in both groups, before and after the training period.
Results:
Patients did not report any adverse effects and were highly compliant. All measured parameters improved in eccentric and concentric group, except for 200-m fast walk test: symptom-limited Vo2 (+14.2% versus +4.6%), peak workload (+30.8% versus +19.3%), 6-minute walk test distance walked (+12.6% versus +10.1%) and leg extensor strength (+7% versus +13%) improved to a similar degree in both groups (P < 0.01); ankle plantar flexor strength improved in both groups with a significantly greater increase in the eccentric group (+17% versus +7%, P < 0.05).
Conclusion:
Patients with stable coronary artery disease can safely engage in eccentric endurance training, which appears to be as efficient as usual concentric training, with reduced oxygen consumption.
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