Aquatic Aerobic Training, Cardiorespiratory and Metabolic Variables in Coronary Artery Disease
Condition: Arteriosclerosis, Coronary
MeSH terms: Coronary Artery Disease; Myocardial Ischemia; Coronary Disease; Arteriosclerosis
Study type: Interventional

Summary: 
      Although approaches to reduce cardiovascular disease, coronary artery disease (CAD) remains
      the leading cause of mortality in the industrialized world. In order to reduce the
      deleterious effects of the atherosclerotic process, proposals for non-pharmacological
      treatment have been used, such as cardiac rehabilitation programs, with emphasis on exercise
      -based therapy. Traditionally aerobic exercises like biking, walking and jogging are
      conducted, however, alternative ways such as aquatic exercise training have been proposed,
      however, the cardiorespiratory adaptations in this population are not well documented in the
      literature. Thus, the aim of this study was to evaluate the effects of aquatic aerobic
      training (AAT) on body composition, autonomic modulation of heart rate (HR) and
      cardiorespiratory and metabolic variables in patients with CAD. This was a longitudinal
      clinical trial with a sample allocated for convenience, in which twenty-one patients were
      male, with a diagnosis of CAD, which were divided into control group (CG were studied, n=8),
      who was only assessed, and training group (TG, n=13). All patients underwent assessment of
      body composition, heart rate variability (HRV) at rest in the supine posture, and
      cardiopulmonary exercise testing (CPET), performed before and after the AAT program. The
      training protocol consisted of three sessions per week on alternate days for 16 weeks,
      totaling 48 sessions, which had lasted approximately one hour. The exercise intensity was
      prescribed between 80 and 110% of the first ventilatory threshold (VT1) obtained in CPET.
      Given that these parameters represent risk markers for cardiovascular events in the
      population studied, the results suggest that the AAT proposed in this study may be an
      important therapeutic strategy to be incorporated into cardiac rehabilitation programs.
    

Detailed description: 
      1. Personal Data recording:

             -  History: personal data, lifestyle and food, family history, current and previous
                history of disease.

             -  Physical examination: cardiac and lung auscultation,measurement of heart rate (HR),
                blood pressure (BP), body weight and height.

        2. Assessments:

           All experimental procedures were performed in the morning in order to minimize the
           influence of circadian cycle. The temperature of the experimental room was maintained
           between 22 ° C and 24 ° C with relative humidity between 40% and 60%. Patients were
           familiarized with the experimental protocol, and instructed not to ingest stimulant
           drinks such as coffee, tea and soft drinks, do not drink alcohol, do not perform
           strenuous exercise (48 hours before surgery), and to perform a light meal at least four
           hours before the collections.

           Aiming to verify if the baseline conditions were suitable for the beginning of the
           experimental procedures, the patients remained 15 minutes of rest in the supine
           position, and recorded blood pressure (BP) and HR.

           After this, were performed:

             -  Analysis of body composition by bioelectrical impedance analysis.

             -  Registration of HR and NN intervals (NN) during rest, in the supine and sitting
                positions.

             -  Recording of HR and NN during rest in the supine position, sitting, standing and
                during respiratory sinus arrhythmia maneuver.

             -  Spirometric test and

             -  Cardiopulmonary exercise test (CPET). This is a submaximal CPET performed on a
                treadmill, in order to verify and identify possible changes in hemodynamic,
                electrocardiographic induced to physical exertion, their aerobic functional
                capacity as well as to prescribe physical training protocol.

        3. Training:

           After this assessment the volunteers were trained by a aerobic water based physical
           training program for 4 weeks.

        4. Second assessment:

      Components of the first assessment have been repeated at the end of each month of physical
      training.
    

Intervention name(s): Exercise, Aerobic (Water based)
Intervention type(s): Other
Intervention description(s): Patients of this group were submitted to an aerobic water based physical training
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Autonomic Nervous System, Body composition, Oxygen Uptake,; Water Based Physical Training.