Non-linear is not superior to linear aerobic training periodization in coronary heart disease patients

We aimed to compare: (1) two different periodized aerobic training protocols (linear (LP) versus non-linear (NLP)) on the cardiopulmonary exercise response in patients with coronary heart disease; (2) the proportion of responders between both training protocols.

A randomized controlled trial.

A total of 39 coronary heart disease patients completed either LP (n = 20, 65 ± 10 years) or NLP (n = 19, 66 ± 5 years). All patients completed a cardiopulmonary exercise testing with gas exchange measurements. Patients underwent a 12-week supervised exercise program including an isoenergetic aerobic periodized training and a similar resistance training program, 3 times/week. Weekly energy expenditure was constantly increased in the LP group for the aerobic training, while it was deeply increased and intercepted with a recovery week each fourth week in the NLP group. Peak oxygen uptake (peak V̇O₂), oxygen uptake efficiency slope, ventilatory efficiency slope (V̇E/V̇CO₂ slope), V̇O₂ at the first (VT₁) and second (VT₂) ventilatory thresholds, and oxygen pulse (O₂ pulse) were measured. Responders were determined according the median value of the Δpeak V̇O₂ (mL.min^-1.kg^-1).

We found similar improvement for peak V̇O₂ (LP: +8.1%, NLP: +5.3%, interaction: p = 0.37; time: p < 0.001) and for oxygen uptake efficiency slope, VT₁, VT₂ and O₂ pulse in both groups (interaction: p > 0.05; time: p < 0.05) with a greater effect size in the LP group. The proportion of non-, low and high responders was similar between groups (p = 0.29).

In contrast to the athletes, more variation (NLP) does not seem necessary for greater cardiopulmonary adaptations in coronary heart disease patients.